The brilliant and irrepressible Morgan Housel, articulated something stark about three sides of risk a fortnight ago:

· The odds you will get hit.

· The average consequences of getting hit.

· The tail-end consequences of getting hit.

The first two are easy to grasp. It’s the third that’s hardest to learn, and can often only be learned through experience.

Tail-end consequences are the low-probability, high-impact events, like pandemics and depression, that end up defining an era, and fill up most of our history books

It’s not always that one can throw a loaded term like unprecedented, and not be accused of hyperbole or overstatement. Yet nothing else quite captures the strange times that we are living in. Like all black swan events, which are impossible to predict, yet irreversibly change the dynamic of the times, the current COVID-19 crisis has slowly but surely changed the dynamics of our free-flowing sputtering globalized economic order, for the foreseeable future.

The current disruption holds the potential to pause, restart and rebuild institutions, systems, and funding structures. In the same way that the world was rebuilt in the wake of WW1 and WW2, the pandemic has made sure that SDG 3: Good Health And Well-Being hogs the current Mindspace of the global order.

There are numerous examples of how crises have played an indispensable role in progression and subsequent adoption of innovation in an accelerated manner, right from the American Civil War bringing about the widespread use of anaesthesia to WWI increasing the adoption of blood transfusions and ambulances. Before anaesthesia, surgery success was based on how quickly it was completed. After its introduction, the marker of success shifted to the quality and outcome of the surgery. WWII led to expanded use of antibiotics and the discovery of penicillin. Also discovered was the positive impact of using metal plates to help heal fractures. Vietnam War led to the widespread use of frozen blood products (extending the life of blood from 30 days to a year). The treatment of Vietnam veterans led to the acceptance and recognition of PTSD.

Software may seem to be eating the world, but healthcare has somehow escaped its stranglehold, despite the incessant encouraging forays being repeatedly made by players of all shapes and sizes. While almost every meaningful personal interface is on the pathway to digitization or connectivity, healthcare delivery still is stuck at the stage where movement from paper slips to SMSes is highlighted as a digital transformation miracle.

This crisis brings an unprecedented opportunity to make the quantum leap in the realm of healthcare diagnostics and delivery, as the pandemic holds the potential to affect permanent behaviour change among large swathes of the population. We should expect widespread interest and support for healthcare innovation and collaboration, right from better hygiene practices to prevent the spreading of the virus, better healthcare data to enable us to control the virus better, or better healthcare services to enable us to treat affected patients better (currently just their symptoms).

The tail-end consequences of this experience should lead to some clear changes among consumer preferences, especially with respect to increased spending by consumers on healthcare, be it on established brands or new startups. Established healthcare companies will invest their additional revenue in searching for innovations that meet patient demands and enable them to deal with higher volumes of patients. Governments will procure more services, fast-track regulatory approvals for innovations that directly help, invest directly in innovation, and actively help successful innovations scale globally.

Investors will prioritize healthcare (and the small number of other industries that win) for investment and shift away from their pre-COVID investment thesis. They will see the opportunity presented by increased demand, spending, scale, and regulatory support.

Global collaboration could see new global monitoring systems for potential pandemics, new international institutions (or the strengthening of existing ones), and potentially new international regulatory standards (to aid the speed of global scale-up). Sharing and coordination of aggregated and anonymized healthcare data might become the norm.

Specific opportunity areas and risks

The buzzword of this experience is going to be ‘pandemic-proof’, as systems will be built which will claim their effectiveness and ability to work non-stop, even during a pandemic.

Some of the foremost delivery systems across prevention/wellness, primary care, secondary care, specialist care, funding and cross-segment enablers (e.g. data, analytics, BI) that would work towards becoming pandemic proof would be

· Digital primary care / front doors to care

· 24/7 Personal health monitoring

· Chronic disease management, particularly COPD diabetes, CVD, cancer,etc

· Digital therapeutics (e.g. Elly)

· Mental health

· Healthcare at home / Providing care support from far away

· Medical supply chains (e.g. Delivery of drugs through drones)

The pandemic experience has also increased the probability of significant acceleration of adoption of AI in the primary three use cases, defined by renowned medical futurist Eric Topol, which are: for clinicians, predominantly via rapid, accurate image interpretation; for health systems, by improving workflow and the potential for reducing medical errors; and for patients, by enabling them to process their data to promote health.

Every crisis brings about a significant level of disruption in the status quo. It is up to the healthcare community to assess how it can use the current disruption to restart, rebuild, and significantly enhance the reach of quality healthcare by injecting affordable and user-friendly solutions to achieve the dream of pandemic-proof, universally accessible healthcare.