Whilst investment appetite remains huge for health care, the operators themselves face massive uncertainty. What will government contracts look like in February or March? How fast will electives return and at what pace? Where will they get their staff?

The one certainty is that COVID has accelerated digital adoption. Many CEOs now see this as their number one or two priority. In practice, the quality of their digital toys is a major determinant on how hospitals and other service businesses are now valued. The large digital players like Ping An and Teladoc are already embedded in healthcare systems and own some of the world’s largest datasets.

It is also clear that governments are seeing the fruit of big data deployment. Martin Brunninger, director-general for Austria, says he can now slice and dice patient populations in new ways leading to the formulation of better, more accurate healthcare policies. But even with digital, much uncertainty remains. Public sector doctors may still row back towards face-to-face when the pandemic finally ends.

Lab and some hospital groups made much of their new stronger relationships with governments. By coming to the rescue with their skills and capacity, operators have often gained much goodwill and access at the ministerial level. But how long this will last when the crisis ends is an imponderable. We think these warm new personal relations will continue but governments and the public sector will try to strike tougher bargains as recession hits. New governments can easily erode and end partnerships.

Roll-up opportunities for big, strongly-backed groups will be huge as a tired generation of frazzled 50- and 60-years-olds opt for early retirement after a nightmare year.

Finally, all the big groups are expanding into neighbouring areas that give better life-time values and contacts with patients or customers. Nursing home group Korian wants to get 20% of its revenue from care delivered at home, for instance, and online pharmacy group Zur Rose is building a solution to supply both medicines and digital therapeutics. Hospital groups are marching into primary care, rehabilitation and chronic care.