The COVID-19 pandemic might have pushed alternative treatments channels like telemedicine forward, but in terms of regular care, there was a decided backlash. Now, thanks to continuing statistical research, a clearer picture is starting to emerge in terms of who missed care and how various parts of the medical establishment were affected.

In terms of those who put off care during the pandemic, a TIME-Harris Poll from earlier this year revealed some interesting trends. Conducted in February, the survey asked 1,093 participants about their healthcare patterns from the previous 12 months. Seventy-eight percent off that group reported putting off at least one medical service, with dental services leading at a rate of 30 percent. Following visits to the dentist’s office, respondents reported skipping annual physicals (27 percent), eye exams (25 percent) and visits to specialists (15 percent).

That last statistic is particularly worrisome, as the category includes critical care physicians such as oncologists and cardiologists.

Even more illuminating than what kind of care was being skipped, the poll revealed who was skipping it. College-educated affluent respondents lead the way in terms of socioeconomic standing, while in terms of race, Hispanics reported the highest rates of putting off doctor visits — 48 percent said they had delayed visits, versus 20 percent of whites and 30 percent of African Americans.

“Conditions like diabetes and hypertension are more common among people with lower income. They might feel like they just know they can’t miss a check-up, so they make it more of a priority,” Jessica Justman, an infectious disease specialist and epidemiologist at Columbia University’s Mailman School of Public Health, told TIME. “People with higher income have more options for diet and exercise and are healthier overall.”

Trial By COVID

Not only was there a direct impact on doctor visits during the pandemic, but there may be a long-tail effect due to the fact that clinical trials were also hampered by the spread of the virus. According to a report released Wednesday (April 7) from Penn State, while clinical trial starts weren’t really affected by the pandemic, completions certainly were. In an analysis of 117,000 trials in the U.S., Asia, Europe and other regions, researchers found that completion rates fell between 13 and 23 percent between April and October 2020.

“The pandemic has made it more difficult for researchers to recruit and follow up on patients in clinical trials,” said Nour Hawila, a research assistant from Penn State’s Department of Public Health Sciences. “This analysis revealed that the impact was substantial — particularly for trials funded by government, academic or medical entities.”

The report also found that trials with pharmaceutical sponsors were more successful at getting completed than those sponsored by academic or governmental institutions or hospitals.

Rebound Effect 

Now that more and more people are getting vaccinated, there may start to be a rebound effect on medical facilities across the country. Not only will vaccinated people begin to return to normal care routines but those who put off care may present with more serious conditions due to earlier postponement. Doctors at Ochsner and Baton Rouge General hospitals are starting to see such a trend.

“So instead of coming with mild gallbladder symptoms, you come with a septic infected gallbladder, instead of a bleed from an ulcer you come in with a hole in your stomach from an ulcer,” Ochsner Vice President of Medical Affairs Dr. Ralph Dauterive told ABC affiliate WBRZ. He also said his hospital has seen a spike in cardiac cases and people presenting with renal failure.

Meanwhile, in Bakersfield, California, the Houchin Community Blood Bank has put out a call for donations to cover a shortfall brought about by fewer donations during the pandemic and a return to surgical procedures as hospitals return to normal operations.

Certainly, the long-term impacts of delayed care will continue to unfold, sometimes quickly — and sometimes over years. In one study, the National Cancer Institute reported that cancer screenings that were put off during the pandemic could lead to almost 10,000 excess deaths from breast and colorectal cancer over the next decade.

“Rather than finding it on a mammogram … the patient now comes in because they feel something and we’re making the diagnosis later on in the course of disease, which unfortunately means a lower likelihood of being cured,” Richard Bold, physician-in-chief at the UC Davis Comprehensive Cancer Center, told ABC10.

 

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