Five ways the pandemic has affected routine medical care

Since the start of the pandemic, COVID has infected at least a third of the UK population and is estimated to have taken into account the deaths of nearly 200,000 people in the UK. Importantly, COVID has also had a devastating impact on our healthcare systems. While it was expected, new evidence is beginning to reveal the scale of the problem – especially the effects for people living with long-term health conditions.

Here are five ways the pandemic has affected access to routine medical care.

1. Heart disease

A 2022 review looked at the evidence for the pandemic’s impact on heart disease and care, covering 158 studies in 49 countries.

In all types of heart disease and in all countries studied, there were fewer hospitalizations, treatments and medical appointments than before the pandemic. This may sound like a good thing, but in reality, it means people put off seeing a doctor when they have heart problems. Indeed, this review found that people who went to hospital were sicker than patients hospitalized with heart problems before the pandemic.

The impact has been most severe in low- and middle-income countries, where in-hospital deaths from heart disease have increased.

2. Diabetes

Diabetes care and services have been disrupted throughout the pandemic, from new diagnostics to critical screening and treatment programs. A study published in May 2022 finds that in England, death rates (excluding deaths caused by COVID) were higher among people with diabetes in 2021 compared to previous years. A recent analysis linked this to disruptions in routine care caused by the pandemic.

People from the most disadvantaged groups performed worse than those from more advantaged groups. This is playing out globally, too – people with access to sophisticated diabetes technology, like continuous blood glucose monitors, appear to have had relatively stable blood sugar levels during the pandemic. But others have experienced serious declines in their health and wellbeing, in part due to issues with access to insulin.

Read more: People who’ve had COVID seem more likely to develop diabetes — here’s why it might be

3. Immunization services

Another recent report gathered data from 170 countries and territories and showed that, compared to the pre-pandemic period, the administration of vaccines against common childhood diseases has declined. Vaccine supply and demand were disrupted and fewer health professionals were available to deliver vaccines.

People may also have been hesitant to go get vaccinated for fear of contracting COVID. The reductions covered the various areas studied by the researchers, but tended to be larger in low- and middle-income regions.

This introduces the possibility of future outbreaks of vaccine-preventable diseases, as we have seen following the disruption caused by Ebola in parts of Africa. A risk-benefit analysis of reopening vaccination clinics during the pandemic in African countries found that for every COVID death acquired at the clinic, 84 deaths from vaccine-preventable diseases could be averted.

4. Cancer diagnosis and care

2022 data from Cancer Research UK shows cancer care delivery has declined across the board. In the first year of the pandemic, one million fewer screening invitations were sent out, 380,000 fewer people saw a specialist after an urgent referral for suspected cancer, ten times as many people waited six weeks or more for cancer screening tests and nearly 45,000 fewer people have started cancer. treatment.

It’s not because fewer people had cancer. Cancers were less likely to be detected and, once detected, less likely to be treated promptly. In November 2021, cancer waiting time standards in the UK were exceeded by larger margins than ever before. Significant efforts are underway to address this, but there is still a long way to go. Such disruptions to cancer care have been seen around the world.

The COVID pandemic has seen fewer routine vaccinations administered.
Jacob Lund/Shutterstock

5. Waiting Lists

Treatment backlogs — of people who should be getting treatment but haven’t yet — existed before the pandemic, but the pandemic has made them much worse. A February 2022 report from the NHS in England showed that 6million people were on the waiting list for elective care (care planned in advance, as opposed to emergency care), up from 4.4million before the pandemic.

This is of course not unique to England. In Finland, for example, waiting times for elective surgeries have increased by a third since before the pandemic, even though the rate of elective surgeries rose by a fifth after lockdown restrictions were lifted.

Delayed treatments, including surgeries, can increase preventable deaths and impair well-being. Delays in receiving health care are associated with anxiety, depression and poor quality of life in patients and caregivers.

And then ?

It will be years before we can say for sure what the impacts of all these disruptions will be. There is no doubt that they will be devastating at individual, national and global levels. There is also no doubt that some people will be much more affected than others, including those who already live with long-term conditions, people from less privileged backgrounds and those who live in areas where health systems are less fair.

In our third year of the pandemic, prioritization – of treatments, patients and services – continues to be both complex and necessary, and strong funding and support for health services and personnel are more essential than never.

Read more: The NHS is having its worst winter ever – and the reasons run much deeper than COVID

On an individual level, if you need to undergo a check-up or a vaccine, do your best to ensure that you receive it. If you have a worrying symptom, don’t let fears of contracting COVID keep you from getting it checked out.

On a societal level, we would do well to remember that the risks from COVID disruptions have not been evenly distributed. As we plan to respond to and recover from these disruptions, we must recognize that digital advancements will not be a solution for all groups and direct more resources to the people and areas that need them most.