It’s a common misperception among people who are outside the health care industry that COVID-19 has been big business for hospitals and health systems. Hardly – with heavy investments in PPE, a halt to non-urgent surgeries, and fewer visits to emergency departments, physician offices and radiology practices, hospitals and health systems are facing expected total losses of at least $323 billion in 2020 and layoffs and furloughs are a given for most.

Americans are avoiding in-person medical care at all costs – “medical distancing”, if you will – and sometimes the greatest cost is to their own health.

The data has been rolling in – and preventive screenings and vaccinations are down and Americans are avoiding seeking care when they are experiencing symptoms of life-threatening conditions such as heart attack and stroke. Medical distancing is a secondary impact of COVID-19 and it’s undoing years of advances in public health.

Forgoing Preventive Care and Vaccines

We’ve been fighting for Americans to understand the value of preventive care for years and have made great strides as a result of increased access through the Affordable Care Act (“Obamacare”) and campaigns to educate the public. The rate of people over age 50 who are up to date on colorectal cancer screening has improved greatly in the past several years, from 38% in 2000 to 66% in 2018, according to the American Cancer Society.

  • Data from electronic health records supplier Epic revealed that COVID-19 had a staggering impact on appointments for screenings for cancers of the cervix, colon, and breast, which were down between 86% and 94% in March, compared to average volumes in the three years before the first COVID-19 case was confirmed in the U.S.
  • Orders for and administration of childhood vaccines plummeted after the national emergency was declared – especially among children older than 24 months.

It’s easy to understand why. Telemedicine quickly became the channel of choice for receiving medical care in the early days of the pandemic – and it isn’t suitable for vaccinations or most cancer screenings. 

Fewer Cancer Diagnoses

Fewer cancer diagnoses sounds like it would be a good thing – and under some circumstances it could be.  In the case of the COVID-19 pandemic, there was a dramatic decrease in cancer diagnoses that had nothing to do with improvements in public health and everything to do with avoiding necessary screenings and care.

  • University of Pennsylvania Health System reported the number of new skin cancers diagnosed by dermatopathologists was down around 80% in March from early February. Especially concerning was the decrease in invasive melanomas, which are aggressive and benefit from treatment as soon as possible.
  • In recent months, cancer centers have reported significant drops in new cancer patients, with the University of Nebraska Medical Center reporting their weekly volume of new cancer patients cut in half and Mount Sinai’s Tisch Cancer Center in New York recording a 30-50% drop in new cancer patients.

Avoiding Lifesaving Care for Urgent Symptoms

Even more concerning than avoiding preventive care and cancer screenings is the avoidance of urgent symptoms, because patients may not get a second chance to get the lifesaving care they need. Patients are remaining at home too long and may be experiencing irreversible damage or death.

  • An April 2020 survey of nine major hospitals showed the number of severe heart attacks being treated had dropped by nearly 40% since the COVID-19 pandemic took hold in March.
  • Clinicians report a decrease of appendicitis and stroke cases, as well. The University of Alabama-Birmingham (UAB) Stroke Center experienced a 50% decrease in stroke cases in March and April, even though it’s located on the “buckle of the stroke belt in the southeast United States.”
  • In April, emergency room visits nationwide dropped more than 40%, according to the Centers for Disease Control and Prevention.

The Role of Communicators

In the early days of the pandemic, we encouraged patients to stay home and we cancelled elective surgeries to help protect health care resources. Now, communicators are charged with making them feel comfortable to come back. The American Hospital Association launched its Always There, Ready to Care campaign in early June and individual hospitals and health systems are developing their own programs to help give patients a nudge to feel comfortable seeking the care they need to stay healthy.

Our role as communicators is to acknowledge the dangers of COVID-19, our efforts to mitigate it, and highlight when the risk of avoiding care exceeds the risk of receiving it.  No doubt, there are difficult times ahead for hospitals and for all of us – but they will be made more difficult if medical distancing becomes a long-term trend.

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