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The Impact of Delay of Healthcare Access and Treatment During the Pandemic

May 13, 2020

While we can see how proactive measures like social distancing and sheltering at home are saving lives in Michigan, a Modern Healthcare report shows that many patients are delaying visits to their physicians to address their acute conditions—and what state directives have now declared to be “elective” procedures.

Since March 11th when COVID-19 was declared a pandemic, the number of hospital visits nationwide has declined 32% to 60% compared to overall pre-coronavirus activity, according to research from TransUnion Healthcare of over 500 U.S. hospitals.

As a result of the pandemic, those with multiple chronic conditions or those who’ve experienced past issues managing an aspect of their condition, facility closures or significant delays in accessing their regular provider may be extremely problematic. This will be true particularly for patients who require regular check-ins with practitioners or periodic lab tests to keep their conditions in check. It’s an issue healthcare providers have yet to address adequately.

Michigan Governor Gretchen Whitmer’s Executive Order 2020-17 places temporary restrictions on “non-essential medical and dental procedures.” The order defines a “non-essential procedure” as “a medical or dental procedure that is not necessary to address a medical emergency or to preserve the health and safety of a patient, as determined by a licensed medical provider.”

Of course, these measures are designed to conserve personal protective equipment (PPE) and free up medical staff and facilities for COVID-19 patients. But the Michigan Ambulatory Surgery Association notes that 95% of the state’s surgery centers have closed.

This leaves many Michiganders in need of medical care that isn’t a medical emergency, and it’s increasing the risk of harm and bad outcomes.

COVID-19’s Impact on Healthcare Access and Treatment for Non-COVID-19 Care

A question that is bothering many Michigan residents is how they will get their non-elective care that has been re-categorized as “elective” because of the pandemic and the strain on the healthcare system.

There are an abundance of conditions that are chronic and require routine medical attention such as diabetes, hypertension, depression, and Crohn’s disease, as well as arthritis, kidney disease, lupus, and multiple sclerosis.

About 25% of cancer patients reported delays in their care because of the pandemic, including access to in-person appointments, imaging, surgery, and other care, according to a recent survey by the American Cancer Society’s Cancer Action Network. And the number of cancer screenings and tests dropped by as much as 68% nationwide from March 19th to April 20th, according to Komodo Health. In the same manner, some clinical trials for cancer in which patients receive innovative therapies have also been suspended because of the pandemic.

Physicians also have concerns about this issue. Their patients who had their routine care disrupted during the coronavirus pandemic may experience a relapse in their illnesses or new complications after this crisis ends.

There is some evidence to support this apprehension. Research at two universities in Taiwan and the Johns Hopkins Bloomberg School of Public Health after the 2002-2004 SARS outbreak found that chronic-care hospitalizations for diabetes dropped during the crisis. But hospitalizations soared after the health crisis subsided. Many health experts are worried that similar phenomena may arise because of the Covid-19 pandemic.

Plus, there is the fact that more than 200 facilities around the U.S. have furloughed some or most of their staff. Many have let go nonclinical employees, but some facilities have even ordered temporary unpaid leave for nurses and doctors.

Moving Forward

With the number of new cases and deaths from the coronavirus beginning to decrease, healthcare facilities in some states have started to schedule procedures and appointments. However, the bad news is that it may take months—not weeks—to see a doctor. That’s because hospitals and health facilities will have a large backlog when they reopen for elective procedures.

In Michigan, Governor Whitmer’s suspension of non-essential medical and dental procedures was set to expire May 1st, but it was extended to the end of the month to help prevent the spread of COVID-19. This means an additional wait for those who need medical attention for a condition that’s not an emergency, or a trip to the ER if the condition worsens and becomes life-threatening.