CDC: Over 40% of Americans Missing Medical Care During COVID-19 Pandemic

Though the famous expression “first, do no harm” does not actually appear in the Hippocratic oath, “non-maleficence” is a key bio-ethical principle.

The directive toward non-maleficence advises clinicians that sometimes, it may be better not to pursue a course of action than to risk causing more harm than good.

Delayed or avoided medical care can increase death, severity of illness, and the chronic health impacts of acute illness.

A new US Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report cites data showing that by June 30, 2020, because of concerns about COVID-19, an estimated 41% of U.S. adults had already delayed or avoided medical care.

This 41% includes urgent or emergency care (12%) and routine care (32%).

Routine care is a vital part of preventing emergency room visits and life threatening conditions like cancer.

“Avoidance of urgent or emergency care was more prevalent among unpaid caregivers for adults, persons with underlying medical conditions, Black adults, Hispanic adults, young adults, and persons with disabilities,” according to MMWR authors.

According to the authors, understanding factors associated with care avoidance can lead to targeted care delivery approaches and communication efforts encouraging better uptake.

The data were collected from June 24—30, 2020, when a total of 5,412 (54.7%) of 9,896 eligible adults completed the web-based COVID-19 Outbreak Public Evaluation Initiative surveys administered by Qualtrics, LLC.

Quota sampling and survey weighting were employed to improve cohort representativeness of the U.S. population by gender, age, and race/ethnicity.

Caregivers who reported caring for adults at increased risk for severe COVID-19 were less likely to get care, possibly due to concern about exposure for care recipients. It is unlikely that as many older care recipients necessarily understand how to use telehealth apps.

Persons with underlying medical conditions that increase their risk for severe COVID-19 were also more likely to avoid having these conditions looked at due to perceived or actual increased risk of exposure to SARS-CoV-2 in health care facilities.

“In a recent study, states with large numbers of COVID-19—associated deaths also experienced large proportional increases in deaths from other underlying causes, including diabetes and cardiovascular disease,” MMWR authors added.

Substantial numbers of cancer screenings have also been missed since the start of ‘lockdown’ measures for the pandemic.

Investigators publishing in The Lancet Oncology estimate in the United Kingdom alone, clinicians will see increases of:

• 7.9—9.6% in the number of deaths due to breast cancer up to year 5 after diagnosis,
• 15.3—16.6% in the number of deaths due to colorectal cancer,
• 4.8—5.3% in the number of deaths due to lung cancer,
• and 5.8—6.0% in the number of deaths due to oesophageal cancer.

For these 4 tumour types, the total additional years of life lost in the UK alone is estimated to be 59,204—63,229 years.