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Opinion |  How to prevent the post-Covid-19 healthcare crisis

The coronavirus pandemic is not yet over, but we are already starting to feel the aftershocks. Even as thousands of Americans continue to die from Covid-19 every day, many people suffer from serious health problems unrelated to the virus because their health care has been disrupted. While many Americans are still afraid to visit hospitals and doctor’s offices, a second, more subtle pandemic is now looming due to illnesses that have not been diagnosed and treated since March 2020.

A study published in the Journal of the National Medical Association in December reported that 43% of Americans missed preventative care appointments during the pandemic. In the three months following the imposition of the first lockdown measures, the Epic Health Research Network found that breast, colon and cervical cancer screenings fell by two-thirds.

When the pandemic began, health care resources were diverted from primary and preventive care operations to fight the coronavirus. Sadly, we’re already seeing the measurable effects of skipped dates: This week the Centers for Disease Control and Prevention reported that in the first six months of 2020, life expectancy in the United States has declined on average. one year. The CDC estimates that about 512,000 more people have died since last March than U.S. mortality statistics typically predict in the absence of a pandemic.

While this excessive death figure both understands and suggests an undercount of deaths from Covid-19, it is also a sign that more people are dying from other causes and that people of color are being affected in ways disproportionate. Last year, excess deaths rose 14.7% for whites, but 44.9% for Latinos and 28.1% for black populations, according to CDC Just as the pandemic has disproportionately affected communities of color, this hidden crisis will target those same minority populations, who have higher rates of diseases like hypertension and diabetes, and less access to quality health care.

I have already seen the increased suffering of my patients at Howard University Hospital, an institution that primarily treats people of color. In January, I operated on a patient with pancreatic cancer who had the highest level of jaundice I have ever seen. He told me he hadn’t seen a doctor earlier because he was afraid to come to the hospital during the pandemic. As a result, his condition was worse than it would have been otherwise and extended his stay in the hospital.

If we don’t act now, the pandemic could leave many preventable deaths in its wake even after the number of Covid-19 cases has declined. Preventive health measures have been shown to reduce the incidence and mortality of disease as well as health care costs. But even before the pandemic, these efforts were not prioritized enough by the healthcare industry.

Scaling up primary and preventive care efforts is urgent and long overdue. We should train more health professionals who have regular contact with patients to provide primary care services. Imagine going to the dentist or the pharmacy and having a mammogram or screening for diabetes, in addition to having your teeth cleaned or taking a prescription. With more professionals trained to find patients, we can prevent emerging issues from becoming emergencies.

The healthcare industry should also invest more in patient awareness, communication and education. Patients should not be required to fully understand their health risks and navigate complex systems to receive the care they need. They shouldn’t have to travel far for this either. We need to create more convenient possibilities for patients to receive health care, especially for those who cannot take time off work or afford transportation. We need to expand telemedicine efforts, which are still inaccessible for many minority communities that do not have constant access to the Internet. We should also bring mobile health care services to low-income communities, just as we have set up coronavirus testing and vaccination sites in our cities.

This type of change is less a global transformation and more a return to the roots of organized medicine. Too often when we talk about improving health care, we are talking about problems and solutions at the industry level: we need to train more doctors. We need to control the costs of prescription drugs. We need to reform health insurance. We need to flatten the curve.

Of course, all of these are important. But we don’t discuss each patient’s needs as much as we should. That’s why, even in the midst of a pandemic that has turned our collective attention to healthcare, patients who need help still fall through the cracks and die from preventable causes.

Too often black and brown patients are left behind. At the start of the pandemic, when we reconfigured our health care system to fight Covid-19, we neglected to protect many of those who worked in our health care centers, grocery stores, meat packing factories. and our transit systems. We neglected the on-call staff who continued to keep our businesses and medical offices clean, hygienic and safe. When we canceled appointments and closed testing centers, we forgot those who faced other life-threatening conditions.

By focusing now on the full spectrum of patient needs, we can prevent more deaths and protect communities of color that have suffered an undue share of our national devastation.

Wayne AI Frederick (@ HUPrez17) is President of Howard University and Professor of Surgery at Howard University College of Medicine.




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