Go see your doctor — but wear a mask!
By Kenneth E. Thorpe
Millions of Americans have postponed lifesaving screenings and other preventative care due to Covid-19.
Doctors performed 67 percent fewer mammograms, conducted almost 72 percent fewer colonoscopies, and administered 22 percent fewer childhood vaccines in March and April than in January and February 2020, before the pandemic began. And while the total number of doctor’s visits and screenings rebounded somewhat this summer and fall, they’re still not back to pre-pandemic levels in many areas.
In early 2020, patients’ fears of catching Covid-19 at doctor’s offices and hospitals were understandable. But we’ve learned a lot since then.
Today, it’s clear that foregoing care is usually counterproductive. It’s incumbent upon politicians and the public health community to encourage and enable Americans to once again visit the doctor, so long as proper precautions are taken.
Diagnosing cancer, heart disease, diabetes, and other chronic conditions early can make the difference between life and death. That’s why the drop in screenings is so disconcerting. Outpatient visits — like wellness checkups, CT scans, and ultrasound imaging — declined nearly 60 percent between mid-February and early April of this year.
For many patients, these delays prove far more dangerous than Covid-19 itself. Dr. Therese Bevers — medical director of the Cancer Prevention Center — recently remarked “I’ve seen women who tell me they found a lump [in their breast] in March, and when I’m seeing them [in July] it’s in the lymph nodes.”
Some Americans are so leery of Covid-19 that they’re even forgoing emergency care, with fatal consequences. In March and April, the total number of emergency room visits declined more than 40 percent compared to the same period last year. CDC officials cited a particularly notable drop in visits for chest pain and heart attack-related symptoms.
Skipping doctor’s visits also hurts patients who already know they’re sick. A majority of doctors’ appointments lead to either new prescriptions, prescription refills, or check-ins regarding a prescription.
When Americans don’t go to the doctor, it’s tougher to ensure they’re getting the right medication at the right time. In April 2020, Americans’ use of statins — which help treat and prevent heart disease — and diabetes medications dropped 8.1 percent and 6.6 percent year-over-year, respectively. This drop is concerning, because drugs are some of our most powerful tools to manage chronic disease.
Prescription nonadherence rates already fluctuated between 40 and 50 percent for most chronic disease patient groups, even before the pandemic. And nonadherence frequently leads to serious — and expensive — health complications. In fact, it causes roughly 125,000 deaths annually and one in 10 hospitalizations, and swells U.S. healthcare spending by nearly $300 billion a year.
This combination of unchecked chronic conditions and prescription nonadherence — all caused by delayed care — will strain on our nation’s healthcare system long after Covid-19 subsides.
Fortunately, it’s not too late to soften the blow. Politicians and policy experts need to level with the public and explain that, yes, Covid-19 is dangerous — but so are cancer, heart disease, and diabetes. Politicians, in particular, can pursue reforms making it easier and cheaper for people to visit the doctor and take their medications.
It’s time to send a clear message to patients — go back to the doctor, refill that prescription, and schedule that operation. Just put on a mask first.
Kenneth E. Thorpe is a professor of health policy at Emory University and chairman of the Partnership to Fight Chronic Disease. This piece originally ran at Salon.com.