On March 16, 2020, the federal government announced new social distancing policies and practices in response to rising cases of Wuhan coronavirus. In them, they called on hospitals, dental facilities and doctors offices across the country to put "elective" surgeries or procedures on hold. A solid date for when operations could continue was not given outside of the "15 days to stop the spread" guidelines, which were extended to 30-days on April 2.
But while concerns hospitals would be overrun with Wuhan coronavirus were valid, facilities have had time to prepare with models, new data, PPE and stocking of ventilators. According to the latest data, social distancing measures have worked to slow the spread of the disease and flatten the curve. This is the case even in the hardest-hit areas of America like New York, New Jersey and Louisiana.
Because of this success, doctors and emergency rooms are waiting for patients. They're also bleeding money.
Hospitals across the country have deferred or canceled non-urgent surgeries to free up bed space and equipment for covid-19 patients. But that triage maneuver cut off a main source of income, causing huge losses that have forced some hospitals to let go of health-care workers as they struggle to treat infected patients.
For hospitals already in bad financial shape before the outbreak, the loss of income has raised doubts about their ability to keep treating patients.
Worse, people whose important surgeries have been put on hold after being classified "elective," are suffering severely. Tests for deadly diseases like cancer are being postponed. Surgeries to fix a collapsed lung have been canceled indefinitely.
Writing in an op-ed for Chicago's Daily Herald, Orthopedic surgeon Dr. Benjamin Domb explains the dire, dangerous situation and long term consequences (bolding is mine).
As it rightly should be, the attention is focused on immediate treatment of those experiencing symptoms of COVID-19, or the necessary preparations for the expected surge of patients in every state of the nation.
However, while we remain focused on the urgent medical needs today, a secondary health care crisis is also brewing, and it threatens to be much larger than the crisis caused by the virus itself. It is the crisis of every other medical ailment that is being ignored, postponed or left untreated while we focus on coronavirus.
Federal and state governments have recommended a complete stoppage of all "non-urgent" procedures. Women cannot get annual mammograms. People with heart disease cannot get routine blood tests. Cancer screenings are becoming an afterthought. As a nation, we are in grave danger of pushing aside every aspect of medical care that is not related to COVID-19, and if we do not act quickly to balance our efforts, the conditions we are ignoring may incur a human cost that could far overshadow that of the virus.
As an orthopedic specialist, I'm seeing this come to life in my own practice. Just this week, I performed surgery on a vibrant, 28-year-old young man named Jeffrey who had fully torn his hamstring tendon.
A terrific former high school soccer player who still loves to play a variety of sports, Jeffrey was sidelined from all physical activity due to his injury. In the midst of this public health crisis, it took six weeks for him to get his MRI scan showing a significant tear, and longer yet to get referred to my care. If his surgery were delayed any further, his tendon tear would have become irreparable, and he would have suffered lifelong weakness and chronic pain.
The hospital where he received his diagnostic imaging said he could not have the surgery, because it was deemed "elective." He disagreed, and so did I. Last week, I safely repaired his tendon at an alternate surgical center, and he is now expected to make a full recovery.
Another recent patient of mine, Eric, a 43-year-old father of three young boys, had been suffering from increasing levels of hip pain due to arthritis for several months. In good overall health, he had had not been able to walk due to catching and locking of his hip joint, and he could not play with his children due to severe pain. He had scheduled a hip resurfacing procedure for the beginning of April.
A week before his planned procedure, he received a call that his surgery was canceled because it also was considered "elective."
That same week, he lost his job as a manufacturing manager when his plant was shut down due to the stay-at-home order. Now, facing indefinite financial uncertainty, and disabled by his hip pain, he pleaded with me to get his surgery done.
Delaying or foregoing treatment of problems will, no doubt, cause irreversible damage.
If millions suffering from joint pain cannot get treatment, many will lose employment due to disability, develop opioid dependence or addiction while managing pain, succumb to depression or mental health disease, or worse, die of a blood clot due to immobility. These dire consequences cannot be ignored, and treatment cannot simply be pushed aside as "elective."
Future implications of current policies, if not changed soon, will be far worse than the consequences of the virus. Hospitals and doctors have been given the time to prepare for Wuhan coronavirus patients. It's time policies allow them to treat everyone else with urgent health issues.
How many people who are sick with non-COVID illnesses are going to die because they didn't—or couldn't—seek care over the last month? I'm not aware of any epidemiologists modeling that. https://t.co/o0kmmL48w1 #COVID19
— Avik Roy (@Avik) April 22, 2020
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