“Stay safe; stay home.”
Messages of this nature have been resounding in the ears of Americans since COVID-19-related stay-at-home orders took effect. And although a decline in new cases in hard-hit areas indicate these efforts have been effective from a transmission standpoint, emerging data and anecdotal evidence suggest they may be causing a different kind of harm — one that experts are afraid may have equally serious implications.
Where Are All the ‘Other’ Emergencies?
With hospitals expanding or modifying capacity to accommodate COVID-19 patients, clinicians are raising concerns about the other critical patients who aren’t presenting in the emergency room in usual numbers. According to The Washington Post, physicians across the U.S. are seeing notably fewer cases of heart attacks and strokes, as well as dangerously delayed cases of treatable-if-caught-early ailments like appendicitis.
A nationwide decrease in these acute conditions is doubtful; if anything, experts believe stressors of the COVID-19 pandemic would be more likely to increase the risk of heart attacks and strokes. A grim but probable explanation is that these major health events are not making it into the emergency room — that, or they’re already there, presenting instead as COVID-19 complications. In the case of the former, fear of contracting the virus from what is seen as a high-risk setting may be leading people to ignore symptoms of serious illness, increasing the likelihood of a severe outcome once they are forced to seek care.
When Preventive Care Is Urgent Care
From the onset of COVID-19, the search for a vaccine has been a major topic of discussion. Less talked about, but of equal consequence, are the vaccines we currently rely on to prevent outbreaks of other devastating diseases. As parents of young children heed recommendations to stay home unless absolutely necessary, well-child checkups are inevitably falling by the wayside — and with them, vital early childhood immunizations.
As we’ve seen with recent outbreaks of diseases thought to have been effectively eradicated, delaying or neglecting to vaccinate carries profound health risks and cost implications. The U.S. already spends billions of dollars each year treating vaccine-preventable diseases (VDPs), and the World Health Organization (WHO) warns that even a brief interruption to immunization services could instigate a resurgence of measles, polio and other VDPs. Data from PCC cited in The New York Times shows a 50% drop in the administration of measles, mumps and rubella shots in the midst of the U.S. COVID-19 pandemic.
Not New, But Exacerbated
Much like the search for a cure to the coronavirus itself, addressing the fear and behaviors this traumatic event has inevitably instilled in people will be a long and multifaceted effort. Adding to the complexity is the fact that a lot of these behaviors aren’t newly emerging as a result of COVID-19. For example, financial issues, health illiteracy and various other socioeconomic and environmental factors have long contributed to delays in seeking care among vulnerable populations. In 2019, vaccine hesitancy was named one of WHO’s top threats to global health, one that also threatened the U.S.’ 20-year measles elimination status.
Changing Behavior Through Targeted Outreach
Issues like these can stem from misinformation. Misinformation fuels uncertainty; uncertainty fuels fear; fear influences behavior. Mitigating this chain of events starts with getting relevant, factual information into the hands of the healthcare consumer.
At a time when routine care and in-office visits are on the decline, healthcare professionals must look to proactive, targeted outreach mechanisms to reach vulnerable consumers and inspire them to take action for their health. For instance, sharing basic health information and available resources can be helpful in preventing late hospital presentations and resulting complications. Equally, providing fact-based, contextually relevant vaccine information can help counter misperceptions threatening past, present and future disease control efforts.
COVID-19 has generated widespread fear and uncertainty. Communication and outreach must be rooted in data and behavioral science to address concerns at the individual level and overcome fear at the root cause. Otherwise, we risk a parallel and equally urgent crisis.