In the first wave, because non-urgent medical consultations and tests were suspended; then, because of the amount of medical resources the coronavirus absorbs, and now also because many patients don’t want to go to the doctor unless it’s an emergency. Some patients ask to postpone their check-ups for several months for fear of becoming infected.
“Pre-Covid healthcare has not yet been resumed,” says Carina Escobar, president of the Patient Organizations Platform, and many follow-ups are still remote (telephone or telematic), which does not replace tests needed to arrive at diagnoses and treatments “.
One of the reasons for the current traffic jam is that many tests (endoscopies, biopsies) now require a negative PCR, explains Jesús García Foncillas, director of the oncology department at the Fundación Jiménez Díaz hospital. “And this means a slight delay in diagnoses, although it has already been reduced to a minimum,” he says.
Chronic patients have been among the most affected because, according to Escobar, “the health system is set up mostly by acute.” To give an example, deaths from heart attacks doubled in the first stage of the pandemic and 28% fewer patients with symptoms of heart attacks were treated, according to the Spanish Society of Cardiology (SEC). Not to mention other pathologies such as cancer or rare diseases.
Biopsies were reduced by 41% and chemotherapy by 9.5% during confinement
For Eva Fernández, the epidemic has been a blow. Her baby, Diego Torronteras, 19 months, was diagnosed with Allan Herndon Dudley syndrome, a disease that causes cerebral palsy for more than six months.
“In addition to suspending him from physiotherapy sessions (two per week), crucial for these children, who achieve all the advances in the first six years of life, many of them were telephone and the child was not progressing,” explains Fernández, who has resorted to the private sector, which means about 700 euros a month.
The Jiménez Díaz Foundation has resumed rehabilitation, but reduced it to one session per week “because there is no room and they are still waiting to be awarded an early care center, key to recovery.”
Other affected groups
Among chronic patients, diabetics, especially the older ones, have been severely impaired by suspending tests. Especially for type 2, says Antonio Pérez, president of the Spanish Society of Diabetes. “The management of these patients is usually performed in outpatients, do not use continuous glucose monitoring (glucosensor) and can not self-adjust treatment,” compared to those of type 1, the follow-up is hospital, “he says.
In addition, they have had difficulty obtaining drugs and disease control material, says this head of the endocrine unit of the Hospital de la Santa Creu y Sant Pau (Barcelona), which is extrapolated to Spain the data of a UK study where diagnoses of type 2 diabetes dropped by 70% between March and May.
The elderly with type 2 diabetes, the most affected by the suspension of tests
“Cancer care was also significantly affected,” García Foncillas acknowledges. In fact, according to the study Health impact of coronavirus in oncohematological patients of the Spanish Association Against Cancer, at this stage there was a reduction of 57% of diagnostic cytologies, 41% of biopsies, 9.5% of chemotherapy treatments and the day hospital treated 14% fewer patients.
“Covid is a tragedy that accelerates another tragedy and, therefore, vaccination must be accelerated to reduce cases and pressure on the health system,” said Dolors Montserrat, a member of the European Parliament’s public health committee and former minister of Health. Moreover, for Sandra Ibarra, president of the Sandra Ibarra Foundation, “it is urgent that hospitals articulate care protocols to provide care to cancer patients.”
The same has happened with cardiac patients. “In two or three years we will see the consequences of the decline in care,” warns Angel Cequier, president of the SEC (Spanish Society of Cardiology). “We saw how the patients on the waiting list for moderate interventions got worse and some died. And although from the second wave all the acute processes were already treated, not all the tests can still be done (cardiac rehabilitation , etc.), it will take months to reach the previous level of care, as almost 40% of the structures are absorbed by the coronavirus “.
Hurricane SARS-CoV-2
Treatments. According to a report from the Patient Care Platform Observatory, 25% of patients had trouble accessing their treatment at the community pharmacy and hospital.
Radiotherapy. The number of patients cared for in radiotherapy services fell by 9%, as did treatments with this technique by 5%.
Transplants. From March to May, transplants from unrelated donors fell by 50%, according to a study by the Spanish Association Against Cancer.
Europe. A new European Commission plan will allocate € 4 billion to cancer prevention and treatment. The goal: to vaccinate 90% of girls with the possibility of contracting human papilloma virus, among other measures.
Neurology. 60% of Spanish neurologists say that cases of new diagnoses of cognitive impairment have increased during the months after March 2020. Almost 30% of epilepsy patients suffered more seizures, according to a study by the Spanish Society of Neurology .
Gota. Many gout sufferers were forced to self-medicate and many were unable to adjust the dose to reduce uric acid.