In the first wave, because non-urgent medical consultations and tests were suspended; later, because of the amount of medical resources absorbed by the coronavirus, and now also because many patients do not want to go to the doctor, unless it is an emergency. Some patients ask to postpone their check-ups for several months for fear of getting infected.
“It has not yet been possible to resume pre-Covid health care,” says Carina Escobar, president of the Patient Organizations Platform, and many follow-ups are still remotely (telephone or telematic), which “does not replace the necessary tests to arrive at diagnoses and treatments ”.
One of the reasons that explains the current traffic jam is that now many tests (endoscopies, biopsies) require a negative PCR, clarifies Jesús García Foncillas, director of the department of oncology 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 especially for acute patients.” For example, death from heart attack doubled in the first stage of the pandemic and 28% fewer patients with heart attack symptoms 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. His baby, Diego Torronteras, 19 months old, was diagnosed with Allan Herndon Dudley syndrome, a condition that generates cerebral palsy, for more than six months.
“In addition to suspending the 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 by telephone and the child did not progress,” says Fernández, who has appealed to the private one, which means about 700 euros per month.
The Jiménez Díaz Foundation has resumed rehabilitation, but reducing 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 his recovery.”
Other affected groups
Among chronic patients, diabetics, especially the elderly, have been greatly affected by suspending the laboratory tests. Especially for type 2, points out Antonio Pérez, president of the Spanish Diabetes Society. “The management of these patients is usually carried out in outpatient clinics, they do not use continuous glucose monitoring (glucosensor) and they cannot self-adjust the treatment”, compared to type 1, whose follow-up is hospitalized, “he indicates.
In addition, they have had difficulties obtaining medicines and material to control the disease, says this head of the endocrine unit of the Hospital de la Santa Creu i Sant Pau (Barcelona), which extrapolates to Spain the data from a study in the United Kingdom where Type 2 diabetes diagnoses dropped 70% between March and May.
The elderly with type 2 diabetes, the most affected by the suspension of analytics
“Cancer care was also significantly affected,” acknowledges García Foncillas. In fact, according to the study Health impact of coronavirus in oncohematological patients of the Spanish Association Against Cancer, in this stage there was a reduction of 57% of diagnostic cytologies, 41% of biopsies, 9.5% of those 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 the cases and pressure on the health system,” says Dolors Montserrat, member of the European Parliament’s public health commission and former minister of Health. Moreover, for Sandra Ibarra, president of the Sandra Ibarra Foundation, “it is urgent that hospitals articulate assistance protocols to provide care for cancer patients.”
The same has happened with heart patients. “In two or three years the consequences of the decrease in care will be seen,” warns Ángel Cequier, president of the SEC (Spanish Society of Cardiology). “We saw how patients on the waiting list for moderate interventions got worse and some died. And although from the second wave, all acute processes have already been treated, not all tests can be done yet (cardiac rehabilitation, etc.), it will take months to reach the previous level of care, since almost 40% of the structures they are absorbed by the coronavirus ”.
Treatments. According to a report by the Observatory of the Patient Care Platform, 25% of patients had problems accessing their treatment at the community pharmacy and hospital.
Radiotherapy. The number of patients treated in radiotherapy services fell by 9%, as did the 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 euros to the prevention and treatment of cancer. The goal: to vaccinate 90% of girls with the possibility of contracting the human papillomavirus, among other measures.
Neurology. 60% of Spanish neurologists affirm that the 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 .
Drop. Many gout sufferers were forced to self-medicate, and many were unable to adjust the dose to reduce uric acid.