A second, hidden pandemic will follow

[struggle4progress]

By Michael L. Barnett
APRIL 8, 2020

... Doctors’ offices across the country have emptied. Many practices, including mine, have canceled practically every routine appointment and elective surgery that can possibly wait to avoid exposing patients to covid-19. Millions of Americans have lost jobs, and with them, health insurance and a stable income to pay out-of-pocket health-care costs. Patients who are older and those with chronic illnesses are justifiably afraid to venture into health-care settings and risk contracting covid-19.

... Americans’ health may deteriorate during the fight against the pandemic. The intensive care units in which doctors make desperate efforts to save covid-19 patients may be the stuff of your nightmares. But what keeps me awake at night are the calm hallways and empty doctors’ schedules outside emergency rooms and ICU wards.

... Many diets will slump. Expecting the typical American to keep up with regular exercise under the circumstances is probably a joke. Patients will avoid filling their prescriptions, out of fear of pharmacies or financial desperation. And mental-health issues will flare as the economy worsens and people are stuck at home for weeks.

... Cardiologists have observed that hospital volumes for the most severe type of heart attack, known as a STEMI, are mysteriously low. Neurologists are also reporting fewer strokes. While it is possible that social distancing is somehow lowering the risk of acute problems such as stroke and heart attack, I fear this is a sign that people are avoiding hospitals — even in extreme circumstances ...

https://www.washingtonpost.com/opinions/2020/04/08/covid-19-pandemic-will-end-americas-next-health-crisis-is-already-starting/?arc404=true

[Maeve]

1. Kick for exposure

[McCamy Taylor]

2. Telehealth! You can do it over the phone with your pcp.

My clinic has gone to telehealth and it is working well.

[pazzyanne]

13. Had an appointment with my rheumatologist by phone on Tuesday.

Decided not to do the lab tests to keep myself out of the clinic. Did schedule my infusions set for October to keep me in remission. Hope things have calmed down by then.

[The Magistrate]

3. There Is Certainly Something To That, Sir

[IronLionZion]

4. Indeed, Americans have more underlying health conditions

like heart disease and diabetes and other chronic conditions that require treatment or it gets worse. Millions losing jobs and health insurance isn't helping. Trump supporters are online claiming that socialist doctors are inflating the numbers by counting heart attacks and similar as COVID-19 deaths because they want to bring down Trump.

You can also make a difference. If you have a medical concern, reach out to your doctors. They are not too busy to help you. Though we may not be battling covid-19 in the intensive care unit, primary care doctors are supporting the front-line medical troops by keeping everything else out of the emergency room. You can help everyone by taking care of yourself before it’s too late.

[RockCreek]

5. And that is just the "body" side

Mental health (and the mind and brain are part of the body, so mental health should not be split off this way is suffering, and is likely to snowball.
The trauma of illness, fear, sudden changes, death.
The increase in emotional, verbal and physical abuse when people are shut in together for long periods of time.
Individual therapy can be done by telehealth -- if someone has the quiet and privacy in their home to participate.
Many groups are already online. Partial hospitals and Intensive outpatient programs are making the switch.
In NYC all City hospitals closed their inpatient psychiatric units last week except the State institute. The extremely seriously ill were transferred there.
Pain, trauma, disruption lead to substance use for many people. We already had an opioid epidemic, and a rapidly growing methamphetamine problem -- on top of alcohol, cigarettes, marijuana, additional illicit substances.
How many people in recovery will relapse? How many will start use and develop substance use problems?

And remember, the above issues apply to and affect kids, old people, whole families not isolated individuals.

The mental health and substance use prevention and treatment systems were struggling or broken throughout the country before this pandemic. What will happen now with the multiple immediate stresses and likely future surge in need?

[Pacifist Patriot]

9. You've expressed my fears.

This is already a huge problem, it is going to get exponentially worse.

[RockCreek]

6. Also see the DU post on new reporting of deaths

https://www.democraticunderground.com/100213256485

The Gothsmist article linked gives more detail for NYC how evaluation is not always able to be done as adequately via telehealth, people are being sent home after only quick evaluations in the ED, and people afraid to get medical care do not go for treatment.

[Progressive dog]

7. The elective surgeries that are rightly being postponed

include many (most) that will become emergencies at some time.
Yesterday, I went to a lab in a large medical building to have blood drawn as prescribed by a specialist after a video visit. There was almost no one else there.
One nurse was at a desk in the lobby. She questioned me about possible symptoms and took my temperature before allowing me to enter. The only other person I saw or heard in the building was the one lab tech who drew my blood.
The sugeries and testing that are being postponed will certainly result in deaths, whether or not the patients could afford the treatments that must be postponed.

[bucolic_frolic]

8. I've assumed since mid February this would go on for 18 months

Never a doubt. Until there is a vaccine with actual mass vaccinations, it will roll onward even if in reduced numbers. The vulnerable won't be safe to seek healthcare until the genie is back in the bottle. Trump has no plan to make that happen.

[gab13by13]

11. I have felt the same way, that this will go on,

because Trump has restricted step #1, Test, Test, Test. We have tested 0.8% of our population and Trump wants to send people back to work May 1st by just taking their temperature. If Trump does this we are in for a 2nd wave. Few testing may have diminished the numbers for Trump politically but the virus doesn't give a damn about politics.

[gab13by13]

10. I find myself extremely lucky,

I had my ablation done to fix my A-Fib on Jan. 23rd. I have been dealing with A-Fib off and on for 10 years. I found out 3 weeks ago that UPMC was no longer doing ablations. I got in before the virus hit the fan. UPMC uses tele-medicine, or whatever you call it, my March 26th appointment was done face time over my phone. I am fine now, I have just been taken off Amiodarone which has 3 bad side effects if taken long enough. One of the side effects is that it deposits on the cornea, which it did for me. I was also lucky in that I got new glasses just in time, it's where I found out about my cornea, but my opthamologist told me the Amiodarone will dissipate after I get off of it. Had I not been so lucky I would still be on that drug until who knows how long. I used the UPMC App to thank all of the people who took care of me. I was truly blessed.

This story is not a life threatening story, I could still be taking the Amiodarone and waiting for an ablation and not have new glasses. Many people are going to face life by postponing non-critical operations and I feel for them. I feel so lucky.

[DVRacer]

12. Mental health is already a big problem.

My wife who dispatches for Tulsa just on Monday alone in a 1hr period handled four suicides later had two more over her 12hr shift. It has not really got anywhere near its peak yet for us. Other crime is increasing as well people are being stressed to breaking points.

[Initech]

15. I know that I have been going through a serious mental crisis since this began.

I've never needed anti anxiety medication in my entire life. Now that the virus has come along I've reached a breaking point. This is the scariest thing I've ever seen.

[Marthe48]

14. Empirical comments

Since this horror has come on us, I have stayed on my food plan to get my fbg down. I've been working on getting it down since Oct. I've lost 32 lbs. I joined a gym with my Silver Sneakers card last fall, but didn't go there much. However, the class is now online and I've participated for 2 weeks. Several other people are in the class as well. I see a lot of my neighbors walking their dogs or themselves every day, which is usual. My daughter and her husband live near DC, and she says when they walk for exercise, there are usually many people out walking, and other exercise. My friend in Cleveland says there are many people in the park and they are friendly but observe social distance.

I have an eye appt in Cleveland May 2. I have decided to cancel it, and it is a hard choice. But I don't want to travel to and from a hot spot. I think I am far enough along in my treatment that I am not risking vision loss, but if it comes to that rock and a hard place, seems preferable to have one good eye and be alive.

One of my husband's good friends just went on hospice. Inoperable cancer. Against this terrifying backdrop of uncontrolled sickness, we are all living our lives.

Thank you for caring. One of the things that hits home to me is the outrage about how our inept government is hoarding supplies, playing favorites among the states and so on is that no one I know says 'I might need a respirator.' They say, 'Someone needs that respirator. Someone needs those masks.' I find joy seeing that so many people care about others and it is a wonderful antidote against the evil that sits among us.

[panfluteman]

16. A Very Thoughtful and Enlightening Post

Just yet another thing that isn't being covered by our shallow and sensationalizing media.

[AtheistCrusader]

17. Our average life expectancy is going to take a big hit this year, and this is

a big chunk of why.

[Zing Zing Zingbah]

18. So many consequences of this

My MIL was just diagnosed with stage 4 cancer this week. It sucks that my husband can't go with her to her doctor's appointments, but because of COVID-19 he's not allowed to go in with her. She is mentally and physically a mess and we're both afraid she isn't going to make the best decisions right now or even understand what her options are. Everything that is going on right now is making it a lot harder to for us to be able to help her.

[Zing Zing Zingbah]

19. Perhaps the reduction in heart attacks and strokes

is related to people to being more sedentary right now? Just a thought.

[Initech]

20. There's going to be a lot of people who need treatment but cant get it.

Whether it's mental health, cancer, or worse. The ripple effects of this pandemic are going to be enormous.

[Blue Owl]

21. K&R