While many heroic doctors, nurses and other health care professionals are working long hours and risking their lives to treat COVID-19 patients, others have seen their workloads and hospital occupancy rates drop dramatically as a result of the coronavirus pandemic. This has created a financial crisis and endangered public health.
At the onset of the COVID-19 outbreak, public health officials urged hospitals to suspend non-essential medical procedures. U.S. hospitals canceled tens of thousands of elective surgeries and other procedures, and urged patients to make use of telehealth.
Americans adapted quickly to this new reality. Doctor visits declined nearly 60 percent from March to April – a stunning amount, according to a new Commonwealth Fund study. Some of the largest drop-offs occurred in surgery and pediatric care. Telehealth visits increased slightly, but not enough to offset the overall drop in care.
With no patients to treat, a number of hospitals are in dire financial straits as they see massive drops in their incomes. The American Hospital Association estimates hospitals are losing more than $50 billion per month due to the COVID-19 slowdown. That could force 100 hospitals to close within a year, according to a USA Today analysis.
Physicians are in a similar predicament. Only half of primary care physicians have enough cash on hand to survive another four weeks, according to a survey from the Primary Care Collective.
COVID-19 is expected to push up to 60,000 family medicine doctors out of their practices by June.
As revenues continue to decline by huge amounts, physicians have little choice but to sell their practices to hospitals, insurance companies, or private equity groups. Such consolidation could make it harder for patients to access care and would cause health care costs to increase further.
The good news for hospitals and medical professionals is that as states begin to relax their coronavirus lockdowns, hospitals are trying to return to normal. Earlier this month, 20 states green-lit the resumption of elective surgeries that had been postponed to preserve personal protective equipment and other resources for the response to COVID-19.
But even without government restrictions on elective surgeries, fear of the coronavirus may keep patients away from hospitals for some time. Nearly half of doctors believe patient visits will only return to pre-COVID-19 levels sometime between July and September.
By that point, patients and providers alike will have suffered real losses.
Patients who stay away from the hospital and put off necessary care risk dying prematurely. Without people to treat, physician practices and hospitals are losing money. Many could soon shut down.
These are some of the unintended consequences of the pandemic. Our leaders must keep them in mind as they work to resurrect the economy in the weeks and months to come.
Fear of the coronavirus and confusion over stay-at-home orders have caused even the sickest patients to avoid hospitals. Emergency room visits are down 50 percent across New York City’s Health and Hospitals System. Admissions for a certain type of heart attack fell nearly 40 percent in nine major hospitals across eight states in March.
The data suggest that even patients experiencing medical emergencies are staying home. Things have gotten so bad that the American Heart Association joined seven other medical groups to remind people to call 911 and go to the hospital if they fear they’ve had a heart attack or stroke.
Interruptions of medical care are taking their toll on patients. Those awaiting hip replacements spend their days in pain, struggling to move. Some doctors have postponed surgeries aimed at addressing early-stage cancer. The longer these “elective” surgeries are postponed, the more people suffer.
Patients in need of treatment aren’t the only ones at risk. The COVID-19 lockdown could lead to 22 million canceled or delayed tests for five common cancers by June, according to a new report by the IQVIA Institute for Human Data Science. This reduction in testing could lead to 80,000 missed cancer diagnoses.
The same report found that colonoscopies dropped 90 percent between February and April; mammograms dropped 87 percent. New visits for cancer patients declined nearly 40 percent over the same period, while cancellations and no-shows nearly doubled.
Such widespread suspensions of medical care may not have been necessary. The pandemic has not hit our country evenly. While the New York City metropolitan area has been hit hard, many hospitals outside COVID-19 hotspots have been practically empty for the past few months.
After months of lockdown, the COVID-19 pandemic has become a public health crisis in more ways than one. While it’s critically important to focus our attention on the deadly pandemic, we have to keep hospitals, outpatient clinics and health care professionals financially solvent so they are there to provide treatment and preventive care for our other important medical needs.