General health care takes Covid-19 hit

So many ordinary activities have been put on hold in the time of coronavirus, but one stands out as an especially punishing loss: people have sharply curtailed their non-Covid health care — not just easily postponed check-ups, but also tumour removals, diabetes tests, prenatal visits, kidney transplants, vaccines, even emergency care after heart attacks.

Since early March in-person doctor visits have fallen about 60% in the US. Cancer screenings have dropped between 86% and 94% . And until recently many hospitals were turning away all patients except those with Covid19, often by order of state officials. Epidemiologists assume the pause in non-Covid health care accounts for some of the tens of thousands of “excess deaths ” that have happened in the past couple of months in the US.

This is a danger in any epidemic; during the Ebola outbreak in West Africa in 2014-2016, the increase in deaths from measles, malaria, Aids and tuberculosis exceeded deaths from Ebola. In the current situation in the US it is unlikely that indirect mortality will ever outpace deaths from Covid-19 itself. But the pause in medicine is an urgent public health challenge in its own right.

The medical profession has every incentive to move as quickly as possible, as doctors and hospitals are taking an enormous financial hit. From mid-February to midMarch about 43,000US health-care workers were laid off. Trouble is, medical offices and hospitals are among the most difficult businesses to reopen in a pandemic environment in which testing and contact tracing are still not up to speed. Hospitals should not even begin to consider treating non-Covid patients, the Centres for Medicare and Medicaid Services has warned, until they ensure they have the capacity to respond to any new coronavirus surge, and until they are able to fully isolate Covid and non-Covid patients (and their care providers) from each other. /New York, May 13