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Unseen crisis emerges as patients delay medical care during the pandemic

For much of the year, millions of Americans have been hunkering down and avoiding crowds to try to stay safe from COVID-19. But with that, many have also been delaying important medical care, sometimes with devastating consequences. John Yang reports.

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  • Amna Nawaz:

    For much of the year, millions of Americans have been hunkering down, avoiding crowds to try to stay safe from COVID-19.

    But that also means many have also been delaying important medical care, sometimes with devastating consequences.

    John Yang reports now on this hidden crisis during the pandemic.

  • John Yang:

    Lorraine Ensor spent her career as a librarian in Springfield, Massachusetts, watching generations of readers grow up.

  • Lorraine Ensor:

    Little kids come in, grew up, got married, had kids of their own. It's been an interesting life.

  • John Yang:

    A few years ago, at age 82, she finally retired. Late last year, she noticed a problem with her right eye.

  • Lorraine Ensor:

    I turned on the TV to listen to the weather and there was a black spot. It was like a small brick. And I thought that was strange.

  • John Yang:

    Her doctor, retina surgeon and ophthalmologist Andrew Lam, diagnosed her with macular degeneration, the leading cause of blindness in patients over 65. He explains there are two versions of the disease, the slower-moving dry kind and the faster-moving wet kind, which is what Lorraine has.

  • Andrew Lam:

    So, it's very serious when people have the wet macular degeneration. Luckily, we have medicines that can halt the progression of wet macular degeneration and often improve vision.

    But the medicines wear off. So, they're often repeated every four to six or eight weeks, depending on each individual's situation.

  • John Yang:

    Lorraine began going to regular appointments to receive those injections, until COVID-19 hit; 85 years old and diabetic, she falls into two high-risk categories for coronavirus, and what she heard on the news terrified her.

  • Lorraine Ensor:

    So, I canceled my appointment. And when I called the girl, she explained that they had prepared the office for everything. But I was still too frightened to go.

  • John Yang:

    She canceled her next appointment as well. In fact, she didn't return to Dr. Lam until she experienced sudden vision loss.

  • Andrew Lam:

    Unfortunately, when she returned in June, after having missed a couple of routine injections during the pandemic, she had severe central vision loss, which was related to a very obvious submacular hemorrhage that had occurred.

  • John Yang:

    Dr. Lam operated and was able to restore some of her vision.

  • Andrew Lam:

    We still are hopeful that some will be regained.

  • John Yang:

    But he's certain he could have prevented it from happening in the first place, not just for Lorraine, but also for so many other patients who've had even worse outcomes.

  • Andrew Lam:

    This summer, literally, we were having people come in with catastrophic vision loss, sometimes in their only good eye, because of deferred medical care. And it's it's a very difficult conversation to have with these patients.

    They're upset. Sometimes, they're crying because they know that they had vision loss that was preventable. But now we're not sure we can get it back.

  • John Yang:

    As COVID-19 has swept the country, sometimes overwhelming hospitals, there's been a less obvious toll of patients skipping both routine and urgent medical care.

    Earlier this year, the Centers for Disease Control and Prevention published a study that found four in 10 Americans had delayed or avoided care during COVID-19, 12 percent of them for urgent or emergency care, like heart attacks and strokes.

  • Kristie Clarke:

    Getting your needed medical care in a timely manner is essential.

  • John Yang:

    Trained as a pediatrician, Commander Kristie Clarke is a public health officer and epidemiologist at the CDC. She's a co-author of the study.

  • Kristie Clarke:

    Routine care is where we as physicians can detect new conditions, worsening conditions, and can provide important preventive care, such as vaccinations, well-child check or health maintenance visits for adults with or without underlying conditions.

  • John Yang:

    As with many of the effects of COVID-19, she says this problem of delayed care is hitting some groups harder than others.

  • Kristie Clarke:

    We found that urgent and emergency care was more likely to be delayed or avoided in people of non-Hispanic Black race or those of Hispanic ethnicity, those with a disability, those with two or more underlying medical conditions, and those who are serving as unpaid caregivers for an adult relative.

  • John Yang:

    Could there be lessons here about how health care professionals and maybe public health officials have been communicating the risks and dangers of the pandemic, that perhaps it's created such a fear that people are unwilling to go to take care of chronic health conditions and have routine health checks, for fear of the virus?

  • Kristie Clarke:

    So, you bring up a really important question.

    And so I'm a physician at the CDC. I'm also the doctor in my family. So I would tell your viewers exactly what I tell my family, which is that, while it's very important to take necessary precautions for avoiding exposure to COVID-19, and I'm glad they're being careful, it's also important to get your timely medical care.

  • John Yang:

    Back in Springfield, Lorraine's vision in her right eye has improved after surgery, but still isn't what it was before she began skipping her appointments.

  • Lorraine Ensor:

    If I look straight ahead, I still see blackness, but I can see the motion behind it.

  • John Yang:

    Looking back, she wishes she'd trusted Dr. Lam's office and their COVID protocols, temperature checks before entering, fewer people allowed in the elevator and in the socially distanced waiting room, the mandatory use of masks.

  • Woman:

    Have you traveled or been around anybody that's been sick recently?

  • Lorraine Ensor:

    No.

  • Woman:

    OK.

  • John Yang:

    With COVID-19 resurgent, she worries that people like her will again choose to delay care.

  • Lorraine Ensor:

    I only hope that the message does get out to other people who are in similar situations. Put down the fear a little and keep their appointments, because it's so important.

  • John Yang:

    It's a message Dr. Lam drives home as well. He says, if patients are still concerned, they should talk to their health care providers about how to balance the risks.

  • Andrew Lam:

    The fact that this is within our power to prevent is very frustrating.

    And so I think the message has to be that people should not avoid going to their doctors for regular care. You know, the chances of getting COVID at your doctor's office or in an emergency room are very remote and far less than the chance of having a bad medical outcome from deferred medical care.

  • John Yang:

    He and others worry that it may not be for some time to come that the true toll of COVID-19 is evident: all the patients who are staying away.

    For the "PBS NewsHour," I'm John Yang.

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