A new survey by the Physician-Patient Alliance for Health and Safety (PPAHS) found that 44% of patients have delayed or avoided doctor’s visits because of fear of COVID-19. This percentage was even higher among those diagnosed with certain chronic conditions, such as cardiovascular disease or respiratory illness. Both are risk factors for poor outcomes. Before diving into the results of the survey, let me describe the circumstances that led up to the survey. PPAHS’ Virtual Patient Care In April 2020, PPAHS launched Virtual Patient Care, a free online chat line where patients can speak with a team of experienced registered nurses in order to get personalized answers to their questions. The telehealth project and resources are thanks to the generous support of the BMS-Pfizer Alliance, as well as the efforts and resources of the following organizations: American Heart Association Anticoagulation Forum Heart Rhythm Society StopAfib.org Mended Hearts Preventive Cardiovascular Nurses Association According to Michael Wong, JD, Founder and Executive Director of PPAHS: “Under current COVID-19 conditions, patients face the burdens of social distancing and increased difficulty in reaching clinicians busy with emergencies. Telehealth has proven essential in addressing patients’ pressing health needs and ensuring good patient-to-clinician dialogue. With today’s launch of Virtual Patient Care and the CV Virtual Clinic, vital telehealth benefits are now also extended to Afib patients in need.” The PPAHS online survey: the impact of fear of COVID-19 As of October 5th, 2020, more than 6,000 people have visited Virtual Patient Care. Many of them have expressed both a fear of COVID-19 and a subsequent hesitancy to seek medical attention. For instance, one individual wrote in, “More than a year ago, my doctor said I had Afib. What risks do I have for getting COVID-19?” Another patient described a sharp pain in their side, asking, “Should I be concerned? What do you think this may be? Should I see a doctor?” One other said simply, “Shortness of breath and extreme headache – go to the ER?” In order to better understand and address these patient concerns and serve the community, PPAHS conducted an online survey with its followers from August 25 to September 7, 2020. The results of the survey About half of the 184 respondents (44%) reported that they had delayed or not gone to see a doctor, dentist, or another healthcare provider during the pandemic. PPAHS’ results are consistent with other research that shows about 4 in 10 US adults have avoided medical care due to COVID-19 concerns. This trend, coined “medical distancing,” has resulted in a 50% decrease in office-based visits, including, a 21% decline in primary care visits a 42% decline in emergency department (ED) visits Unfortunately, PPAHS also found a higher percentage of medical distancing in respondents with clinical conditions that increase their risk of a poor outcome if infected, such as, atrial fibrillation (AFib) or cardiovascular disease (53%) chronic obstructive pulmonary disease (COPD) or respiratory illness (51%) This increase may reflect information from the Centers for Disease Control and Prevention (CDC) that identified cardiovascular and respiratory disorders as underlying medical conditions that may increase the risks of developing severe illness from COVID-19. However, these patients are also those who may be most in need of routine medical care for their chronic conditions. And, that may face dire consequences if their care is delayed. Health consequences of delaying care Research has found that patients have delayed seeing a doctor, resulting in more at-home heart attacks and delayed ED visits during the pandemic. One study found a 23% and 20% decline in ED visits for heart attacks and stroke, respectively. As patients have begun returning to EDs, health care providers have reported seeing worse symptoms due to delayed care. Such delays are particularly significant for patients with AFib or COPD because they are at a higher risk of heart attack and stroke. Cardiovascular conditions undiagnosed or untreated The results of the PPAHS survey also reveal evidence of undiagnosed or untreated cardiovascular conditions. Of the 88 respondents that reported “no diagnosis” of cardiovascular disease, several included comments — such as “cardiac dysrhythmia” and “heart murmur.” This suggests that they may have an undiagnosed condition. Further, they may not be taking appropriate precautions or being monitored for further disease progression. Cardiovascular disease can be treated with changes in diet and exercise if the condition is detected in its early stages. Left undiagnosed, cardiovascular disease may have serious health consequences. Source
