Eight year-old Kayden Tree grimaces as a swab is inserted into his nose by nurse Nellie Smith (L) and Ebonie Hearn during a COVID-19 test at a CareSTL Health testing Site in St. Louis on May 11. Photo by Bill Greenblatt/UPI | License Photo
May 20 (UPI) -- Visits to primary care doctors declined by as much as 60 percent as the COVID-19 outbreak took hold in the United States in early April, an analysis released Wednesday has found.
The impact on health, even as practices begin to reopen for non-coronavirus patients, has been significant, experts say.
In research conducted by The Commonwealth Fund, a non-profit focused on healthcare access and affordability, researchers found that although patients starting to see primary care doctors again in late April, overall visits are down by roughly one-third from normal levels since the start of the year.
A separate analysis published this week by the New England Journal of Medicine found the number of people hospitalized after having a heart attack in northern California dropped by 48 percent since the start of the year compared to the same period in 2019.
The authors, from Kaiser Permanente, which oversees 21 hospitals and 255 health clinics in the region, said the decline isn't due to fewer heart attacks, but rather the reluctance of some people to seek non-coronavirus care during the pandemic.
"We should all be very worried about untreated chronic diseases," Dr. Farzad Mostashari, co-author of the Commonwealth Fund analysis, said during a call with reporters Wednesday. Mostashari also is co-founder and CEO of Aledad, a network of primary care practices in 27 states.
If people are unable to see primary care doctors during the pandemic -- either because the practices are closed or they are concerned about being exposed to the virus -- the United States will "pay the price with more heart attacks and strokes," among other health issues over the long term, Mostashari said.
In addition to treating existing health conditions, the U.S. Centers for Disease Control and Prevention has advised that people who exhibit symptoms of COVID-19, or who are concerned about exposure to the novel coronavirus that causes it, to call their primary care doctors before going to a hospital.
The Commonwealth Fund analysis was focused on assessing the overall business climate for primary care practices across the country in the midst of the COVID-19 outbreak.
The analysis revealed that primary care doctors were among the most affected by the drop in visits since outbreak started.
Pediatricians and eye doctors, as well as other specialists, have seen the most significant decline in traffic, noted Ateev Mehrotra, associate professor of Health Care Policy and Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center.
The concern, Mehrotra said, is that many of these practices could close as a result of the downturn, which then could impact access to care, particularly in rural areas where hospitals are lacking.
Many primary care practices across the country have faced other challenges during the pandemic, as well, including lack of sufficient access to supplies of personal protective equipment, or PPE. As a result, many practices have been forced to close if staff members test positive for COVID-19.
"Believe it or not, the supply chain for PPE is even more broken" for private practices than it is for hospitals, said Mostashari, whose company has outfitted partner practices with $1.2 million in PPE and assisted them in starting telehealth services since the start of the outbreak.
"If the CDC says to call your doctor if you have symptoms, someone has to pick up the phone on the other end," he said. "These practices are on the front lines, and they are trying to deal with keeping staff safe and patients safe."