• Ozzie Paez

Covid's staggering indirect human costs

Updated: Jan 4

It will take years for epidemiologists and medical researchers to tallie the human costs of the Covid pandemic. The easiest will be the direct costs defined as the number of people who tested positive, were treated, hospitalized, and died. They should include estimates of asymptomatic and less severe cases that were not diagnosed and counted.


The most elusive and difficult to quantify will be the secondary indirect human costs defined as the number of non-Covid patients who died and endured life-altering outcomes because needed services were delayed and foregone as a result of pandemic-related barriers and disruptions in care delivery. We can gain perspective into their impacts by considering Hypertension, the most common and strongest factor behind most cardiovascular diseases. Hypertension affects over 75 million people in the US and roughly one-third are undiagnosed. Studies suggest that over 50% of untreated patients will die of ischemic heart disease and stroke. The costs measured in premature deaths and diminished quality of life are staggering. [1] Thankfully, there had been significant gains in early detection, prevention, and care in recent years – then Covid arrived.

According to Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, president of the American Heart Association, “the indirect effects of the pandemic can affect overall cardiovascular health… because most heart disease and stroke deaths are preventable with appropriate medical treatment and healthy lifestyle behaviors… We’d made tremendous progress in those areas over the last two decades, but have seen much of that go out the window...” [2]


Estimates by CDC, The American College of Emergency Physicians, and the Kaiser Family Foundation suggest that Covid related barriers including fear of contracting the virus caused 30-50% of patients to delay, cancel, and forego a wide variety of services including emergency treatment of acute conditions, routine check-ups, pediatric visits, and cancer screenings. [3,4] A study published in Science concluded that delayed diagnoses and treatment will lead to an additional 10,000 excess deaths in Breast and Colorectal Cancers between 2020 and 2030. [5] The assumption at the time of these studies was that the pandemic and its effects would ease and largely end by 2021, so they likely understate the actual impacts.


Summary

Our work and observations suggest that the singular focus on Covid has undermined efforts to prevent, diagnose, and treat other deadly illnesses and conditions. This post is a reminder that most people who have died and are dying during this period were humbled by factors other than Covid. And we've only scratched the surface in quantifying, much less coping with the indirect costs of this dreadful pandemic.


Solutions? In my next post, I will discuss innovative technologies and business models that are poised to change this tragic trajectory in the years ahead. In this context, Covid is driving unparallel innovation and change into the heart of healthcare’s conservative culture.


References


[1] High Blood Pressure Home, Centers for Disease Control and Prevention, accessed 12/29/2020, High Blood Pressure Symptoms and Causes | cdc.gov


[2] COVID-19 Long-term Impacts Will Likely Include Higher Rates of Heart Disease, News, Diagnostic and Interventional Cardiology, July 26, 2021, https://www.dicardiology.com/content/covid-19-long-term-impacts-will-likely-include-higher-rates-heart-disease


[3] Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns-United States, June 2020 /Weekly / September 11, 2020 / 69(36);1250–1257, https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a4.htm


[4] Julius Chen, Rebecca McGeorge, Spillover Effects Of The COVID-19 Pandemic Could Drive Long-Term Health Consequences For Non-COVID-19 Patients, Health Affairs, October 23, 2020, https://www.healthaffairs.org/do/10.1377/forefront.20201020.566558/full/


[5] Norman E. Sharpless, Covid 19 and Cancer, June 19, 2020, Science, https://www.science.org/doi/10.1126/science.abd3377


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