Not Just COVID: Forgotten Health Epidemics of 2021

By: Sarah Du

The crowding of hospitals across the globe at the start of the COVID-19 pandemic pushed other major epidemics to the side, exacerbating death rates across all non-COVID-19-related illnesses. Other patients became increasingly wary of whether the medical care they needed was necessary as hospitals became overcrowded with COVID-19 cases and understaffed. Some decided to delay their treatments and tests until the pandemic subsided- only to find their health in greater jeopardy than before.

Here, I highlight previous epidemics impacted by COVID-19 since 2020. 

Cancer

In 2021, breast cancer became the most commonly diagnosed cancer, surpassing lung cancer. The pandemic is said to have played a significant role in this change–individuals are wary of going to the hospital to treat their illnesses and as a result, delay their annual cancer screenings. Last year, the Epic Health Research Network found that preventative cancer screenings for breast and cervical cancers declined by 94%, while colon cancers declined by 86%.[3]

Though the growth rate of tumors varies by disease, genetics, and the individual, the common thread between cancer diagnoses is that an earlier diagnosis is always more ideal than a late one. Even a four-week delay in treatment could increase the risk of death in almost all common types of cancer, according to a study published by the British Medical Journal.[1]

A June study revealed that the COVID-19 pandemic caused an excess of an estimated 10,000 breast and colon cancer deaths, just in the United States.[2] The National Cancer Institute (NCI) director Norman “Ned” Sharpless, MD, fears that the pandemic may reverse the progress made in reducing cancer rates in the past 3 decades and affect cancer rates for decades to come. 

“I worry that the SARS-CoV-2 pandemic has put those decades of steady progress at risk and may precipitate reversals of these trends,” said Sharpless. 

HIV/AIDS

At the height of the COVID-19 pandemic, health facilities such as Legacy Community Health, the largest federal medical center in Texas, saw a 30% decrease in HIV testing in March 2020. Around the same time, the number of antiretroviral prescriptions such as pre-exposure chemoprophylaxis (PrEP) medications decreased by as much as 72.1% in Boston. By April, almost all patients shifted to telehealth appointments.

For others without the resources to use telehealth, the interruption to treatment could cause damage that may take years to make up for the progression made before the pandemic. The Joint United Nations Programme on HIV/AIDS (UNIADS) reported that the missed 2020 target for HIV/AIDS reduction might have resulted in almost 3.5 million more HIV infections and around 800,000 more deaths related to AIDS in July 2020. The setback caused by the pandemic could take over 10 years to reverse. 

Heart disease

Heart diseases have been the leading cause of death in the United States since 2018, according to the Center for Disease Control and Prevention (CDC). The most common heart disease in the United States is currently coronary artery disease (CAD), an illness that develops over time and can be lethal when plaque buildup blocks blood flow into the heart, causing chest pain and discomfort among other symptoms. While the severity of symptoms may range from virtually none to chronic, blocked blood flow to the heart can cause scarring or damage to the muscle regardless. 

At the Yale School of Medicine, the number of patients admitted for heart attacks reduced by 40% during the pandemic, alarming many physicians from various specialties. 

For Dr. Eric Velazquez, Chief of Cardiovascular Medicine at Yale, he worries that patients “may be having chest pain and deciding to live with it, and that is a problem… when all of this could have been avoided by seeking care.”

Non-COVID Illnesses Neglected

During the peak of the pandemic, resources and medical professionals prioritized COVID-19 patients, pushing aside patients with non-emergent procedures. The consequences of this, however, caused other non-virus-related deaths in the process. At St. Joseph’s Hospital in Orange County, California, two of Dr. Brian Kolski’s patients were postponed for aortic valve replacements (ART) and passed while waiting for the procedure. 

“These patients can’t wait two months… some of them can’t wait two weeks,” Kolski said. For patients who require these procedures, the timing of their operation, pandemic or not, could mean life or death.

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References

[1] Hanna, T., et al. (2020). Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ, 371. https://doi.org/10.1136/bmj.m4087 

[2] Sharpless, N. (2020). COVID-19 and cancer. Science (368)6497. DOI: 10.1126/science.abd3377

[3] Epic Health Research Network. (2020). Preventive cancer screenings during COVID‐19 pandemic. https://ehrn.org/wp-content/uploads/Preventive-Cancer-Screenings-during-COVID-19-Pandemic.pdf