The burden of non-COVID patients: Caring for the left-behind

June 25, 2020

Coronavirus disease 2019 (COVID-19) has exposed gaps in health care systems. Recognition of the impacts of these gaps offers an opportunity for health care professionals working with political institutions to improve the intersection between health and society. Health care systems will need to simultaneously deal with non-COVID-19 chronic conditions ("the people left behind") as well as maintain hospital facilities at a high level of preparedness for urgent care pandemic patients.

Chronic diseases account for 50-75% of total health care costs and the majority of deaths globally. Current delivery models are poorly constructed to manage these chronic diseases with low adherence to quality indicators and poor control of treatable conditions. These same systems also lack flexibility to adjust to rapid swings in demand such as those imposed by the very acute, complicated COVID-19 patients requiring intensive care for an extended period of time (1-3 weeks). This further compromises the care of chronic disorders such as cardiovascular disease, diabetes, hypertension, and cancers with delays of up to 2-3 months. In some hospital systems around the world, during the acute phase of the pandemic, all elective cardiovascular procedures are put on hold and outpatient clinics for chronic disorders have also been temporarily cancelled. In addition, some emergency rooms report dramatic decreases in general patient visits for strokes, transient ischemic attacks, and acute coronary syndromes. In the United States, early on in the pandemic, federal data documented that non-coronavirus deaths exceeded those attributable to the pandemic by nearly two-fold. Similar trends were observed globally.

Optimal medical systems will need to develop strategies to care for the severely ill, acute care cases but, simultaneously, have approaches to continue treatment for patients with chronic disease. Such strategies will involve early identification of patients, task shifting by nursing para medicals, and pharmacists as well as the foundational use of telemedicine.
Notes to editors

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About PCR

The mission of PCR is to serve the needs of each individual patient by helping the cardiovascular community to share knowledge, experience and practice. PCR offers a wide range of other educational meetings and resources for the continuing education of the interventional cardiovascular community. These include major annual Courses across the globe, e-Learning with high-profile PCR Webinars, Courses specifically dedicated to valvular heart disease, tailor-made PCR Seminars on specific topics, online resources and medical publications such as EuroIntervention, the official journal of the EAPCI.

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