Total consultations for emergencies in medical centers fell 74% in April 2020 compared to the same period of the previous year (2019). Every year 100 thousand people die in Argentina due to cardiovascular and encephalovascular diseases, but according to a recent publication of the Cardiovascular Institute of Buenos Aires, we would be at risk of having between 6 thousand and 9 thousand more deaths in 2020 from this cause in 2020.
These data emerged from a investigation carried out by the Association of Clinics, Sanatoriums and Private Hospitals of the Argentine Republic and the Chamber of Outpatient Diagnostic and Treatment Entities (Adecra + Cedim).
As they specified, “thanks to the high adherence of the population to preventive isolation measures and limits to the movement of people, a different scenario has been installed than the one originally planned: health centers with wide availability for emergency care, hospitalization and intensive care, with a low number of infected patients. So far a desirable scenario, but in striking contrast to the marked decrease in consultations, diagnostic studies and therapeutic interventions for non-communicable diseases that cause the highest number of deaths in the country each year: cardiovascular, encephalovascular and cancer“
To collect the data, employed a structured and anonymous survey of 32 institutions associated with general hospitalization and intensive care services, and with the addition of local and international evidence on the benefit of early detection and treatment of major non-communicable conditions: coronary heart disease, stroke (CVA), respiratory and cancer, to assess the risk of prolonged cessation of interventions directed and face-to-face.
Thus they concluded that “it is imperative that we correct course then to avoid increasing complications and deaths from acute and chronic health conditions that receive late or incomplete diagnoses and treatments for fear of contagion by coronavirus. We must not forget that the major causes of morbidity and mortality existed before the epidemic and will continue to exist during the epidemic and when it has ended. ”
The impact of the pandemic on medical treatments
The strong and fast way in which hospital resources were allocated to attend to severe cases of COVID-19 is reflected in the number of consultations and interventions and their impact on the percentage of occupation of hospital beds and intensive care.
Comparing April 2020 with the same month in 2019, practically all indicators fell between 50 and 75%.
Cardiovascular risk is presented as the first alarming figure, perhaps the most worrisome. Why? Every year almost 100,000 people die in our country from cardio and encephalovascular diseases. From Adecra they warn: “If the well-proven detection and treatment activity is not recovered, according to a recent publication by the Cardiovascular Institute of Buenos Aires, we would be at risk of having between 6,000 and 9,000 more deaths than usual from this cause in 2020“
During the last 30 years, extensive research, new treatments, and better information and habits of the population have led to a sustained decrease in cardiovascular mortality. Nearly half of all this positive effect is attributable to the early approach to cardio and encephalovascular problems through the implementation of medications, diagnostic catheterizations, angioplasties, bypass surgeries and other procedures. The 60% drop in the number of coronary angioplasties and bypass surgeries is alarming, since they directly affect the main disease in the western world.
Similarly, that there are 62% fewer hospitalizations for acute coronary symptoms opens the worrying presumption that patients, due to fear of the coronavirus, are suffering from unstable heart attacks and angina at home, exposing themselves to sequelae and risk of death.
Lack of therapeutic control and adjustment for high blood pressure, diabetes, and rapid control of chest pain of cardiac origin are collateral consequences of the pandemic., moving patients away from clinics and health centers. Most of such interventions occur in the outpatient world, in safe settings, and away from critically ill patients admitted to intensive care. We do not know how many people will become sick or die from COVID-19, but we are certain that turning our back on early and regular treatment of cardiovascular disease can only lead to an increase in the annual figure.
According to ADECRA, the prognosis of cardiovascular, encephalovascular, respiratory and cancer diseases is much worse if there is no early diagnosis and intervention..
According to the data they accessed, 97% of the health centers in the sample generated differentiated areas for the care of feverish patients, 100% implemented barriers to the income of the establishments to detect and direct feverish patients, and 100% published posters or screens with COVID safety recommendations -19.
They also noted that the use of barrier measures, isolation codes, and with greater access to reagents has become universal, the confirmation or exclusion times of coronavirus infection have been shortened. The number of feverish patients hospitalized in private centers peaked between the end of March and the beginning of April, and then declined steadily, allowing the separation of affected patients and the staff attending them. By aggregate, less than 20% of patients hospitalized on suspicion of coronavirus infection have tested positive. The associated centers have not detected cross contagion of patients during hospitalization, nor in the outpatient setting.
Delaying cancer care worsens prognosis
Every year 13,000 cases of colon cancer are diagnosed in the country. The combination of laboratory tests with colonoscopy allows early diagnosis and access to early treatment, often in the same study. The fall in the number of studies carried out so far has been 80%, if it is prolonged it will be inevitable that we see a greater number of late diagnoses and a worse prognosis. Practices are almost always ambulatory, they are carried out in specialized rooms or operating rooms with all the barrier measures and personal protection typical of an operating room. They also observed a 16% decrease in chemotherapy treatments, signaling the risk of delays in timely cancer treatment.