The other account of the corona care: ‘Because of delayed care, 100 to 400 thousand years of life were lost’

21/05/2020

The other account of the corona care: 'Because of delayed care, 100 to 400 thousand years of life were lost'

Hospital care for Covid patients has saved many human lives, but the loss of life years in other patients is much greater. As a result, at least 10 thousand people will die on average ten years earlier in the Netherlands alone.

In recent months, many patients have shunned the hospital out of ‘corona anxiety’ and have postponed surgeries and treatments. The consequences were mapped out by consultancy firm Gupta,  in a report  (Dutch Version) published Thursday.

“For every death from covid-19, there are far more deaths from the postponement of regular care,” the report said, citing “unprecedented, disproportionate damage.” Only births were not restrained, but all hospital departments were further affected by the corona care, the analysis shows. For example, in cardiology departments the number of patients under treatment decreased by an average of 29 percent in three months, 28 percent in surgery, and 24 percent in neurology departments.

They are scenarios, warns health economist and emeritus professor Guus Schrijvers, not involved in the report. ‘You can only find out whether those predictions are correct by comparing the amount of care that has been given to patients per hospital in recent months with the same period in recent years. And by following the patients who have not received care. There are probably also those for whom this had no consequences. “

Growing concern

Yet the calculations do illustrate the growing concern of many physicians about the effects of corona on the rest of health care, Schrijvers also acknowledges. “There is something going on, of course, and we should take that seriously.”

GPs have seen up to 70 percent fewer patients during their office hours in recent months, cardiologists told local news paper  early last month  that heart patients stayed away from the hospital en mass. Fear of infection played a role, as did the modesty of patients who believed that their complaints could wait a while. In addition, operations were canceled, scans postponed and transplants canceled. Cancer screening also came to a standstill, the  number of cancer diagnoses  fell by 30 percent in a few months.

The reservoir of delayed care is so great that not all patients will be able to return to it in the coming months. The  delay will result, according to the Gupta report a loss of 100 to 400 thousand years of healthy life, a factor of ten higher than the profit returned to life who care for patients corona.

Face

“I am shocked by the results,” says Rudi Westendorp, professor of geriatric medicine in Copenhagen. “They give a face to many doctors’ concerns.”

That doesn’t mean the lockdown of the past few months has been wrong, he emphasizes. “We were dealing with an unknown disease, a sensible and brave policy has been pursued. But now that the overwhelming epidemic has passed, we have to ask ourselves: what further? The horse remedy we administered to the patient has worked, but the side effects are enormous. The consequences are disproportionate. If we get society going again, there will undoubtedly be new infections. Are we going to do it the same way again? “

The report aims to give that question more urgency, says Gupta researcher Daan Livestro, one of the authors. “A second corona wave is not out of the question, and then we will have to choose, to make trade-offs that have hitherto not been discussed. We will soon not be able to largely stop regular care again. That costs too many human lives. “

The report lists a number of ideas, such as stricter selection of patients to be admitted and concentrating covid19 care in a few hospitals.

NETHERLANDS WEATHER