Throughout the COVID-19 pandemic, many have experienced delays in routine health care. For some, this was a precautionary choice. For others, it was due to a lack of available health care services and resources, something that Hampton, N.H. resident Angelina Ferarri knows all too well. 

In 2018, Angelina was injured in a car accident while living in Australia. As a result, she suffers from Thoracic Outlet Syndrome (TOS), which occurs when blood vessels or nerves in the thoracic area are compressed. 

“My arm goes numb quite often,” she says. “I also experience significant pain in my neck area, making it difficult to complete day-to-day tasks.”

In early 2020, hospitals became overwhelmed by COVID-19 patients.

Angelina began seeking treatment once she returned to the United States in November 2019. However, just a few months into her treatment, the pandemic caused delays in her health care plan. “I was just at the beginning of figuring out what kind of treatments I needed and what options were available,” she says. “At the beginning of the pandemic, my chiropractor, physical therapist, and massage therapist were closed for at least a month or more, so I needed to dial everything back.” 

Angelina points out that because her condition requires manual therapies, it was difficult to manage her pain at home. “The timing of my appointments is critical for managing pain. By the time things started to open back up, I was experiencing so much more pain because my normal treatment schedule was thrown off.”  

Angelina also works in health care, which caused even more delays in care when she either had COVID-19 or was exposed at work and needed to self-isolate. “If you count all of these instances, that was another delay in care that I had to experience, even when other places were beginning to open back up.” 

While delaying medical care was necessary to prevent the spread of infection at the start of the pandemic, two years later, we are seeing how these gaps in treatment are impacting patients’ health. When preventative and other forms of non-urgent care are put on hold, it can cause health issues to worsen, and severe health issues like cancer to go undetected and untreated. In fact, breast and colorectal cancer diagnoses are projected to increase year over year until 2030. 

Delaying medical care has only exacerbated the inequities of the health care system, and it is likely that we will continue to feel the impacts even when the pandemic is over. 

What is limiting health care access?

Approximately one in five American households ​​have been unable to get medical care, and while the circumstances vary, staffing shortages and public health restrictions are contributors. 

Staffing shortages had, and continue to have, an impact on treatment availability.

Hospitals that reached full capacity during the pandemic needed to turn away non-COVID patients. Even if hospitals had open beds, staffing shortages had, and continue to have, an impact on treatment availability. It is projected that by 2034, there will be a shortage of 17,800 to 48,000 primary care physicians. Rationing care is no health care worker’s ideal choice, but the lack of staff is making it necessary to prioritize some cases over others. 

While hospitals prioritized COVID-19 patients, many physicians were forced to be selective in what outpatient services they provided, whether that be elective surgeries or routine checkups. And surges in cases due to new variants circulating within communities have made this a continuous problem. 

As more physicians opted in to provide medical attention to those in the greatest need, the revenue from elective surgeries began to dwindle — health care spending fell as low as 54.1% during 2020 — which contributed to layoffs and a further decrease in hospital workers.

What is holding people back from getting treatment?

Health care facilities wonder whether in-patient visits will rebound as COVID-19 wanes.

A big question in health care is whether or not in-patient visits will rebound. While outpatient visits via telehealth have declined since the early months of the pandemic, they continue to remain elevated even as more people return to in-person appointments. 

However, with COVID-19 still prevalent, some of us may still have reservations about returning to the doctor’s office. Some are avoiding in-person medical appointments in an effort to continue social distancing and quarantining. Others may even be anxious to hear the results of procedures and tests, like mammograms and colonoscopies, that they have pushed off the past two years.

Angelina says that she was eager to get her surgery done as soon as possible. Her surgery was scheduled for January 2022. However, after coming down with COVID-19, her scheduled surgery needed to get put off. “While I expected the wait to be longer, I actually got in within a month because of so many other cancellations,” she says.

Not only are people avoiding in-person visits because of COVID-19, but other implications are hindering them from receiving the care that they need.

In 2021, 29% of individuals reported not taking their medicines as prescribed at some point because of the cost, and other Americans — especially Black, Hispanic, and low-income individuals — are skipping or delaying medical care due to cost. The lack of food and housing security will also continuously force some to ignore their health needs in an effort to mitigate costs. For Angelina, she didn’t have health insurance in Australia and because cost was a factor, she needed to wait until she moved back to the U.S. to receive the level of care that was needed for her chronic pain. 

Delays in care can have a severe impact, especially if there isn’t access to necessary resources. For example, even when schools were forced to move to a virtual model, students that required extra support or attention missed critical services, which can regress development and impact behavioral health.

What ways can we be more proactive about our overall health and well-being?

Overall, a lack of regimented and preventative care could have a severe impact down the line. However, there are various ways to proactively take control of your health: 

• Connect with your primary care provider. While you may be hesitant to go see them in person, primary care providers want to hear from you. Talking to your primary care provider will provide a better idea of what care plan makes the most sense for you. Give them a call to figure out what COVID-19 preventative measures they are taking, such as reduced waiting room capacity, and what services are available to you. If you are having trouble getting an appointment for a certain test or have concerns about cost, your provider can work with you to figure out the best options.

For those concerned about visiting in person, telehealth remains an option in many cases.

• Explore different care and support options. Telehealth is one of the most accessible digital tools individuals can lean on during the pandemic for many of their health care needs. Services through Harvard Pilgrim and Tufts Health Plan, like Doctor on Demand and Teledoc, allow patients to have continuous access to providers regardless of their location. Talkspace gives members virtual access to licensed therapists in their state via private messaging or live video, and Happify provides cognitive behavioral therapy and gives users access to evidence-based activities that can help reduce symptoms of depression and anxiety. While not a permanent fix, telemedicine is a convenient way to access care and also alleviates the risk of being exposed to COVID-19 and other illnesses. 

• Know what health screenings to get when. It’s important to familiarize yourself with the tests needed to monitor your health. Regular health screenings, like cancer screenings, are critical to detecting diseases and preventing serious health problems. Most screenings are covered by insurance, so make sure that you are getting the proper health screenings at the right time. 

Angelina strongly encourages everyone to get back on track with their regular appointments. “I saw how much of an impact it was to my health when my appointment schedule was thrown off, and I can say that I’m not alone,” she says. “Had I sought medical attention earlier on, my condition likely would have been a lot less painful. Always prioritize your health care, as you want to address any existing or new problems or conditions sooner rather than later.”

Harvard Pilgrim Health Care and Tufts Health Plan, as part of Point32Health’s family of companies, are committed to enhancing access to equitable care — physical and mental — for all their members, and for communities throughout New England. Learn more about Point32Health.