The pandemic hit hard in early 2020. So hard that it felt like the entire world was collapsing: countries were shutting down, stock markets were plummeting and people were running scared. Healthcare systems were in crisis management mode. All hands were on deck to fight the virus; its spread and damages. Capacity-building and mitigating measures were critical to achieve success and, as a result, the regular healthcare system was slowed down. Surgeries, outpatient clinics, screening tests and the like were put on hold or reduced to a bare minimum in order to only maintain the most necessary – life essential – procedures. Everything else gave way to the pandemic fight. Of course, it was the right, if not the only, thing to do. But did we miss something all while doing so?
In British Columbia, it was estimated that around 200 critical cancer cases were not detected per month because of pandemic-related suspended screening activities. In Quebec, it was recently announced that it will take at least two years to catch up with the surgical backlog that resulted from reduced surgical productivity. There is also increasing evidence of severe illnesses that have been discovered too late as people feared going to the emergency room or to their local clinic in order to consult during the pandemic. As the crisis is slowly but surely giving way to a post-pandemic resumption of life, all societies take stock of the damage done and discover that not only the covid-19 crisis had severe direct consequences but also that it left significant collateral damage in its wake that may take years to overcome.
The disruption of the worldwide supply chain is a good example of pandemic-related collateral damage. The undetected and/or unattended illnesses as well as the exacerbated healthcare backlogs are other obvious examples of pandemic-induced collateral damage. In Ontario, doctors have estimated the backlog at 16 million medical procedures of all kinds. It will take a while for health systems to catch up and get back to a fully functional state of affairs. But with time and dedication, it will happen.
However, it may never be possible to get the full picture of all collateral damage that have been generated by the pandemic regarding people’s health. The lack of complete data on pandemic-induced collateral damage may prevent us from answering the question: Was the pandemic more damaging directly or indirectly? It would be useful to answer that question in order to (re)calibrate our systems to avoid the worst should we face another pandemic-like crisis. Did we strike a balance in our response?
Of course, some backlog-related statistics are readily available and more data will be collected, as we resume life, to better understand the pandemic impact on the health of populations. However, it will be difficult to determine precisely the depth of that pandemic impact. Many cases just flew under the radar and continue to do so as they are not easily captured in statistics. We can only estimate how many people died of cancer, heart conditions or other undiagnosed and untreated life-threatening illnesses. In addition, there are numerous health-related issues that may have been exacerbated, due to reduced capacity to detect or treat, without necessarily triggering death such as for chronic health conditions or mental health. The pandemic has left quite a legacy for us to deal with…
As we take stock of what the pandemic left behind for us to fix, we would be remiss not to consider all health-related collateral damage that it generated. The pandemic will be remembered for the obvious dramatic consequences it directly caused such as the close to seven million deaths around the world. But we also need to acknowledge that its impact runs much deeper than the direct consequences. We may never get the full picture of what that means in terms of statistics but the pandemic revealed many challenges in our health systems. These challenges may be best seen as opportunities to improve our systems. Digging deeper would certainly yield great ideas for improvements. What are your thoughts on this? Do you see opportunities based on what the pandemic revealed? Write to me with your opinions and ideas at blogbenoitmorin@gmail.com. They will certainly be insightful and will fuel future articles…
In the meantime, may you be well, may you be happy.
B.