Two years into the worst global pandemic in 100 years, it seems that Covid-19 is on a downswing to endemic status in the U.S. Its aftershocks are still with us, however, and will be for some time.
Our data on more than 67,000 insured individuals across the tristate area indicates that as the incidence of new Covid-19 cases fell, people resumed going to the doctor’s office and hospital. Preventive-care visits have increased 14% in the past year, nearly erasing the 16% decline that occurred in 2020. Emergency-room visits have increased as well—rising by 30% to nearly recover the 31% drop we saw in 2020.
Both those numbers are good signs, especially for patients with chronic and high-risk conditions such as heart disease, diabetes and cancer.
We know those individuals weren’t any less sick during the past two years. They just were not inclined to seek care in person while Covid-19 was raging.
Although the data shows those patients are back, they appear to be sicker.
Risk scores, which reflect the diagnoses submitted by primary-care physicians for preventive visits, have increased and in fact have surpassed pre-Covid levels. Simultaneously, hospital admissions and inpatient lengths of stay have increased—reaching more than double their prepandemic levels.
We suspect that the higher risk scores, increased admissions and longer hospital stays reflect further progression of chronic diseases that were left unmanaged during the pandemic and now require greater effort and resources to treat.
Sicker patients contribute to a much higher ICU rate and consequently a higher average length of stay.
As preventive-care visits climb and patients get the support they need, we hope to see the risk scores fall and hospital stays drop to steady levels.
At the same time, we must recognize that symptoms of “long Covid” are manifesting in 10% to 22% of infected patients, according to national data.
Many of those individuals are experiencing fatigue, breathlessness, cough, chest pain, palpitations, muscle pain, joint pain, headache, insomnia and “brain fog” that can last for months.
Research also indicates some individuals infected with Covid-19 develop long term mental health issues such as anxiety disorders, depression, sleep disorders and cognitive decline. Our data shows admissions for psychoses are up 35% from before the pandemic.
Meanwhile, recent studies are indicating an increased risk of stroke or heart failure within a year of a Covid-19 infection.
All of us in the health care community should be encouraging the return to preventive care and ensuring every insured individual receives a comprehensive annual wellness ex.am. The exams can serve as a re-entry to routine health care and encourage a return to relevant screenings, such as exams for breast and colon cancer-which fell sharply during the pandemic.
Staying up to date on preventive care, chronic condition management and mental health concerns will be critical to mitigating the potentially long lingering effects of the pandemic.
Dr. Nancy K. Klotz is chief medical officer at Brighton Health Plan Solutions
