Rochester's fear of coronavirus in the doctor's office has been causing other health problems, local physicians say.
Dr. Michael Mesick of the Rochester Clinic can attest to that.
“There’s a pretty big concern across health care that things were delayed and haven’t caught up yet,” he said. “For example, vaccinations in children."
“We’re worried, especially with the youngsters, they might pick up measles or something else if they don’t get caught up,” Mesick added.
Dr. Randy Hemann, OMC’s chief medical officer and family medicine provider, echoed that concern.
Olmsted Medical Center has noticed a decline in tests performed for preventable diseases such as breast cancer, heart disease, and colon cancer, he said, as well as both childhood and adult vaccinations.
According to a study by the Health Care Cost Institute, “The Impact of COVID-19 on the Use of Preventive Health Care,” mammograms and colonoscopies fell 10% compared to 2019, but the greatest decline has been with childhood immunizations, which are down by nearly a quarter.
At OMC, mammograms and colonoscopies fell by 18% in 2020, and childhood vaccinations fell by 11% over the past year. Adult vaccinations also fell by nearly 20% for influenza and tetanus.
“It is especially important this season that patients do not delay COVID-like respiratory illness vaccinations such as those for the influenza or pneumonia,” Hemann said.
Mesick said it’s perfectly safe to schedule annual checkups and well-child visits, and to go to the emergency room if acute care is needed. He believes some people are avoiding emergency departments, and may suffer as a result.
“I think there was a time when people were avoiding going to the doctor,” he said. “Even speaking for myself, I hesitated going to my doctor. … But what you’ll find is that going to the clinic is very safe. They’re asking everyone to wash their hands and wear masks, they’ve modified exam rooms. Most of the staff has been vaccinated.”
OMC has not recorded a single case of COVID transmission between providers and patients, Hemann added.
Lack of preventive care causes problems
Dr. Shivan Nelson, the dental director of Community Dental Care, has seen a similar decrease in visits, especially for children. And unfortunately, putting off dental care just means more work needs to be done later.
“With children, the enamel on their baby teeth is smaller — a cavity can go from an itty-bitty cavity to a big one much faster,” she said. And because small cavities generally don’t hurt, by the time a patient is aware that there’s a problem, “we’re generally not talking about a filling anymore — the nerves are being affected, and we’re talking about root canals, removals, crowns.”
A six-month delay in a child’s dental care is a problem, while a delay in adult care is slightly less concerning, she said. However, Nelson has seen far more cavities during recent visits — possibly because of those gaps in care, but also because more time at home means more snacking.
“We snack a whole lot more when we’re home, especially children,” she said. “They’re constantly exposing those teeth to carbohydrates, to sugar. … When your kid’s home and they’re wanting to snack, we tell parents to be mindful about what kinds of foods they’re having.”
Dr. Christine Klassen, who works at Mayo Clinic’s Center for Women’s Health and Breast Clinic, said delaying routine cancer screenings more than a few months can have deadly consequences.
“Keeping up with the routine screenings all around are important,” she said.
“I think that we’re noticing, even just with the last year, that we’re having more and more late diagnoses of cancer in the Breast Clinic, and we know that there’s a relationship between early diagnosis and survival,” she said. “If we can find cancer at an earlier stage, there’s a higher chance of survival.”
Dr. Sarah Traxler, chief medical officer for Planned Parenthood's North Central States, said the clinics had walked back some of their preventive care and screening services early in the pandemic. Over the summer, they began inviting patients back, but also ramped up telemedicine visits for at-risk or concerned patients.
Traxler said if a patient has been putting off a screening and feels comfortable coming in to a health center, they should schedule a visit. However, she said virtual appointments can still be helpful for those who weigh the risk of contracting the virus by leaving their homes.
And obviously, if a patient has an active concern, the window for preventive care has passed — it’s now a question of treatment, which should always be sought.
Hemann said that while telemedicine allows providers to stay connected with patients, “it then makes it more difficult to manage patient care since we cannot check blood pressure or obtain a cholesterol or blood sugar test. Therefore, heart disease may be occurring or worsening in some patients who have not been checked.”
Even early in the pandemic, there has been an increase in deaths due to diabetes and heart disease, he said.
“COVID’s going to be around for another six to 12 months, maybe longer,” Klassen said. “We can take safety precautions we know work, like wearing a mask at the office to avoid infection, but at this point, I don’t recommend people delay dental appointments, Pap smears, any sort of routine care.”
- Any outstanding vaccines
- Dental cleanings and checkups
- Routine cancer screenings, especially those that have been put off
- General wellness checkups, especially for patients with blood pressure or diabetes concerns
- Any doctor’s visit for a specific concern