From rotten teeth to advanced cancer, people are feeling effects of pandemic treatment delays

With medical visits picking up now that people are getting vaccinated against COVID-19, health providers are starting to see the consequences of a year of pandemic-delayed preventive and emergency care.

They are finding more advanced cancer and rotting and damaged teeth, among other ailments.

Dr. Brian Rah, who chairs the cardiology department at Montana’s Billings Clinic, says he was confused in the early days of the pandemic about why there was a sudden drop in heart attack patients being seen. And why did some who did come arrive hours after feeling chest pains?

Two patients, both of whom suffered greater heart damage by delaying care, provided what came to be typical answers. One was afraid of contracting COVID at the hospital. The other went to the emergency room in the morning, left after finding it crowded, then returned that night when he figured there would be fewer people.

“For a heart attack patient, the first hour is known as the golden hour,” Rah said, after which the likelihood of death or lifelong health consequences grows.

Dr. JP Valin, executive vice president and chief clinical officer at SCL Health of Colorado and Montana, says he’s “kept awake at night” by delays for medical tests.

“People put off routine breast examinations, and there are going to be some cancers hiding that are not going to be identified, potentially delaying intervention,” Valin says.

He also worries that people aren’t seeking timely treatment for appendicitis symptoms like abdominal pain, fever and nausea. A burst appendix generally involves more risk and a week’s hospitalization, instead of a day of treatment for those who get care quickly, he says.

Dr. Fola May, a gastroenterologist who is quality director and a health equity researcher at UCLA Health, worries about the consequences of an 80% to 90% drop in colonoscopies by the health system’s doctors the first months of the pandemic.

“All of a sudden, we were downplaying health measures that are usually high-priority — such as trying to prevent diseases like cancer — to manage the pandemic,” May says.

Many people will be coming out of the pandemic with teeth worn down from grinding, back problems from slouching at makeshift home-work stations and mental health problems from isolation — or being too close to family.

Dr. Despina Markogiannakis, a dentist in Chevy Chase, Maryland, says her patients don’t argue when she tells them they’ve been grinding or clenching their teeth and might need a root canal, dental implant or night guard.

“These are people stuck at home all day and feeling lonely and feeling a little depression,” Markogiannakis says. “It is induced by the world we live in and all the changes in our lives.”

A recent American Dental Association survey found more than 70% of its members saw an increase in patients grinding or clenching their teeth during the pandemic. More than 60% reported an increase in other stress-related conditions, like chipped and cracked teeth.

Dr. Gerard Mosby, a Detroit pediatrician, finds his young patients are suffering more stress, depression and weight gain. Many live in multigenerational homes or foster homes or have experienced COVID illnesses or death among family.

“Since their ability to get out is limited, they can’t vent to friends or other family members,” Mosby says. “Most will not have access to mental health for grief counseling.”

Nancy Karim, a Bridgeport, Connecticut, licensed professional counselor and art therapist, says that some patients are stressed by living too closely with people without breaks on work and school days.

Matthew Jones, an Arkansas optometrist, says some patients stopped taking drops for conditions like glaucoma. He’s also seeing more eyestrain “because people are spending so much time in front of a computer screen.”

Physical therapy needs are also on the rise.

“Patients that have transitioned to remote work are typically working with poor ergonomic set-ups and spending a lot more time sitting,” says Kaylee Smith, president of Smith Physical Therapy and Performance Studio in San Diego.

“I am seeing more pain and injuries related to poor posture,” Smith says, including neck pain and low back pain, “and a significant increase in patients coming in with tight hips related to increased sitting time.”

Some healthcare providers says they’re finally nearing pre-COVID patient levels, but some not so much.

“Although we have seen an improvement over the past six weeks, it’s still not much,” says Neville Gupta of Gupta Gastro in Brooklyn and Far Rockaway, New York. “Our patients are still avoiding getting the care they need, no matter the safety precautions in place.”

Kaiser Health News is an independent newsroom providing coverage on health issues.