Emergency department visits are still down around 30% at Providence's St. Joseph Hospital, and those who are coming in are sicker.
Fewer people have gone to the Orange, Calif.-based hospital over the past year for endoscopies, colonoscopies and other preventative gastrointestinal procedures that can catch early signs of cancer. Symptom severity has increased by about 10% even as ED volumes have dropped, said Glenn Raup, executive director of behavioral health, emergency and observational health at St. Joseph, noting that is a conservative estimate.
More people are coming in with GI bleeding and other serious conditions, which pose grave long-term consequences for both patients and the healthcare system, he said.
"Fear is still continuing to keep people away from their routine or, I would argue, urgent care," Raup said, emphasizing that hospitals and clinics are safe. "You also can't deny the impact COVID has had on employment and the economy."
About 1 in 5 U.S. adults have skipped healthcare over the past year because they couldn't afford it, a new West Health and Gallup survey of 3,753 Americans conducted in mid-February found. Low-income earners were hit the hardest, with 35% relaying that they couldn't pay for care.
"COVID is not the only pandemic—cost is a pandemic," said Tim Lash, chief strategy officer for West Health. "We talk about the toxicity of drugs and side effects of certain interventions, but we rarely talk about the financial toxicity that travels with this expensive system."
The COVID-19 pandemic has exacerbated underlying healthcare inequity and affordability issues.
People of color, who have been disproportionately impacted by COVID-19, have less access to healthcare. While many have had to forgo care prior to the pandemic due to a lack of coverage or high costs, the recession raised those hurdles.
Black adults were almost twice as likely to not be able to afford care compared to white adults, with 29% and 16% reporting cost barriers, respectively. More than 20% of Hispanics wouldn't be able to afford care, according to the survey.