Large numbers of people with chronic medical conditions put off seeing a doctor during the various waves of the epidemic in Belgium, according to figures from the Independent Health Funds.
During the first wave, in March-April 2020, the number of physical consultations fell by 27% in March compared to the same period in 2019, before the pandemic. Then in April the numbers plummeted by a massive 63%.
The following month, in May 2020, the comparison with 2020 showed a deficit of 39%.
The problem with the chronically ill involves various aspects. In many cases, hospitals were simply overrun by Covid cases and there were no specialists available for certain conditions. Appointments with specialists make up the lion’s share of the missed consultations, rather than GPs.
In addition, people with chronic illnesses are wary of any outing where there are many people, and a hospital where lots of patients are waiting for a few appointments can be seen as a dangerous place in a time of pandemic. For good reasons or bad, those people prefer to delay a consultation rather than take the risk.
In the spring of 2020, of course, even those with chronic conditions were still not being vaccinated.
From mid-March, the medical insurers decided to reimburse consultations by telephone or online, which accounted for a recovery of around half of those appointments lost earlier in the wave. However not all situations can be dealt with by these means, and older people in particular (including doctors) may not be ready for online consultations.
More worrying was the fall in hospital admissions among this group of long-term patients. In March the number of admissions – even for one overnight stay – fell by 22%, and in April and May by 49% and 37% respectively.
Those admissions – usually described as ‘for observation’ – are crucially important for medical staff to take stock of a patient’s condition over a period of time, something that cannot be done during a 20-minute consultation. But when beds are not available, the urgent Covid cases take precedence.
But according to the health funds, even urgent admissions, for reasons such as stroke or heart problems, were also affected by the pandemic. In both waves, emergency admissions not related to Covid were 25% down compared to 2019 – and not because the population was more healthy.
One positive aspect of the pandemic: the number of flu vaccines delivered in the last trimester of 2020 went up by 33% compared to 2019.