While the direct effects of the COVID-19 pandemic have been substantial, including infections, hospitalizations and deaths, the indirect effects are no less significant.
The pandemic has disrupted work and social routines as well as personal habits in ways that have had broad societal impacts, including economic, occupational and educational impacts, just to name a few. Yet, the indirect effects of the COVID-19 pandemic on health behaviors and health outcomes have been among the most concerning.
To begin with, for the past two years COVID-19 has consumed a substantial amount of the bandwidth of our health and public health infrastructure. In some instances, such as during variant-driven surges, it has overwhelmed resources. In normal times, we rely on the continuous availability of medical and surgical facilities, services and providers to address the common acute and chronic health needs of our communities. But during COVID-19, elective procedures have often been delayed or postponed, routine care has been less accessible or less sought-after and urgent conditions have been managed in the context of the pandemic.
This often-necessary shift in health care priorities has had unintended consequences with undesirable results. People with chronic health conditions may have experienced fewer episodes of direct care, with the resulting loss of potential opportunities to prevent avoidable complications. Childhood immunization rates for common vaccine-preventable illnesses, such as measles, whooping cough and meningitis, have fallen during the pandemic, raising the risk of preventable non-COVID-19 outbreaks of infectious disease.
Mental health has suffered during the pandemic as well. For many, social distancing has led to social isolation. Grief resulting from the loss of loved ones has been a substantial challenge, especially among children who have lost parents and other caregivers. Social support networks in the workplace and community have been disrupted. Financial and health-related hardships have contributed to the general stressors imposed by the pandemic. Children may have experienced missed opportunities for academic, developmental and social growth.
This has led to increases in rates of anxiety and depression. The pandemic has seen a substantial rise in the misuse and abuse of substances. It has magnified the severity of the opioid epidemic, with a spike in overdose-related deaths. Alcohol use has increased across a wide spectrum of age and gender demographics.
There is no question that recovery from the pandemic, which continues to affect our communities directly, will depend on our ability to recognize and address the indirect health and public health impacts of COVID-19. It will require a renewed focus on access to routine health care, such as chronic care management, immunizations and mental health services, which we cannot afford to neglect.
Working together, people, families, communities and health care staff members can promote recovery from the pandemic. Even as we strive to manage the SARS-CoV-2 virus through public health measures, vaccinations and emerging medications, we must also strive now to address its indirect effects to promote health and well-being.
Dr. Matthew A. Clark, a board-certified physician in internal medicine and pediatrics, works for the Indian Health Service.
