The dilemma of the “invisible curve”

Health experts assess the unintended effects of COVID-19.

 

The ongoing threat of coronavirus has forced us all to rethink how we approach personal health, hygiene and even the places we go in our daily lives. But another threat lurks amid the whole pandemic crisis: what is known as “the invisible curve”.

 

In May, CNN en Español reported that many people in Argentina are putting off seeking medical care for other concerns, conditions or sudden situations unrelated to coronavirus, for fear of catching it by visiting a hospital. To make matters worse, we are also battling an “infodemic”, defined as “an overabundance of information – some accurate and some not – that makes it hard for people to find trustworthy sources and reliable guidance when they need it”, according to the World Health Organization. Latin America has become the global epicentre of the virus, with more than 1.5 million COVID-19 cases across the region, including the Caribbean, according to PAHO (Pan American Health Organization).

 

In the Dominican Republic, the Minister of Public Health declared the entire national territory an epidemic zone to control the spread of coronavirus, keeping entertainment and leisure venues such as casinos, nightclubs, cinemas and theatres closed.

 

Leading health institutions in the United States have also flagged this worrying trend and have begun urging patients with serious health conditions to continue their treatment.

 

In a joint opinion piece published in the New York Times, the presidents and CEOs of Cleveland Clinic and Mayo Clinic, Tom Mihaljevic (CC) and Gianrico Farrugia (MC), stressed the impact of this invisible curve and how it could claim lives at a rate similar to coronavirus, which has reportedly claimed more than 100,000 lives in the US. The loss of jobs and the health insurance they provided, together with government stay-at-home orders, have made the situation more severe. The article also points to “considerable declines in new cancer diagnoses (45 per cent) and reports of heart attacks (38 per cent) and strokes (30 per cent)”. They also state that out-of-hospital deaths unrelated to COVID-19 have increased, while hospital mortality has fallen.

 

This crisis has altered the fundamental practice of medicine in a matter of months. In the Dominican Republic, to expand citizens’ support, service and access to information about coronavirus (COVID-19), the Ministry of Public Health launched Aurora MSP, a bot fed and updated by more than 200 professionals, available on WhatsApp, Telegram and Facebook, offering guidance, consultations and telemedicine care on COVID-19.

At Cleveland Clinic, for example, 94 per cent of patients with diabetes were seen virtually in April. Although the shift to “virtual” has also played an important role in navigating the pandemic, telemedicine has obvious limitations. Cleveland Clinic has also committed to maintaining a safe and clean environment in its facilities, while creating a set of protocols for various industries, including healthcare, and working with other industries such as hotels and airlines to help them transition to reopening.

 

“There is no substitute for in-person care for patients with serious illnesses or who need early intervention for life-threatening conditions,” Mihaljevic and Farrugia stress in the opinion piece. “They are the ones who, even in the midst of this pandemic, must seek the care they need.”