Along with staff and care space concerns, hospital survey respondents reported that healthcare equipment was also challenged. Access to COVID-19 testing was one concern, with only 35% of respondents reporting availability for all patients at the beginning of the pandemic, and 56% reporting availability for only select patients based on symptom severity. 1 Access to personal protective equipment (PPE) was also affected, with PPE always available according to 83% to 95% of respondents but just 35% having access to N95 masks. 1 Additionally, 26% reported that there were no respirators in their hospital, and 11% reported limited ventilators. 1
Although resource depletion is a problem, studies have looked at public health measures that helped to mitigate this issue. With proper public health planning and implementation, such as physical distancing, aggressive testing, contact tracing, and increased hospital capacity, by freeing up existing resources or adding additional support, public health modeling showed that resources may be able to withstand the increase. 13 Development of reallocation models at local, state, national, and international levels is an important step to be able to deal with future public health crises. 14
The long-term impact from the pandemic includes disruption in the physical environment of healthcare, production, supply chain, staff structure, and workforce alterations. 4 For example, the physical shape of healthcare facilities is changing to accommodate increasing volumes and decrease the risk of spreading disease. 4 To accommodate the burden on staffing structure and workforce alteration, telehealth gained a prominent role. 4 All in all, the pandemic has changed the healthcare system; however, institutions, organizations, and policy makers need to evaluate which measures were impactful and should be considered for long-term inclusion in healthcare practice.
Impact on Other Diseases: Cancer, Heart Disease, Chronic Illnesses, and Other Viruses
The treatment of other new and existing conditions has also been affected by the pandemic. Cancer, especially, is a disease of concern. Elective surgeries and screening were halted or altered during the pandemic, which is modeled to lead to higher cancer mortality in years to come. 2 The most affected cancers were breast, lung, and colorectal cancer. 2 A study of colorectal cancer screening showed that colonoscopies were delayed due to COVID-19 and that gastroenterology visits declined by 49% to 61%. 15 This will likely lead to delayed cancer diagnoses and possible increases in mortality. 15 Breast cancer screening was also delayed and many patients continued to avoid it for various reasons such as fears of contracting COVID-19 infection in healthcare facilities, and the economic effects of the pandemic such as job loss and healthcare coverage loss. 16 These delays will result in an estimated potential 0.52% overall increase in breast cancer deaths by 2030. 17
A study of 368 patients from Spain showed a 56.5% decrease in hospital admissions, usually related to heart attacks, in March and April of 2020, compared to January and February 2020. 18,19 For other chronic illnesses, the pandemic resulted in decreased preventative care and management. 20 The care of other infections similarly suffered. The World Health Organization announced that the number of patients receiving treatment for tuberculosis (TB) dropped by 1 million, setting the disease mitigation back considerably. 20 An estimated 500,000 more people died in 2020 from TB. 21 The drastic shift in focus to COVID-19 care during this period will continue to have a profound impact on other diseases like these for many years post-pandemic.