Behind the Mask

COVID-19 – what’s to worry about?

As part of Behind the Mask, many different stakeholders were asked about their healthcare systems, as well their main concerns relating to COVID-19.

In the latest survey of 210 respondents, only three* reported no fears at all. Others described 335 individual concerns, categorised into three similarly sized domains:

As shown above, 29% of participants reported concerns over health and the knock-on effect of COVID-19 disruption on healthcare outcomes, 30% reported macro-level concerns about people’s behaviour, the future and the economy, and a further 30% reported concerns about their healthcare system and its infrastructure.

Although concerns varied widely, reflecting the ways in which this unique situation has impacted us individually, one dominant concern emerged in each of the three domains.

Concerns over health and outcomes

Due to a knock-on effect of COVID-19, concerns over reduced healthcare capacity were twofold – not only were participants worried about reduction in the actual number of appointments, but also the subsequent detrimental impact on outcomes.

[I am distressed about the] possibility of healthcare collapsing not due to corona, but because of building up already long waiting lists and time for elective procedures and admission, and delayed diagnosis after onset of symptoms. There is already an increasing incidence of diagnosed carcinomas with delayed treatment of in-hospital patients due to coronavirus hospital policy, lack of staff and creating safe and non-infective corridors.

Cardiologist, UK 

Macro-level concerns

Among the macro-level issues, it was found that ‘people not playing their part and obeying the rules’ was seen as a major problem – a suspicion cited twice as often as any other concern.

“People not following CDC guidelines. Many people are choosing to let their guard down especially in areas where we have recovered. For instance I live in NY and people are wearing masks less and less”

Patient with Rheumatoid Arthritis, USA

“The infection numbers that are increasing again, the increasing recklessness of the population is causing me most distress”

PCP, Germany

Concerns over systems and infrastructure

Interestingly, concerns over systems and infrastructure were not dominated by the effects of the virus, but by pre-existing concerns about the system itself – bringing to light that even the most ‘sophisticated’ healthcare systems had been challenged long before the pandemic.

Open quotation marks (black)

I am concerned about the lack of physician independence, a ridiculous amount of oversight from administrators who do not practice/have never practiced medicine and the loss of the art of medicine to an overabundance of protocols and algorithms

Cardiologist, USA

Close quotation marks (black)

“Bureaucracy, bad procedures, inefficiency in hospitals.”

PCP, Germany

One third of unprompted overall responses related to the impending health crisis caused by healthcare systems operating below capacity – a finding especially pronounced among healthcare professionals, with only Germany bucking the trend.

And while concerns over the length of time a vaccine will take to develop and how prepared the systems are for subsequent waves topped their groups, capacity and its effects came a very close second in both cases .

Ordinarily, protests might be expected, with people around the world demanding action. But despite public campaigns, people are still understandably nervous about healthcare settings – seeing them not as places to get well, but as hotspots to contract the virus.

of patients feel unsafe going to a hospital.

feel extremely unsafe.

do not want to attend any physician office.

While we must reinforce that seeking care has more benefit than risk, perhaps our greatest pre-occupation should be reforming every step of the healthcare system as it returns to capacity.

*  A German patient, a German Pulmonologist and a Neurologist from the UK.

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