Behind the Mask

Chronic disruption

In our piece about readiness of healthcare systems to wave 2 of the pandemic “Were we ready for round two?” we looked at the impact of the pandemic on healthcare systems overall readiness. In this article, we will focus on the care of long-term patients with chronic conditions to provide some interesting insights into the specific challenges they face.

Early in the pandemic, 62% of patients who responded to our Behind the Mask survey believed that the care they needed for chronic diseases was ‘available’, but only 46% of secondary care physicians were of the same opinion. Later in the year, there was a modest fall in patients’ beliefs that care was ‘open’ (from 62% to 55%), and this time 58% of secondary care physicians agreed. Despite this, even now only 20% of these physicians believe that their patients affected with chronic disease are getting all the care they need – a statistic that is having a significant impact on their teams:

“The teams were feeling very stretched and exhausted in terms of poor decisions at first. Non-clinical management have since learned from those mistakes (particularly around PPE supply), however this was at the detriment of morale. Patient care was affected for non-COVID patients as lists were cancelled and many still are not up and running”

Payer, UK, August 2020

Patients’ trust that the system is there for them has been tempered by experience – the proportion of patients believing that chronic are is ‘mostly available’ vs. not is now almost equal, at 55% to 45%. We have also seen that the more patients have interacted with the healthcare system, the less they believe in their system’s ability to deliver care.

“[I am distressed about the] Lack of capacity at the second wave, so that people who have negligently got infected under certain circumstances may overstretch the health system to such an extent that there is less capacity for the normal chronically ill, and therefore long-term damage is incurred due to waiting times that are too long.”

Patient with Rheumatoid Arthritis, Germany, August 2020

23% of patients believe that there is ‘no significant care’ available for chronic diseases.

Clearly the impact of COVID-19 is far-reaching, extending well beyond those directly affected by the virus itself. The second wave of COVID-19 is on its way, and everyone’s health is on the line – regardless of whether they contract it or not.