Delay or avoidance of medical care because of COVID-19–related concerns—United States, June 2020.
Open accessAbstract
versus those without disabilities (aPR = 1.3). Given this widespread reporting of medical care avoidance because of COVID-19 concerns, especially among persons at increased risk for severe COVID-19, urgent efforts are warranted to ensure delivery of services that, if deferred, could result in patient harm. Even during the COVID-19 pandemic, persons experiencing a medical emergency should seek and be provided care without delay (3).
AI snapshot
Written from the paper’s full text.
TL;DR
In a nationwide web-based survey conducted June 24–30, 2020, 40.9% of U.S. adults reported delaying or avoiding medical care because of COVID-19 concerns, including 12.0% for urgent or emergency care and 31.5% for routine care. Avoidance was higher among unpaid caregivers for adults, persons with multiple underlying medical conditions, Black and Hispanic adults, young adults, and persons with disabilities.
Key findings
- Overall, 40.9% of 4,975 respondents reported delaying or avoiding any medical care because of COVID-19 concerns; 12.0% avoided urgent or emergency care and 31.5% avoided routine care.
- Adjusted prevalence ratios for urgent or emergency care avoidance were significantly higher among unpaid caregivers for adults versus noncaregivers (aPR = 2.9), persons with two or more selected underlying medical conditions versus none (aPR = 1.9), insured versus uninsured persons (aPR = 1.8), non-Hispanic Black adults (aPR = 1.6) and Hispanic adults (aPR = 1.5) versus non-Hispanic White adults, adults aged 18–24 versus 25–44 years (aPR = 1.5), and persons with disabilities versus without (aPR = 1.3).
- Groups with urgent or emergency care avoidance exceeding 20% and any care avoidance exceeding 50% included adults aged 18–24 years (30.9%; 57.2%), unpaid caregivers for adults (29.8%; 64.3%), Hispanic adults (24.6%; 55.5%), persons with disabilities (22.8%; 60.3%), persons with two or more selected underlying medical conditions (22.7%; 54.7%), and students (22.7%; 50.3%).
- In adjusted models for any care avoidance, unpaid caregiver status (aPR = 1.64), having health insurance (aPR = 1.61), disability (aPR = 1.33), believing oneself to be at high risk for severe COVID-19 (aPR = 1.33), and having two or more underlying conditions (aPR = 1.31) were significantly associated with greater avoidance.
Methods
- A web-based survey was administered by Qualtrics, LLC, during June 24–30, 2020, to a nationwide sample of U.S. adults aged ≥18 years; 5,412 (54.7%) of 9,896 eligible adults completed surveys, and 4,975 (91.9%) provided complete data for this analysis.
- Quota sampling and survey weighting were used to improve representativeness of the U.S. population by gender, age, and race/ethnicity.
- Delay or avoidance was assessed for emergency, urgent, and routine medical care; urgent and emergency responses were combined for analysis. Multivariable Poisson regression models with robust standard errors estimated adjusted prevalence ratios, 95% CIs, and p-values (α = 0.05).
Limitations
- Stated in the paper: self-reported data are subject to recall, response, and social desirability biases; the survey did not assess reasons for avoidance, baseline care-seeking patterns, or timing/duration of avoidance; perceptions of whether a condition was life-threatening might vary; and the web-based survey might not be fully representative for income, educational attainment, and access to technology.
- Evident from the text: the cross-sectional design cannot establish temporality or causality between COVID-19 concerns and care delay/avoidance.
- Evident from the text: urgent and emergency care responses were combined because respondents might interpret “life-threatening” differently, limiting separate estimates for emergency versus urgent care.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
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- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
An estimated 12.0% of U.S. adults avoided urgent or emergency medical care during the pandemic because of concerns about COVID-19.
“Overall, an estimated 40.9% of U.S. adults have avoided medical care during the pandemic because of concerns about COVID-19, including 12.0% who avoided urgent or emergency care and 31.5% who avoided routine care.”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“As of June 30, 2020, among 4,975 U.S. adult respondents, 40.9% reported having delayed or avoided any medical care, including urgent or emergency care (12.0%) and routine care (31.5%), because of concerns about COVID-19 (Table 1).”
Quote in the paperSubstantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
The estimated prevalence of urgent or emergency care avoidance was significantly higher among unpaid caregivers for adults than among noncaregivers (aPR = 2.9; 95% CI = 2.3-3.6).
“unpaid caregivers for adults* versus noncaregivers (adjusted prevalence ratio [aPR] = 2.9)”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“unpaid caregivers for adults versus noncaregivers (2.9; 2.3–3.6)”
Quote in the paperSubstantial claim - Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
The estimated prevalence of urgent or emergency care avoidance was significantly higher among non-Hispanic Black adults than among non-Hispanic White adults (aPR = 1.6; 95% CI = 1.3-2.1).
“non-Hispanic Black (Black) adults (aPR = 1.6)”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“Black adults (1.6; 1.3–2.1)”
Quote in the paperSubstantial claim - Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
The estimated prevalence of urgent or emergency care avoidance was significantly higher among persons with health insurance than among those without health insurance (aPR = 1.8; 95% CI = 1.2-2.8).
“persons with health insurance versus those without health insurance (aPR = 1.8)”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“persons with health insurance versus those without health insurance (1.8; 1.2–2.8)”
Quote in the paperSubstantial claim - Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
An estimated 40.9% of U.S. adults avoided any medical care during the pandemic because of concerns about COVID-19.
“Overall, an estimated 40.9% of U.S. adults have avoided medical care during the pandemic because of concerns about COVID-19, including 12.0% who avoided urgent or emergency care and 31.5% who avoided routine care.”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“As of June 30, 2020, among 4,975 U.S. adult respondents, 40.9% reported having delayed or avoided any medical care, including urgent or emergency care (12.0%) and routine care (31.5%), because of concerns about COVID-19 (Table 1).”
Quote in the paperSubstantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
The estimated prevalence of urgent or emergency care avoidance was significantly higher among persons with two or more selected underlying medical conditions than among those without those conditions (aPR = 1.9; 95% CI = 1.5-2.4).
“persons with two or more selected underlying medical conditions† versus those without those conditions (aPR = 1.9)”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“persons with two or more selected underlying medical conditions versus those without those conditions (1.9; 1.5–2.4)”
Quote in the paperSubstantial claim - Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
An estimated 31.5% of U.S. adults avoided routine medical care during the pandemic because of concerns about COVID-19.
“Overall, an estimated 40.9% of U.S. adults have avoided medical care during the pandemic because of concerns about COVID-19, including 12.0% who avoided urgent or emergency care and 31.5% who avoided routine care.”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“As of June 30, 2020, among 4,975 U.S. adult respondents, 40.9% reported having delayed or avoided any medical care, including urgent or emergency care (12.0%) and routine care (31.5%), because of concerns about COVID-19 (Table 1).”
Quote in the paperSubstantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, any care avoidance was 60.3% for persons with disabilities.
“persons with disabilities (22.8%; 60.3%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
The estimated prevalence of urgent or emergency care avoidance was significantly higher among persons with disabilities than among those without disabilities (aPR = 1.3; 95% CI = 1.1-1.5).
“persons with disabilities§ versus those without disabilities (aPR = 1.3)”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“persons with disabilities versus those without disabilities (1.3; 1.1–1.5)”
Quote in the paperSubstantial claim - Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingreasoning
Avoidance of both urgent or emergency and routine medical care because of COVID-19 concerns was highly prevalent among unpaid caregivers for adults, respondents with two or more underlying medical conditions, and persons with disabilities.
“Avoidance of both urgent or emergency and routine medical care because of COVID-19 concerns was highly prevalent among unpaid caregivers for adults, respondents with two or more underlying medical conditions, and persons with disabilities.”
Quote in the paperSubstantial claim - Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, any care avoidance was 54.7% for persons with two or more selected underlying medical conditions.
“persons with two or more selected underlying medical conditions (22.7%; 54.7%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, urgent or emergency care avoidance was 30.9% for adults aged 18-24 years.
“adults aged 18–24 years (30.9% for urgent or emergency care; 57.2% for any care)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, any care avoidance was 57.2% for adults aged 18-24 years.
“adults aged 18–24 years (30.9% for urgent or emergency care; 57.2% for any care)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data
Among U.S. adults, an estimated 12% reported having avoided urgent or emergency care because of concerns about COVID-19 as of June 30, 2020.
“including 12% who reported having avoided urgent or emergency care”
- Also stated in: § What is added by this report? · plain
“including urgent or emergency care (12%)”
Quote in the paperSubstantial claim - Also stated in: § What is added by this report? · plain
- Findingown data
Nearly one third (32%) of U.S. adult respondents reported having delayed or avoided routine medical care because of concerns about COVID-19.
“Nearly one third of adult respondents reported having delayed or avoided routine medical care”
- Also stated in: § What is added by this report? · plain
“and routine care (32%)”
Quote in the paperSubstantial claim - Also stated in: § What is added by this report? · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, urgent or emergency care avoidance was 22.7% for students.
“students (22.7%; 50.3%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingnone given
Increased prevalences of reported urgent or emergency care avoidance were observed among Black adults and Hispanic adults compared with White adults.
“Increased prevalences of reported urgent or emergency care avoidance among Black adults and Hispanic adults compared with White adults are especially concerning given increased COVID-19-associated mortality among Black adults and Hispanic adults (8).”
Quote in the paperSubstantial claim - Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Avoidance of urgent or emergency care was significantly lower among adults aged ≥45 years than among younger adults.
“Avoidance of urgent or emergency care was significantly lower among adults aged ≥45 years than among younger adults.”
Quote in the paperSubstantial claim - Findingreasoning
Respondents with health insurance had a higher prevalence of medical care delay or avoidance than those without insurance.
“The higher prevalence of medical care delay or avoidance among respondents with health insurance versus those without insurance might reflect differences in medical care-seeking behaviors.”
Quote in the paperNot a substantial claim - Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, urgent or emergency care avoidance was 22.7% for persons with two or more selected underlying medical conditions.
“persons with two or more selected underlying medical conditions (22.7%; 54.7%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, any care avoidance was 50.3% for students.
“students (22.7%; 50.3%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
The estimated prevalence of urgent or emergency care avoidance was significantly higher among Hispanic or Latino adults than among non-Hispanic White adults (aPR = 1.5; 95% CI = 1.2-2.0).
“Hispanic or Latino (Hispanic) adults (aPR = 1.5)”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“Hispanic adults (1.5; 1.2–2.0)”
Quote in the paperSubstantial claim - Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
One in four unpaid caregivers reported caring for adults who were at increased risk for severe COVID-19.
“One in four unpaid caregivers reported caring for adults who were at increased risk for severe COVID-19.”
Quote in the paperNot a substantial claim- Rests on an assumption: Selected underlying medical conditions (obesity, diabetes, high blood pressure, cardiovascular disease, and any type of cancer) increase the risk for severe COVID-19.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, urgent or emergency care avoidance was 24.6% for Hispanic adults.
“Hispanic adults (24.6%; 55.5%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, any care avoidance was 55.5% for Hispanic adults.
“Hispanic adults (24.6%; 55.5%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, urgent or emergency care avoidance was 29.8% for unpaid caregivers for adults.
“unpaid caregivers for adults (29.8%; 64.3%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, any care avoidance was 64.3% for unpaid caregivers for adults.
“unpaid caregivers for adults (29.8%; 64.3%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
The estimated prevalence of urgent or emergency care avoidance was significantly higher among young adults aged 18-24 years than among adults aged 25-44 years (aPR = 1.5; 95% CI = 1.2-1.8).
“young adults aged 18–24 years versus adults aged 25–44 years (aPR = 1.5)”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“young adults aged 18–24 years versus adults aged 25–44 years (1.5; 1.2–1.8)”
Quote in the paperNot a substantial claim - Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Findingown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Among U.S. adult respondents, urgent or emergency care avoidance was 22.8% for persons with disabilities.
“persons with disabilities (22.8%; 60.3%)”
Quote in the paperNot a substantial claim- Rests on an assumption: The weighted survey sample is representative of the U.S. adult population.
- Rests on an assumption: Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
- Rests on an assumption: Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
- Findingown data
As of June 30, 2020, an estimated 41% of U.S. adults reported having delayed or avoided medical care during the pandemic because of concerns about COVID-19.
“As of June 30, 2020, an estimated 41% of U.S. adults reported having delayed or avoided medical care during the pandemic because of concerns about COVID-19”
- Also stated in: § What is added by this report? · hedged
“By June 30, 2020, because of concerns about COVID-19, an estimated 41% of U.S. adults had delayed or avoided medical care including urgent or emergency care (12%) and routine care (32%).”
Quote in the paperSubstantial claim - Also stated in: § What is added by this report? · hedged
- Premisecitation§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Temporary disruptions in routine and nonemergency medical care access and delivery have been observed during periods of considerable community transmission of SARS-CoV-2.
“Temporary disruptions in routine and nonemergency medical care access and delivery have been observed during periods of considerable community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [1] Santoli, 2020, Effects of the COVID-19 pandemic on routine pediatric vaccine ordering and administration—United States, 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
- Study design and conductnone given§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Quota sampling and survey weighting, including statistical raking and weight trimming, were employed to improve cohort representativeness of the U.S. population by gender, age, and race/ethnicity.
“Quota sampling and survey weighting¶¶ were employed to improve cohort representativeness of the U.S. population by gender, age, and race/ethnicity.”
- Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
“Statistical raking and weight trimming were employed to improve the cross-sectional June cohort representativeness of the U.S. population by gender, age, and race/ethnicity according to the 2010 U.S. Census.”
Quote in the paperSubstantial claim - Also stated in: § Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020 · plain
- Interpretationreasoning
Delay or avoidance of care might increase risk for life-threatening medical emergencies.
“In contrast, delay or avoidance of care might increase risk for life-threatening medical emergencies.”
Quote in the paperSubstantial claim- Rests on an assumption: Delayed or avoided medical care can increase morbidity and mortality associated with both chronic and acute health conditions.
- Premisecitation
In a recent study, states with large numbers of COVID-19-associated deaths also experienced large proportional increases in deaths from other underlying causes, including diabetes and cardiovascular disease.
“In a recent study, states with large numbers of COVID-19–associated deaths also experienced large proportional increases in deaths from other underlying causes, including diabetes and cardiovascular disease (7).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [7] Woolf, 2020, Excess deaths from COVID-19 and other causes, March–April 2020., JAMA source
Not checked in the free run.
- Interpretationcitation
The findings are consistent with reported declines in hospital admissions and ED visits during the pandemic.
“However, the findings are consistent with reported declines in hospital admissions and ED visits during the pandemic (3–5).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [3] Lange, 2020, Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions—United States, January–May 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
- cites [4] Oseran SA, Nash D, Kim C, Changes in hospital admissions for urgent conditions during COVID-19 pandemic. Am J Manag Care 2020. Epub July 8, 2020. https://www.ajmc.com/view/changes-in-hospital-admissions-for-urgent-conditions-during-covid19-pandemic
Not checked in the free run.
- cites [5] Hartnett, 2020, Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
- Study design and conductreasoning
This web-based survey might not be fully representative of the U.S. population for income, educational attainment, and access to technology.
“Finally, although quota sampling methods and survey weighting were employed to improve cohort representativeness, this web-based survey might not be fully representative of the U.S. population for income, educational attainment, and access to technology.”
Quote in the paperNot a substantial claim - Premisecitation
Before the pandemic, persons without insurance sought medical care much less frequently than did those with insurance.
“Before the pandemic, persons without insurance sought medical care much less frequently than did those with insurance (10), resulting in fewer opportunities for medical care delay or avoidance.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] Zhou, 2017, The uninsured do not use the emergency department more—they use other care less., Health Aff (Millwood) source
Not checked in the free run.
- May combine two claims. 8
- Classified as probably not a substantial claim. 18
May combine two claims.
Findingown dataAvoidance of urgent or emergency care was more prevalent among unpaid caregivers for adults, persons with underlying medical conditions, Black adults, Hispanic adults, young adults, and persons with disabilities.
“Avoidance of urgent or emergency care was more prevalent among unpaid caregivers for adults, persons with underlying medical conditions, Black adults, Hispanic adults, young adults, and persons with disabilities.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020Medical care delay or avoidance might increase morbidity and mortality risk associated with treatable and preventable health conditions and might contribute to reported excess deaths directly or indirectly related to COVID-19.
“However, medical care delay or avoidance might increase morbidity and mortality risk associated with treatable and preventable health conditions and might contribute to reported excess deaths directly or indirectly related to COVID-19 (2).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [2] CDC, National Center for Health Statistics. Excess deaths associated with COVID-19. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2020. https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe survey did not assess baseline patterns of care-seeking or timing or duration of care avoidance.
“Third, the survey did not assess baseline patterns of care-seeking or timing or duration of care avoidance.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe survey did not assess reasons for COVID-19-associated care avoidance.
“Second, the survey did not assess reasons for COVID-19–associated care avoidance, such as adherence to public health recommendations; closure of health care provider facilities; reduced availability of public transportation; fear of exposure to infection with SARS-CoV-2; or availability, accessibility, and acceptance or recognition of telemedicine as a means of providing care in lieu of in-person”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020Comparisons within all subgroups were evaluated using multivariable Poisson regression models with robust standard errors to estimate prevalence ratios adjusted for all covariates, 95% confidence intervals, and p-values to evaluate statistical significance (α = 0.05).
“Comparisons within all these subgroups were evaluated using multivariable Poisson regression models§§§ with robust standard errors to estimate prevalence ratios adjusted for all covariates, 95% confidence intervals, and p-values to evaluate statistical significance (α = 0.05)”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCOVID-19-associated mortality is increased among Black adults and Hispanic adults.
“Increased prevalences of reported urgent or emergency care avoidance among Black adults and Hispanic adults compared with White adults are especially concerning given increased COVID-19-associated mortality among Black adults and Hispanic adults (8).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] Wortham, 2020, Characteristics of persons who died with COVID-19—United States, February 12–May 18, 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
Interpretationnone givenMedical services for persons with disabilities might also be disrupted because of reduced availability of accessible transportation, reduced communication in accessible formats, perceptions of SARS-CoV-2 exposure risk, and specialized needs that are difficult to address with routine telehealth delivery during the pandemic response.
“Medical services for persons with disabilities might also be disrupted because of reduced availability of accessible transportation, reduced communication in accessible formats, perceptions of SARS-CoV-2 exposure risk, and specialized needs that are difficult to address with routine telehealth delivery during the pandemic response.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenQuota sampling methods and survey weighting were employed to improve cohort representativeness.
“Finally, although quota sampling methods and survey weighting were employed to improve cohort representativeness, this web-based survey might not be fully representative of the U.S. population for income, educational attainment, and access to technology.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductreasoning§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020Given the potential for variation in interpretation of whether conditions were life-threatening, responses for urgent and emergency care delay or avoidance were combined for analysis.
“Given the potential for variation in interpretation of whether conditions were life-threatening, responses for urgent and emergency care delay or avoidance were combined for analysis.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationExcess deaths directly or indirectly related to COVID-19 have increased in 2020 versus prior years.
“and that excess deaths directly or indirectly related to COVID-19 have increased in 2020 versus prior years (2).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [2] CDC, National Center for Health Statistics. Excess deaths associated with COVID-19. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2020. https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationIn the United States, the age-adjusted COVID-19 hospitalization rates are approximately five times higher among Black persons and four times higher among Hispanic persons than are those among White persons.
“In the United States, the age-adjusted COVID-19 hospitalization rates are approximately five times higher among Black persons and four times higher among Hispanic persons than are those among White persons (9).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [9] CDC. Coronavirus disease 2019 (COVID-19): health equity considerations and racial and ethnic minority groups. Atlanta, GA: US Department of Health and Human Services, CDC; 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html
Not checked in the free run.
May combine two claims.
InterpretationcitationThe findings of this report align with recent reports of declines in hospital admissions and ED visits and increases in excess deaths related to COVID-19.
“These findings align with recent reports that hospital admissions, overall emergency department (ED) visits, and the number of ED visits for heart attack, stroke, and hyperglycemic crisis have declined since the start of the pandemic (3–5), and that excess deaths directly or indirectly related to COVID-19 have increased in 2020 versus prior years (2).”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [3] Lange, 2020, Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions—United States, January–May 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
- cites [4] Oseran SA, Nash D, Kim C, Changes in hospital admissions for urgent conditions during COVID-19 pandemic. Am J Manag Care 2020. Epub July 8, 2020. https://www.ajmc.com/view/changes-in-hospital-admissions-for-urgent-conditions-during-covid19-pandemic
Not checked in the free run.
- cites [5] Hartnett, 2020, Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
- cites [2] CDC, National Center for Health Statistics. Excess deaths associated with COVID-19. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2020. https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.
InterpretationreasoningFor persons with disabilities, accessing medical services might be challenging because of disruptions in essential support services, which can result in adverse health outcomes.
“For persons with disabilities, accessing medical services might be challenging because of disruptions in essential support services, which can result in adverse health outcomes.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningIf routine care avoidance were sustained, adults could miss opportunities for management of chronic conditions, receipt of routine vaccinations, or early detection of new conditions, which might worsen outcomes.
“However, if routine care avoidance were to be sustained, adults could miss opportunities for management of chronic conditions, receipt of routine vaccinations, or early detection of new conditions, which might worsen outcomes.”
Quote in the paperNot a substantial claim- Rests on an assumption: Delayed or avoided medical care can increase morbidity and mortality associated with both chronic and acute health conditions.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationHospital admissions, overall emergency department visits, and the number of ED visits for heart attack, stroke, and hyperglycemic crisis have declined since the start of the pandemic.
“These findings align with recent reports that hospital admissions, overall emergency department (ED) visits, and the number of ED visits for heart attack, stroke, and hyperglycemic crisis have declined since the start of the pandemic (3–5)”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [3] Lange, 2020, Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions—United States, January–May 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
- cites [4] Oseran SA, Nash D, Kim C, Changes in hospital admissions for urgent conditions during COVID-19 pandemic. Am J Manag Care 2020. Epub July 8, 2020. https://www.ajmc.com/view/changes-in-hospital-admissions-for-urgent-conditions-during-covid19-pandemic
Not checked in the free run.
- cites [5] Hartnett, 2020, Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningPersons at increased risk for severe COVID-19 might have avoided health care facilities because of perceived or actual increased risk of exposure to SARS-CoV-2, particularly at the onset of the pandemic.
“Moreover, persons at increased risk for severe COVID-19 might have avoided health care facilities because of perceived or actual increased risk of exposure to SARS-CoV-2, particularly at the onset of the pandemic.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningThe higher prevalence of medical care delay or avoidance among respondents with health insurance versus those without insurance might reflect differences in medical care-seeking behaviors.
“The higher prevalence of medical care delay or avoidance among respondents with health insurance versus those without insurance might reflect differences in medical care-seeking behaviors.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
Study design and conductnone givenPerceptions of whether a condition was life-threatening might vary among respondents.
“Fourth, perceptions of whether a condition was life-threatening might vary among respondents.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenSelf-reported data are subject to recall, response, and social desirability biases.
“First, self-reported data are subject to recall, response, and social desirability biases.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020Among the 5,412 participants, 4,975 (91.9%) provided complete data for all variables in this analysis.
“Among the 5,412 participants, 4,975 (91.9%) provided complete data for all variables in this analysis.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningFor caregivers who reported caring for adults at increased risk for severe COVID-19, concern about exposure of care recipients might contribute to care avoidance.
“For caregivers who reported caring for adults at increased risk for severe COVID-19, concern about exposure of care recipients might contribute to care avoidance.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationPersons with underlying medical conditions that increase their risk for severe COVID-19 are more likely to require care to monitor and treat these conditions, potentially contributing to their more frequent report of avoidance.
“Persons with underlying medical conditions that increase their risk for severe COVID-19 (6) are more likely to require care to monitor and treat these conditions, potentially contributing to their more frequent report of avoidance.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] Stokes, 2020, Coronavirus disease 2019 case surveillance—United States, January 22–May 30, 2020., MMWR Morb Mortal Wkly Rep source
Not checked in the free run.
- Rests on an assumption: Persons with underlying medical conditions that increase their risk for severe COVID-19 are more likely to require care to monitor and treat these conditions.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020During June 24-30, 2020, 5,412 (54.7%) of 9,896 eligible adults completed the web-based COVID-19 Outbreak Public Evaluation Initiative surveys.
“a total of 5,412 (54.7%) of 9,896 eligible adults¶ completed web-based COVID-19 Outbreak Public Evaluation Initiative surveys”
Quote in the paperNot a substantial claim- Rests on an assumption: Survey respondents who completed the survey are not systematically different from eligible nonrespondents in ways that affect the prevalence estimates.
The paper relies on this without support.
The weighted survey sample is representative of the U.S. adult population.
“a nationwide representative sample of U.S. adults aged ≥18 years”
“Quota sampling and survey weighting¶¶ were employed to improve cohort representativeness of the U.S. population by gender, age, and race/ethnicity.”
The paper relies on this without support.
Respondents' self-reported delay or avoidance of medical care accurately reflects their actual medical care behavior.
““Have you delayed or avoided medical care due to concerns related to COVID-19?””
“40.9% reported having delayed or avoided any medical care”
The paper relies on this without support.
Respondents correctly attribute their delay or avoidance to COVID-19 concerns.
“because of concerns about COVID-19”
““Have you delayed or avoided medical care due to concerns related to COVID-19?””
The paper relies on this without support.
Selected underlying medical conditions (obesity, diabetes, high blood pressure, cardiovascular disease, and any type of cancer) increase the risk for severe COVID-19.
“Selected underlying medical conditions known to increase the risk for severe COVID-19 included in this analysis were obesity, diabetes, high blood pressure, cardiovascular disease, and any type of cancer.”
The paper relies on this without support.
Survey respondents who completed the survey are not systematically different from eligible nonrespondents in ways that affect the prevalence estimates.
“a total of 5,412 (54.7%) of 9,896 eligible adults¶ completed web-based COVID-19 Outbreak Public Evaluation Initiative surveys”
The paper relies on this without support.
Delayed or avoided medical care can increase morbidity and mortality associated with both chronic and acute health conditions.
“Delayed or avoided medical care might increase morbidity and mortality associated with both chronic and acute health conditions.”
The paper relies on this without support.
Health care facilities are implementing important safety precautions to reduce the risk of SARS-CoV-2 infection among patients and personnel.
“However, health care facilities are implementing important safety precautions to reduce the risk of SARS-CoV-2 infection among patients and personnel.”
The paper relies on this without support.
Persons with underlying medical conditions that increase their risk for severe COVID-19 are more likely to require care to monitor and treat these conditions.
“Persons with underlying medical conditions that increase their risk for severe COVID-19 (6) are more likely to require care to monitor and treat these conditions, potentially contributing to their more frequent report of avoidance.”
Cites
Coronavirus disease 2019 case surveillance—United States, January 22–May 30, 2020.
Stokes, E. K., Zambrano, L. D., Anderson, K. N., Marder, E. P., Raz, K. M., El Burai Felix, S., Tie, Y., & Fullerton, K. E. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6924e2 · Cited by 1,538 · cited 1× · see citing works
“Persons with underlying medical conditions that increase their risk for severe COVID-19 (6) are more likely to require care to monitor and treat these conditions, potentially contributing to their more frequent report of avoidance.”
BackgroundHartnett, K. P., Kite-Powell, A., DeVies, J., Coletta, M. A., Boehmer, T. K., Adjemian, J., Gundlapalli, A. V., & Practice, N. S. S. P. C. O. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6923e1 · Cited by 1,139 · see citing works
Santoli, J. M., Lindley, M. C., DeSilva, M. B., Kharbanda, E. O., Daley, M. F., Galloway, L., Gee, J., Glover, M., Herring, B., Kang, Y., et al. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6919e2 · Cited by 701 · cited 1× · see citing works
“Temporary disruptions in routine and nonemergency medical care access and delivery have been observed during periods of considerable community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1).”
BackgroundExcess deaths from COVID-19 and other causes, March–April 2020.
Woolf, S. H., Chapman, D. A., Sabo, R. T., Weinberger, D. M., & Hill, L. (2020) · JAMA · doi:10.1001/jama.2020.11787 · Cited by 541 · cited 1× · see citing works
“In a recent study, states with large numbers of COVID-19–associated deaths also experienced large proportional increases in deaths from other underlying causes, including diabetes and cardiovascular disease (7).”
BackgroundLange, S. J., Ritchey, M. D., Goodman, A. B., Dias, T., Twentyman, E., Fuld, J., Schieve, L. A., Imperatore, G., Benoit, S. R., Kite-Powell, A., et al. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6925e2 · Cited by 367 · see citing works
Characteristics of persons who died with COVID-19—United States, February 12–May 18, 2020.
Wortham, J. M., Lee, J. T., Althomsons, S., Latash, J., Davidson, A., Guerra, K., Murray, K., McGibbon, E., Pichardo, C., Toro, B., et al. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6928e1 · Cited by 241 · cited 1× · see citing works
“Increased prevalences of reported urgent or emergency care avoidance among Black adults and Hispanic adults compared with White adults are especially concerning given increased COVID-19-associated mortality among Black adults and Hispanic adults (8).”
BackgroundThe uninsured do not use the emergency department more—they use other care less.
Zhou, R. A., Baicker, K., Taubman, S., & Finkelstein, A. N. (2017) · Health Affairs · doi:10.1377/hlthaff.2017.0218 · Cited by 112 · cited 1× · see citing works
“Before the pandemic, persons without insurance sought medical care much less frequently than did those with insurance (10), resulting in fewer opportunities for medical care delay or avoidance.”
BackgroundChanges in Hospital Admissions for Urgent Conditions During COVID-19 Pandemic
Oseran, A. S. (2020) · The American Journal of Managed Care · doi:10.37765/ajmc.2020.43837 · Cited by 91 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ensuring trust in COVID-19 data
(2021) · doi:10.1097/md.0000000000026972 · Cited by 4,745 · see citing works
Koonin, L. M., Hoots, B., Tsang, C. A., Leroy, Z. C., Farris, K., Jolly, B., Antall, P., McCabe, B. K., Zelis, C. B. R., Tong, I., et al. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6943a3 · Cited by 1,048 · see citing works
Economic Costs of Diabetes in the U.S. in 2022
(2023) · doi:10.2337/dci23-0085 · Cited by 808 · see citing works
Flor, L. S., Friedman, J., Spencer, C. N., Cagney, J., Arrieta, A., Herbert, M. E., Stein, C., Mullany, E. C., Hon, J., Patwardhan, V., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)00008-3 · Cited by 364 · see citing works
Race, Ethnicity, and Age Trends in Persons Who Died from COVID-19 — United States, May–August 2020
Gold, J. A. W., Rossen, L. M., Ahmad, F. B., Sutton, P. D., Li, Z., Salvatore, P. P., Coyle, J. P., DeCuir, J., Baack, B. N., Durant, T. M., et al. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6942e1 · Cited by 336 · see citing works
Surveillance of Vaccination Coverage Among Adult Populations —United States, 2018
Lu, P.-J., Hung, M.-C., Srivastav, A., Grohskopf, L. A., Kobayashi, M., Harris, A. M., Dooling, K. L., Markowitz, L. E., Rodríguez-Lainz, A., & Williams, W. W. (2021) · MMWR Surveillance Summaries · doi:10.15585/mmwr.ss7003a1 · Cited by 347 · see citing works
Trends in Cardiovascular Disease Mortality Rates and Excess Deaths, 2010–2022
Woodruff, R. C., Tong, X., Khan, S. S., Shah, N. S., Jackson, S. L., Loustalot, F. V., & Vaughan, A. S. (2023) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2023.11.009 · Cited by 272 · see citing works
COVID-19 and Chronic Disease: The Impact Now and in the Future
Hacker, K. A., Briss, P. A., Richardson, L. C., Wright, J. S., & Petersen, R. (2021) · Preventing Chronic Disease · doi:10.5888/pcd18.210086 · Cited by 242 · see citing works
Townsend, R., Chmielewska, B., Barratt, I., Kalafat, E., van der Meulen, J., Gurol‐Urganci, I., O’Brien, P., Morris, E., Draycott, T. J., Thangaratinam, S., et al. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.100947 · Cited by 206 · see citing works
“Women ’ s health-care-seeking behaviour has changed; women have reported being less willing to attend hospital due to fear of contracting COVID-19 [13,14].”
Impact of the COVID-19 Pandemic on Cardiovascular Health in 2020
Roth, G. A., Vaduganathan, M., & Mensah, G. A. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.06.008 · Cited by 215 · see citing works
“Taken together, these results could reflect either decreases in CVD event rates or increased difficulty for patients accessing health care during the early pandemic because of patient or health system choices.(24)”
ResultPatel Murthy, B., Zell, E., Kirtland, K., Jones-Jack, N., Harris, L., Sprague, C., Schultz, J., Le, Q., Bramer, C. A., Kuramoto, S., et al. (2021) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7023a2 · Cited by 192 · see citing works
Blood Pressure Control Among US Adults, 2009 to 2012 Through 2017 to 2020
Muntner, P., Miles, M. A., Jaeger, B. C., Hannon, L., Hardy, S. T., Ostchega, Y., Wozniak, G. D., & Schwartz, J. E. (2022) · Hypertension · doi:10.1161/hypertensionaha.122.19222 · Cited by 186 · see citing works
Jassat, W., Mudara, C., Ozougwu, L., Tempia, S., Blumberg, L. H., Davies, M., Pillay, Y. G., Carter, T., Morewane, R., Wolmarans, M., et al. (2021) · The Lancet Global Health · doi:10.1016/s2214-109x(21)00289-8 · Cited by 190 · see citing works
Trends in US Outpatient Antibiotic Prescriptions During the Coronavirus Disease 2019 Pandemic
King, L., Lovegrove, M. C., Shehab, N., Tsay, S. V., Budnitz, D. S., Geller, A. I., Lind, J. N., Roberts, R. M., Hicks, L. A., & Kabbani, S. (2020) · Clinical Infectious Diseases · doi:10.1093/cid/ciaa1896 · Cited by 161 · see citing works
Changes in Cancer Screening in the US During the COVID-19 Pandemic
Fedewa, S. A., Star, J., Bandi, P., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.15490 · Cited by 174 · see citing works
Christie, A., Brooks, J. T., Hicks, L. A., et al. (2021) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7030e2 · Cited by 161 · see citing works
Rise in Blood Pressure Observed Among US Adults During the COVID-19 Pandemic
Laffin, L. J., Kaufman, H. W., Chen, Z., Niles, J. K., Arellano, A. R., Bare, L. A., & Hazen, S. L. (2021) · Circulation · doi:10.1161/circulationaha.121.057075 · Cited by 154 · see citing works
Medical admissions among adolescents with eating disorders during the COVID-19 pandemic.
Otto, A. K., Jary, J. M., Sturza, J., Miller, C. A., Prohaska, N., Bravender, T., & Van Huysse, J. (2021) · PEDIATRICS · doi:10.1542/peds.2021-052201 · Cited by 156 · see citing works
“The COVID-19 pandemic has also been associated with delayed care for non–COVID-19 conditions.(13,14) In many settings, in-person clinical care has been significantly disrupted and/or limited as a result of measures enacted to reduce the risk”
BackgroundSplinter, M. J., Velek, P., Ikram, M. K., Kieboom, B. C. T., Peeters, R. P., Bindels, P., Ikram, M. A., Wolters, F. J., Leening, M. J. G., de Schepper, E. I. T., et al. (2021) · PLoS Medicine · doi:10.1371/journal.pmed.1003854 · Cited by 140 · see citing works
Alkureishi, M. A., Choo, Z.-Y., Rahman, A., Ho, K., Benning-Shorb, J., Lenti, G., Velázquez Sánchez, I., Zhu, M., Shah, S. D., & Lee, W. W. (2021) · JMIR Human Factors · doi:10.2196/33364 · Cited by 143 · see citing works
Long COVID and Health Inequities: The Role of Primary Care
Berger, Z. D., Jesus, V. V. A. D., Assoumou, S. A., & Greenhalgh, T. (2021) · Milbank Quarterly · doi:10.1111/1468-0009.12505 · Cited by 129 · see citing works
Fifty Years of Trust Research in Health Care: A Synthetic Review
Taylor, L. A., Nong, P., & Platt, J. E. (2023) · Milbank Quarterly · doi:10.1111/1468-0009.12598 · Cited by 143 · see citing works
The race to a COVID-19 vaccine: opportunities and challenges in development and distribution
Burgos, R. M., Badowski, M. E., Drwiega, E. N., Ghassemi, S., Griffith, N., Herald, F., Johnson, M., Smith, R. O., & Michienzi, S. M. (2021) · Drugs in Context · doi:10.7573/dic.2020-12-2 · Cited by 119 · see citing works
Trends in US Ambulatory Care Patterns During the COVID-19 Pandemic, 2019-2021
Mafi, J. N., Craff, M., Vangala, S., Pu, T., Skinner, D., Tabatabai-Yazdi, C., Nelson, A., Reid, R., Agniel, D., Tseng, C.-H., et al. (2022) · JAMA · doi:10.1001/jama.2021.24294 · Cited by 120 · see citing works
Wadhera, R. K., Figueroa, J. F., Rodríguez, F., Liu, M., Tian, W., Kazi, D. S., Song, Y., Yeh, R. W., & Maddox, K. E. J. (2021) · Circulation · doi:10.1161/circulationaha.121.054378 · Cited by 118 · see citing works
Pagaoa, M. A., Grey, J. A., Torrone, E., et al. (2021) · Sexually Transmitted Diseases · doi:10.1097/olq.0000000000001506 · Cited by 115 · see citing works
“As reflected in the lower number of chlamydia cases diagnosed at private physicians/HMOs, the decrease in STD screenings and limited services to symptomatic cases may continue to disproportionately affect detection of chlamydia cases, as most cases are identified from asymptomatic screening and routine preventive care…”
BackgroundCantor, J., Sood, N., Bravata, D. M., Pera, M. F., & Whaley, C. (2022) · Journal of Health Economics · doi:10.1016/j.jhealeco.2022.102581 · Cited by 111 · see citing works
Lu, P., Kong, D., & Shelley, M. (2021) · Journal of Aging and Health · doi:10.1177/08982643211002084 · Cited by 104 · see citing works
Stephenson, E., Butt, D. A., Gronsbell, J. L., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255992 · Cited by 109 · see citing works
“We found that periodic health visits ceased almost entirely with the onset of the COVID-19 pandemic, which is consistent with other reports of physicians limiting and patients avoiding seeking preventive care [39, 40].”
ResultChevinsky, J., Tao, G., Lavery, A. M., Kukielka, E. A., Click, E. S., Malec, D. J., Kompaniyets, L., Bruce, B. B., Yusuf, H. R., Goodman, A. B., et al. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab338 · Cited by 101 · see citing works
The impact of relaxation of methadone take-home protocols on treatment outcomes in the COVID-19 era
Amram, O., Amiri, S., Panwala, V., et al. (2021) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2021.1979991 · Cited by 106 · see citing works
Currie, J., Schnell, M. K., Schwandt, H., & Zhang, J. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.6147 · Cited by 99 · see citing works
Nath, B., Williams, B., Jeffery, M. M., O’Connell, R. T., Goldstein, R. L., Sinsky, C. A., & Melnick, E. R. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.31490 · Cited by 100 · see citing works
HIV Testing Before and During the COVID-19 Pandemic — United States, 2019–2020
DiNenno, E. A., Delaney, K. P., Pitasi, M. A., et al. (2022) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7125a2 · Cited by 98 · see citing works
“During 2020–2021, the COVID-19 pandemic disrupted health care delivery, including HIV testing in part because many persons avoided services to comply with COVID-19 risk mitigation efforts (2).”
BackgroundGertz, A., Pollack, C. C., Schultheiss, M. D., & Brownstein, J. S. (2022) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2022.101882 · Cited by 95 · see citing works
Acosta, N., Bautista, M. A., Hollman, J., McCalder, J., Beaudet, A. B., Man, L. L. H., Waddell, B. J. M., Chen, J., Li, C., Kuzma, D., et al. (2021) · Water Research · doi:10.1016/j.watres.2021.117369 · Cited by 94 · see citing works
Ismail, H., Marshall, V. D., Patel, M. R., Tariq, M., & Mohammad, R. A. (2021) · Journal of the American Pharmacists Association · doi:10.1016/j.japh.2021.11.013 · Cited by 89 · see citing works
Comparison of Pregnancy and Birth Outcomes Before vs During the COVID-19 Pandemic
Molina, R. L., Tsai, T. C., Dai, D., Soto, M. J., Rosenthal, N. A., Orav, E. J., & Figueroa, J. F. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.26531 · Cited by 87 · see citing works
Decreases in Hepatitis C Testing and Treatment During the COVID-19 Pandemic
Kaufman, H. W., Bull–Otterson, L., Meyer, W. A., Huang, X., Doshani, M., Thompson, W., Osinubi, A., Khan, M. A., Harris, A. M., Gupta, N., et al. (2021) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2021.03.011 · Cited by 88 · see citing works
“During 2020, the coronavirus disease 2019 (COVID19) pandemic has impacted the practice of medicine.(12,13) CDC released guidance on delaying nonessential procedures and postponing routine clinical visits as part of initial mitigation strategies for the COVID-19 pandemic.”
Yingst, J. M., Krebs, N. M., Bordner, C. R., Hobkirk, A. L., Allen, S. I., & Foulds, J. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18041795 · Cited by 76 · see citing works
Arnault, L., Jusot, F., & Renaud, T. (2021) · European Journal of Ageing · doi:10.1007/s10433-021-00645-3 · Cited by 80 · see citing works
Dang, A. T., Thakker, R. A., Li, S., Hommel, E. L., Mehta, H. B., & Goodwin, J. S. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.1754 · Cited by 78 · see citing works
Mogharab, V., Ostovar, M., Ruszkowski, J., Hussain, S. Z. M., Shrestha, R., Yaqoob, Ú., Aryanpoor, P., Nikkhoo, A. M., Heidari, P., Jahromi, A. R., et al. (2022) · Globalization and Health · doi:10.1186/s12992-022-00836-2 · Cited by 82 · see citing works
“Another report has approximated that 41% of individuals in the United States have postponed or avoided medical care, including urgent (12%) or non-urgent care (32%) [12].”
BackgroundMicrobiome Analysis for Wastewater Surveillance during COVID-19
Brumfield, K. D., Leddy, M. B., Usmani, M., Cotruvo, J. A., Tien, C.-T., Dorsey, S., Graubics, K., Fanelli, B. C., Zhou, I., Registe, N., et al. (2022) · mBio · doi:10.1128/mbio.00591-22 · Cited by 83 · see citing works
Lee, H., & Singh, G. K. (2021) · Annals of Epidemiology · doi:10.1016/j.annepidem.2021.07.014 · Cited by 79 · see citing works
Ghoshal, S., Rigney, G. H., Cheng, D., Brumit, R., Gee, M. S., Hodin, R. A., Lillemoe, K. D., Levine, W. C., & Succi, M. D. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.27443 · Cited by 82 · see citing works
Long-term health-related quality of life concerns related to the COVID-19 pandemic: a call to action
Bryson, W. J. (2020) · Quality of Life Research · doi:10.1007/s11136-020-02677-1 · Cited by 75 · see citing works
“adult population and, again, may have deleterious effects on health and HRQoL even among those without COVID-19 infections [8].”
BackgroundSelf-collection of capillary blood using Tasso-SST devices for Anti-SARS-CoV-2 IgG antibody testing
Hendelman, T., Chaudhary, A., LeClair, A. C., van Leuven, K., Chee, J., Fink, S. L., Welch, E. J., Berthier, E., Quist, B. A., Wald, A., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255841 · Cited by 76 · see citing works
Gotanda, H., Liyanage-Don, N. A., Moran, A. E., Krousel-Wood, M. A., Green, J. B., Zhang, Y., & Nuckols, T. K. (2022) · Hypertension · doi:10.1161/hypertensionaha.122.19861 · Cited by 73 · see citing works
The Great Unequalizer: Initial Health Effects of COVID-19 in the United States
Alsan, M. M., Chandra, A., & Simon, K. I. (2021) · The Journal of Economic Perspectives · doi:10.1257/jep.35.3.25 · Cited by 71 · see citing works
Socio-economic and ethnic health inequalities in COVID-19 outcomes across OECD countries
Berchet, C., Bijlholt, J., & Ando, M. (2023) · OECD health working papers · doi:10.1787/6c2a96c9-en · Cited by 75 · see citing works
Ikeda, T., Igarashi, A., Odani, S., Murakami, M., & Tabuchi, T. (2021) · Applied Research in Quality of Life · doi:10.1007/s11482-021-09918-6 · Cited by 73 · see citing works
Tuberculosis — United States, 2020
Deutsch-Feldman, M., Pratt, R. H., Price, S. F., et al. (2021) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7012a1 · Cited by 72 · see citing works
Okoro, C. A., Strine, T. W., McKnight-Eily, L. R., Verlenden, J., & Hollis, N. D. (2021) · Disability and health journal · doi:10.1016/j.dhjo.2021.101110 · Cited by 74 · see citing works
Nab, M., Vehmendahl, R. V., Somers, I., Schoon, Y., & Hesselink, G. (2021) · BMC Emergency Medicine · doi:10.1186/s12873-021-00449-9 · Cited by 72 · see citing works
Jiskrova, G. K., Bobák, M., Pikhart, H., & Ksinan, A. J. (2021) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2021-216715 · Cited by 69 · see citing works
Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy Outcomes in a U.S. Population
Son, M., Gallagher, K., Lo, J. Y., Lindgren, E., Burris, H. H., Dysart, K., Greenspan, J. S., Culhane, J. F., & Handley, S. C. (2021) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000004547 · Cited by 73 · see citing works
Jone, P.-N., John, A., Oster, M. E., Allen, K., Tremoulet, A. H., Saarel, E. V., Lambert, L. M., Miyamoto, S. D., & de Ferranti, S. D. (2022) · Circulation · doi:10.1161/cir.0000000000001064 · Cited by 83 · see citing works
Reitzle, L., Schmidt, C., Färber, F., Huebl, L., Wieler, L. H., Ziese, T., & Heidemann, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147661 · Cited by 63 · see citing works
“On the other hand findings suggest that a reduced demand for patients’ care may have additionally led to decreased utilization of health care services [26] as some people postponed and avoided routine care and even urgent care because of concerns of COVID-19 [27].”
BackgroundDeath Toll of COVID-19 on Asian Americans: Disparities Revealed
Yan, B. W., Hwang, A., Ng, F., Chu, J. N., Tsoh, J. Y., & Nguyen, T. T. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-07003-0 · Cited by 68 · see citing works
Fisher, A., Roberts, A., McKinlay, A. R., Fancourt, D. E., & Burton, A. (2021) · BMC Public Health · doi:10.1186/s12889-021-11751-3 · Cited by 71 · see citing works
COVID-19 and antimicrobial stewardship: lessons learned, best practices, and future implications
Pierce, J. W., & Stevens, M. (2021) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2021.10.001 · Cited by 68 · see citing works
Factors Associated with the Patient’s Decision to Avoid Healthcare during the COVID-19 Pandemic
Soares, P., Leite, A., Esteves, S., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182413239 · Cited by 70 · see citing works
Papautsky, E. L., Rice, D. R., Ghoneima, H., McKowen, A. L. W., Anderson, N., Wootton, A. R., & Veldhuis, C. B. (2021) · Journal of Medical Internet Research · doi:10.2196/25446 · Cited by 70 · see citing works
“In June 2020, under dynamic circumstances, researchers found that 32% and 12% of adults deliberately delayed or avoided routine care and emergency care, respectively [19].”
BackgroundHandberry, M., Bull–Otterson, L., Dai, M., Mann, N. C., Chaney, E., Ratto, J., Horiuchi, K., Siza, C. R., Kulkarni, A., Gundlapalli, A. V., et al. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab373 · Cited by 66 · see citing works
Sansone, A., Mollaioli, D., Limoncin, E., Ciocca, G., Bắc, N. H., Thắng, N. C., Hou, G., Yuan, J., Zitzmann, M., Giraldi, A. G. E., et al. (2021) · Sexual Medicine Reviews · doi:10.1016/j.sxmr.2021.11.001 · Cited by 70 · see citing works
“Other long-term complications of COVID-19 As for many other chronic diseases, long COVID has important socio-economic consequences [174], resulting in, among the others, delayed medical care [175], xenophobia [176], and impaired”
Teoh, S. E., Masuda, Y., Tan, D. J. H., Liu, N., Morrison, L. J., Ong, M. E. H., Blewer, A. L., & Ho, A. F. W. (2021) · Annals of Intensive Care · doi:10.1186/s13613-021-00957-8 · Cited by 69 · see citing works
“In addition, independent of the reluctance to seek help, patients with severe acute illness may have deteriorated due to reduced access to emergency health services, such as emergency department overcrowding and delayed ambulance response time [17, 19, 52].”
BackgroundHorwitz, L. I., Thaweethai, T., Brosnahan, S. B., Cicek, M. S., Fitzgerald, M. L., Goldman, J. D., Hess, R., Hodder, S., Jacoby, V. L., Jordan, M. R., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0286297 · Cited by 69 · see citing works
Kelly, E. L., Cunningham, A., Sifri, R., Pando, O., Smith, K. R., & Arenson, C. A. (2022) · The Annals of Family Medicine · doi:10.1370/afm.2775 · Cited by 60 · see citing works
Anderson, K. N., Radhakrishnan, L., Lane, R. I., Sheppard, M., DeVies, J., Azondékon, R., Smith, A. R., Bitsko, R. H., Hartnett, K. P., Lopes-Cardozo, B., et al. (2022) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2022.0164 · Cited by 62 · see citing works
The impact of COVID-19 on individual oral health: a scoping review
Dickson‐Swift, V., Kangutkar, T., Knevel, R. J. M., & Down, S. (2022) · BMC Oral Health · doi:10.1186/s12903-022-02463-0 · Cited by 69 · see citing works
Czeisler, M. É., Howard, M. E., & Rajaratnam, S. M. W. (2021) · American Journal of Health Promotion · doi:10.1177/0890117120983982b · Cited by 66 · see citing works
Self-citationWorld Trade Center Health Program — United States, 2012−2020
Azofeifa, A., Martin, G. R., Santiago‐Colón, A., Reissman, D. B., & Howard, J. (2021) · MMWR Surveillance Summaries · doi:10.15585/mmwr.ss7004a1 · Cited by 63 · see citing works
Zhong, S., Huisingh-Scheetz, M. J., & Huang, E. S. (2022) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17805 · Cited by 65 · see citing works
“In these studies, racial/ethnic minorities, unpaid caregivers, and those with health insurance, disabilities, younger age, or chronic health conditions were more likely to delay care during the pandemic.(7) While multiple studies have documented delays in medical care, key questions remain unanswered.”
BackgroundCOVID-19 Vaccine Hesitancy Among Community-Dwelling Older Adults: The Role of Information Sources
Bhagianadh, D., & Arora, K. (2021) · Journal of Applied Gerontology · doi:10.1177/07334648211037507 · Cited by 64 · see citing works
Taha, A. R., Shehadeh, M., Alshehhi, A., Altamimi, T., Housser, E., Simsekler, M. C. E., Alfalasi, B., Memari, S. A., Hosani, F. I. A., Zaabi, Y. A., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0264436 · Cited by 57 · see citing works
“Since the start of the COVID-19 pandemic, there has been a trend of patients either delaying or avoiding seeking non-COVID related medical care due to concerns related to the COVID19 virus, with this finding found to be more common in those with disabilities and those with two or more underlying conditions [44].”
BackgroundRates of Routine Cancer Screening and Diagnosis Before vs After the COVID-19 Pandemic
Oakes, A. H., Boyce, K., Patton, C., et al. (2022) · JAMA Oncology · doi:10.1001/jamaoncol.2022.5481 · Cited by 64 · see citing works
Estrela, M., Silva, T. M., Gomes, E. R., Piñeiro‐Lamas, M., Figueiras, A., Roque, F., & Herdeiro, M. T. (2021) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2021-216732 · Cited by 60 · see citing works
Makaroff, K. E., Shergill, J., Lauzon, M., Khalil, C., Ahluwalia, S. C., Spiegel, B. M. R., & Almario, C. V. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2022.07.012 · Cited by 62 · see citing works
The COVID-19 Pandemic Strikes Again and Again and Again
Myers, L. C., & Liu, V. X. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.1760 · Cited by 60 · see citing works
Schuster, N. A., de Breij, S., Schaap, L. S., van Schoor, N. M., Peters, M. J. L., de Jongh, R. T., Huisman, M. A., & Hoogendijk, E. O. (2021) · European Geriatric Medicine · doi:10.1007/s41999-021-00514-3 · Cited by 54 · see citing works
Hassanein, M., Hussein, Z. B., Shaltout, I., et al. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108674 · Cited by 57 · see citing works
Kitano, T., Brown, K. A., Daneman, N., MacFadden, D. R., Langford, B. J., Leung, V., So, M., Leung, E., Burrows, L. L., Manuel, D. G., et al. (2021) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofab533 · Cited by 50 · see citing works
“The pandemic may have also affected patients’ behavior for seeking health care, and certain patient subgroups faced more substantial barriers to accessing in-person or virtual care than other groups [7].”
BackgroundFactors associated with delaying medical care: cross-sectional study of Nebraska adults
Ratnapradipa, K. L., Jadhav, S., Kabayundo, J., Wang, H., & Smith, L. C. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09140-0 · Cited by 56 · see citing works
“Patt D, Gordan L, Diaz M, Okon T, Grady L, Harmison M, et al. Impact of COVID-19 on cancer care: how the pandemic is delaying cancer diagnosis and treatment for American seniors.”
BackgroundInfluentialDefining medical deserts—an international consensus-building exercise
Brînzac, M. G., Kuhlmann, E., Dussault, G., Ungureanu, M., Cherecheș, R. M., & Baba, C. O. (2023) · European Journal of Public Health · doi:10.1093/eurpub/ckad107 · Cited by 57 · see citing works
Reduced pediatric urgent asthma utilization and exacerbations during the COVID‐19 pandemic
Hurst, J. H., Zhao, C., Fitzpatrick, N. S., et al. (2021) · Pediatric Pulmonology · doi:10.1002/ppul.25578 · Cited by 55 · see citing works
Hashish, E. A. A., & Atalla, A. D. G. (2023) · SAGE Open Nursing · doi:10.1177/23779608231160463 · Cited by 64 · see citing works
Cassell, K., Zipfel, C. M., Bansal, S., & Weinberger, D. M. (2022) · Nature Communications · doi:10.1038/s41467-022-33686-y · Cited by 54 · see citing works
“the pandemic period include: (1) changes in the underlying population covered by the insurance payers included in our analysis or changes in which hospitals (or types of hospitals that) are within the insurance service areas, (2) diagnoses that are a direct result of a prior SARS-CoV2 infection, and (3) mechanisms tha…”
Causes and costs of global COVID-19 vaccine inequity
Ferranna, M. (2023) · Seminars in Immunopathology · doi:10.1007/s00281-023-00998-0 · Cited by 56 · see citing works
“…the overtaxing of healthcare systems [5, 6], the disruption of routine immunization and medical testing [7], delays in treatments [8], and reduced willingness to seek care out of fear of infection or pandemic-related negative income shocks (e.g., unemployment and health insurance loss) [9].”
BackgroundStrika, Z., Petković, K., Likić, R., & Batenburg, R. S. (2024) · Postgraduate Medical Journal · doi:10.1093/postmj/qgae122 · Cited by 59 · see citing works
Mental Disorders Associated with COVID-19 Related Unemployment
Yao, R., & Wu, W. (2021) · Applied Research in Quality of Life · doi:10.1007/s11482-021-09950-6 · Cited by 53 · see citing works
“Limited access to medical care is another consequence of the measures used to contain the spread of the COVID-19 virus (Andrade et al. 2020; Czeisler et al. 2020).”
BackgroundGale, R., Eberlein, S. A., Fuller, G., Khalil, C., Almario, C. V., & Spiegel, B. M. R. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.20940 · Cited by 46 · see citing works
Patient Perceptions of SARS-CoV-2 Exposure Risk and Association With Continuity of Ophthalmic Care
Lindeke-Myers, A. T., Zhao, P. Y., Meyer, B. I., Liu, E. A., Levine, D. A., Bennett, O. M., Ji, S., Newman-Casey, P. A., Rao, R. C., & Jain, N. (2021) · JAMA Ophthalmology · doi:10.1001/jamaophthalmol.2021.0114 · Cited by 50 · see citing works
Macchi, Z. A., Ayele, R., Dini, M., Lamira, J., Katz, M., Pantilat, S. Z., Jones, J., & Kluger, B. M. (2021) · Palliative Medicine · doi:10.1177/02692163211017383 · Cited by 49 · see citing works
Fedewa, S. A., Cotter, M. M., Wehling, K. A., et al. (2021) · Cancer · doi:10.1002/cncr.33859 · Cited by 50 · see citing works
“INTRODUCTION The emergence of the coronavirus disease 2019 (COVID- 19) pandemic in the United States in the first quarter of 2020 caused delays in health care procedures, including cancer screening.(1,2) Recent reports have noted steep drops in breast cancer screening utilization at the start of the COVID- 19 pandemic.”
BackgroundTang, M. J., & Reddy, A. S. (2022) · Cancers · doi:10.3390/cancers14081884 · Cited by 49 · see citing works
“adults surveyed reported having delayed or avoided seeking medical care during the pandemic because of fears of the infectious spread of the virus [21,22].”
BackgroundEffect of COVID-19 on asthma exacerbation
Salciccioli, J. D., She, L., Tulchinsky, A., Rockhold, F. W., Cardet, J. C., & Israel, E. (2021) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2021.04.038 · Cited by 49 · see citing works
Grundstein, M. J., Fisher, C., Titmuss, M., & Cioppa-Mosca, J. (2021) · Physical Therapy · doi:10.1093/ptj/pzab145 · Cited by 48 · see citing works
Stone, M., Germanio, C. D., Wright, D. J., Sulaeman, H., Dave, H., Fink, R. V., Notari, E. P., Green, V., Strauss, D., Kessler, D., et al. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab537 · Cited by 47 · see citing works
Czeisler, M. É., Drane, A., Winnay, S. S., Capodilupo, E. R., Czeisler, C. A., Rajaratnam, S. M. W., & Howard, M. E. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.08.130 · Cited by 51 · see citing works
Self-citation
- Authors
- Czeisler, M. É., Marynak, K., Clarke, K. E. N., Salah, Z., Shakya, I., Thierry, J. M., Ali, N., McMillan, H., Wiley, J. F., Weaver, M. D., Czeisler, C. A., Rajaratnam, S. M. W., & Howard, M. E.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Czeisler, Mark É.
- ORCID
- Venue
- MMWR. Morbidity and Mortality Weekly Report
- Published
- 2020-09-11
- Volume
- 69
- Issue
- 36
- Pages
- 1250-1257
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC7499838
- OpenAlex
- W3081553985
- Semantic Scholar
- 26adc3936e3a469aea50c096d625acca6166d56d
- Cited by
- 1,516
- References
- 7
- Citations by year
- 2026: 95 · 2025: 133 · 2024: 209 · 2023: 346 · 2022: 402 · 2021: 304 · 2020: 24 · 2013: 1 · 2012: 1
- FWCI
- 97.16
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- Brigham and Women's Hospital
- US-UK Fulbright Commission
- Fulbright Australia
- Monash University
- Kinghorn Foundation
- Centers for Disease Control and Prevention
- Office of Rural Health
- Topics
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- COVID-19 pandemic, delayed care, health care utilization, severe COVID-19 risk, disability, emergency care, pandemic impact on healthcare
- MeSH terms
- COVID-19, Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Pneumonia, Viral, United States, Treatment Refusal, Coronavirus Infections, Young Adult, Pandemics, Time-to-Treatment
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