By Glenn Ellis
We have all been overwhelmed for what seems like an eternity with this pandemic. We are all exhausted, stressed out, and some of us depressed. We are fed up with the constant face masks; hand sanitizer; and distancing 6 feet from everyone. Now, we are hearing about the “second wave.” It seems that most of lives revolve around COVID-19, in one way or another.
One important aspect of health and healthcare that has been totally overlooked during the flood of news and reports from the media is chronic conditions. Remember those?
The Centers for Disease and Control Prevention (CDC) defines chronic conditions as, “…conditions that last one year or more and require ongoing medical attention or limit activities of daily living or both. Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States”. Well did you know that an estimated 45.4 percent of adults in the United States are at an increased risk for complications from COVID-19 because of heart disease, diabetes, lung diseases, high blood pressure, or cancer?
By the CDC definition, they emphasize that chronic conditions require ongoing medical attention, but getting primary care for chronic diseases has always been an ongoing, and major challenge; particularly for African Americans. It has gotten worse during the pandemic. This is not limited to physical conditions; almost 80 percent of patients with COVID-19 said that their mental health got worse. The importance of primary care is a real issue for millions.
As we enter the flu season, while witnessing the “second wave” of COVID-19, managing and getting routine care for existing chronic conditions is crucial. We have no idea of what type of health crisis these two viruses (COIVD-19 and the flu) can create as they hit us at the same time.
According to Anthony Fauci, MD, director of the NIH National Institute of Allergy and Infectious Diseases, “The flu has a mortality of 0.1 percent. COVID-19 has a mortality of 10 times that,” …and it rises dramatically with age.
It’s important to note that 50 percent of African Americans have high blood pressure, and if you reach 70-years old, it increases to 70 percent. High blood pressure is but one chronic condition that leads to lower immunity, making you more likely to get, and die, from COVID-19. We also carry a greater burden of heart disease, diabetes, lung disease, and cancer. For seniors and elders, risk for severe illness from COVID-19 is even greater, because they are more likely to have more than one chronic condition, such as heart disease or diabetes.
There is reason to be particularly concerned about where we are in this pandemic. In a normal year, the number of people who get an influenza vaccination in below 50 percent.
With all of the talk about “Operation Warp Speed” to develop a COVID-19 vaccine, increasing public doubt and suspicion, just based on past patterns with the seasonal influenza vaccination, it probably safe to assume that a lot of people won’t be taking the vaccine even if they come up with one.
My point? If you know that statistics say if you are reading this column, you probably have at least one chronic condition and chronic conditions not only make you more vulnerable to being infected with COVID-19 but increases your chances of dying. You don’t need to get infected with COVID-19; any one of the chronic conditions are potentially deadly on their own.
What has not been reported is the extent to which the ability of a person needing primary care for chronic conditions has been limited by the pandemic. Community health center and solo practices are being decimated; reducing hours; seeing fewer patients; and staff shortages. This means fewer billings, which means fewer dollars to operate the clinic. This process has spiraled down to clinics and primary care offices reducing days/hours of operation. The end result is the lack of availability for basic chronic disease management.
Chronic conditions must be managed by a primary care provider. There are too many potential complications associated with all chronic conditions, that things could get out of hand pretty quickly, and before you know it, strokes; amputations; heart attacks; and other events result.
Please understand that the one answer is just to make sure you take your medications. The pharmacies are being hit hard as well. Pharmacies are experiencing the same short staffing and busy workplaces. Under these circumstances they are trying to fill all the prescriptions, waiting on customers at the drive-through, answering phone calls from people who just want to know what time you close, giving people flu shots, working the cash register; not to mention counseling patients and calling doctors’ offices and insurance companies for authorizations.
I don’t want to get too deep, but you must be vigilant in staying on top of your health, especially if you have chronic conditions. Our history has been to fight several battles on different fronts at the same time; we know what we need to do.
Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Fellow in Research Bioethics and Writing. He is author of Which Doctor? and Information is the Best Medicine. He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com
