“This is either the second or first worst pandemic in modern human history,” said Dr Howard Markel, a pandemic historian and pediatrician at the University of Michigan. “We knew there would be repercussions and unintended consequences.”
Now, there is a “whole menu of neglect” to address as a national vaccine campaign allows people to slowly emerge from a year of lockdowns and social distancing. “There is no historical precedent for this,” added Markel.
In the first few months of the pandemic alone, at least 400,000 children missed screenings for lead, a toxic heavy metal. Doctors and nurses ordered 3m fewer vaccines for children and 400,000 fewer for measles specifically.
For the first time, clinics were forced to ration lab tests for sexually transmitted diseases as lab capacity and supplies were diverted to test for Covid-19. Contact tracers were also re-deployed from tracking chlamydia, gonorrhea and syphilis cases to finding people in contact with Covid-19 patients.
Data from one large commercial lab showed 669,000 fewer HIV tests were processed. Compared to 2019, the lab diagnosed nearly 5,000 fewer cases of HIV. Delayed diagnosis can lead to people unwittingly transmitting the virus.
Last year, more than 87,000 Americans died of drug overdoses as substance abuse clinics shuttered – the highest death toll since the opioid epidemic began. Some of those clinics never fully reopened, as funding dried up.
While some of these metrics have rebounded since the most severe lockdown in March and April 2020, most have failed to fully catch up as health services remain stretched due to ongoing Covid outbreaks and budget cuts. Meanwhile millions of Americans have lost employer health insurance, slipped into poverty or had lives thrown into upheaval.
Importantly, experts warn that the pandemic is likely to widen health inequalities for those who already had disproportionately worse health – including racial and sexual minorities, the poor and the rural Americans.
“Just as this has accelerated all of the disruptive movements of American society, this has really exposed vulnerability based on poverty, poor access to healthcare, housing issues – the social determinants of health we’ve been talking about for years,” said Markel.