During the first wave, the novel coronavirus (SARS-CoV-2) had a major impact on healthcare in the Netherlands. Many patients faced delays in appointments and treatments. Some appointments were cancelled by patients, who feared becoming infected or wanted to avoid overloading the healthcare system.
The health effects of the reduction in provided care have now been estimated for the first time. The postponement of some aspects of hospital care during the first wave of COVID-19 will lead to a loss of at least 50,000 healthy years of life. This finding is presented in the report on Impact of the first wave of COVID-19 on regular healthcare and health that RIVMNational Institute for Public Health and the Environment is publishing at the request of the Ministry of Health, Welfare and Sport (VWS).
In hospitals, general practitioners and other care institutions, many appointments and treatments were cancelled or postponed between March and August. As a result, the health benefits that these treatments normally provide have not been achieved. Within specialist medical care alone, the delayed treatments will already cost at least 50,000 healthy years of life. A healthy year of life can be lost as a result of premature death or reduced quality of life. In the estimate of at least 50,000 healthy years of life lost, reduced quality of life represents a relatively large percentage, while premature death represents a smaller percentage. Some part of the health loss does not have to be permanent if additional treatments can be carried out in the coming years. However, this will require a significant effort on the part of healthcare workers.
Cataract, knee and hip surgeries
RIVM researched about 30% of specialist medical care. This showed that most of the healthy years of life lost are the result of discontinued treatments in the specialist fields of ophthalmology and orthopaedics, such as cataract, knee and hip surgeries. These treatments are performed frequently and result in proportionately significant health gains, and therefore also lead to significant losses if the care is not continued. It is certain that the total loss of health within specialist medical care exceeds the specified figures, but these findings cannot be extrapolated directly to the 70% of hospital care that was not included in the study. Estimating the effects of the reduction in care provided in sectors other than hospital care will require additional research.
RIVM also researched the scope of the reduction in care provided outside the hospitals. A great deal of normal healthcare was also scaled down in non-hospital contexts. However, part of the care was replaced by remote care, for example by telephone or videoconferencing. At the beginning of the summer, regular care was restored in many healthcare sectors, but did not manage to catch up on the backlogs. Some forms of care, such as paramedical care, adult day services and group treatments, had a more difficult time restarting, because they had to be adapted to comply with COVID-19 guidance, for example guidelines on maintaining sufficient distance from others or cleaning treatment areas between treatments. This meant that it was often not possible to provide the same amount of care as before.