8 very unexpected ways COVID-19 has affected medicine

The COVID-19 pandemic has upended the lives of just about everyone in the United States and around the world. As a consequence of the outbreak, we stay 6 feet apart, we wear masks in public, we don’t go to restaurants, movie theaters, or little league games. Many doctors and nurses are overworked. Many other Americans can’t go to work, either because they've lost their jobs or their lives. 

At the outset, some of these consequences could have been—or were—expected. But, there have been a number of other repercussions in healthcare that hardly anyone saw coming...

Fewer organ transplants

Because of stay-at-home orders, fewer people are on the roads. This means fewer traffic accidents, which also means fewer donated organs. The end result: fewer organ transplants. 

For instance, traffic accidents and crash-related injuries and deaths dropped by half during the first 3 weeks of California’s shelter-in-place order, according to a report from the Road Ecology Center at the University of California, Davis. 

At the same time, the number of organ donors who died in motor vehicle accidents in the United States declined 23% from March 8 to April 11, compared with the same period last year, according to the United Network for Organ Sharing (UNOS). While this may seem like good news, consider that transplant procedures have also fallen by 52% between March 8 to April 11, according to UNOS data.

Decrease in childhood vaccinations 

What’s the one thing most people are desperately anticipating in order to get back to their normal daily lives? A coronavirus vaccine. But, it seems that a large portion of Americans are shying away from vaccines altogether, which has other dangerous repercussions.

The CDC reported a “substantial reduction” in the number of pediatric vaccinations for all noninfluenza vaccines from the start of the year until mid-April, compared with the same time in 2019. 

“The decline [in noninfluenza childhood vaccines] began the week after the national emergency declaration; similar declines in orders for other vaccines were also observed,” according to the report. A corresponding decline in measles vaccinations began around the same time.

This could pose a threat to communities as a whole.

“The identified declines in routine pediatric vaccine ordering and doses administered might indicate that U.S. children and their communities face increased risks for outbreaks of vaccine-preventable diseases,” wrote the authors of the report. 

In fact, the lack of vaccinations could cause outbreaks of other infectious diseases, the authors noted. 

“As social distancing requirements are relaxed, children who are not protected by vaccines will be more vulnerable to diseases such as measles. In response, continued coordinated efforts between health care providers and public health officials at the local, state, and federal levels will be necessary to achieve rapid catch-up vaccination,” they concluded. 

Increase in domestic violence

Reports indicate that domestic violence has been on the rise during the COVID-19 pandemic. And it’s no wonder. With people stuck at home during a stressful national emergency, domestic violence victims are left vulnerable and without a safe place to escape from their abusers. 

In New York, for instance, calls to the state’s domestic violence hotline increased 18% in just one month from February to March, and were up 30% in April 2020 compared with April 2019. State Police reported domestic violence incident calls were up 15% in March 2020 compared with last March.

Outside of New York City, large police departments reported a 12% increase in intimate partner victimizations for the first quarter of 2020, compared with the first quarter of 2019, according to the NYS Division of Criminal Justice Services.

“Since the beginning of this pandemic, New York has seen a dramatic increase in the number of domestic violence cases across the state,” said Governor Andrew Cuomo at a recent press meeting announcing the creation of a new domestic violence task force. “While we have already taken aggressive actions to help some of our most vulnerable New Yorkers get the help they need and get away from their abusers, there is more that we can do to modernize the services we provide as we begin to enter a new normal.”

More ‘deaths of despair’

About 90,000 Americans have died due to COVID-19–related illnesses. However, that’s not the total number of deaths COVID-19 is responsible for. A recent report indicates that tens of thousands of American lives have been lost due to “deaths of despair,” which are deaths linked to drugs, alcohol, and suicide. 

“Deaths of despair have been on the rise for the last decade, and in the context of COVID-19, deaths of despair should be seen as the epidemic within the pandemic,” wrote the authors of the report. 

Right now, three factors are already at work increasing deaths of despair: unprecedented economic failure paired with massive unemployment, mandated social isolation for months and possible residual isolation for years, and uncertainty caused by the sudden emergence of a novel, previously unknown microbe.

The report approximates the total US deaths of despair to be around 75,000, but the number could range anywhere from 27,644 deaths on the low end—if we account for a quick recovery from the pandemic and minimal impact of unemployment on deaths of despair—to 154,037 on the high end—accounting for a long, drawn-out pandemic and maximum impact of unemployment on deaths of despair. “When considering the negative impact of isolation and uncertainty, a higher estimate may be more accurate,” the authors noted. 

Packing on the pounds

Have you gained weight? If so, you’re not alone. Call it the “Quarantine 15”—it’s the proverbial number of pounds that some Americans have gained during the COVID-19 crisis. About 47% of US women and about 22% of men reported they’ve gained weight as a result of the pandemic, according to a recent WebMD survey. 

“People’s habits have changed quite a bit since we’re spending more time at home,” said Donald Hensrud, MD, MS, medical director of Mayo Clinic’s Healthy Living Program. “Obviously, the more weight we gain and the longer it’s maintained, the more it affects our health.”

In the survey, nearly 60% of Americans reported that both stress eating and a lack of exercise have caused their recent weight gain. About 21% said they put on weight from consuming more alcohol. Of those who kept track, nearly 50% said they gained up to 6 lb, and 25% said they added 10 lb or more. 

“Eating healthy and eating well don’t have to be drudgery. It can and should be an enjoyable way to live. And if we can do that, then we can better manage our weight and our overall health during this pandemic,” Dr. Hensrud advised. In fact, the foods you choose to eat during the pandemic may very well bolster your immune response or hurt it.

‘Fewer’ heart attacks? 

Hospitals and emergency departments have been reporting significantly fewer cases of heart attacks and strokes. Has the coronavirus somehow put the kibosh on cardiac events? 

Probably not. Rather, health experts speculate that people may be suffering heart attacks, strokes, and cardiac arrest at home instead of going to the ER. 

“The number of heart attacks and strokes are not necessarily declining. While ongoing research may uncover other underlying reasons for decreasing numbers of heart attack and stroke patients in hospitals, the prevailing theory is that people just aren’t calling 911,” wrote leaders of eight major health organizations—including the American Heart Association, the American College of Cardiology, the American College of Emergency Physicians, and others—in a public statement. 

Fear of catching COVID-19 from other patients in the hospital is most likely what’s keeping people away. But, if someone thinks they’re having a heart attack or stroke, the hospital is the best and safest place to be, the health leaders advised. 

“The bottom line is the same as it’s always been. When a medical emergency strikes, call 911. Get to a hospital,” they wrote.

Less air pollution

But it’s not all bad news. Coinciding with COVID-19 lockdowns and subsequent reductions in airplane and automobile traffic, air pollution levels in major cities around the world have dropped precipitously, at rates from 9% to 60%, according to a recent air quality report. 

In New York City, outdoor air pollution decreased 25% since its lockdown. In Los Angeles, air pollution reached historic lows—fine particle pollution dropped 31% during the lockdown compared with the same period in 2019, and fell 51% compared with the previous four-year average. 

Worldwide, outdoor air pollution is associated with an estimated 4.2 million premature deaths each year, primarily due to heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and acute respiratory infections (in children), according to the World Health Organization.

Accordingly, less air pollution could mean less death and disease—at least until cities and states resume business as usual. 

More bikes on the road, and in the home

Although some Americans may be stress eating and avoiding exercise, others have revisited an old activity: bicycling. With gyms closed and playgrounds roped off, sales of bicycles have increased by 31% (to $1.3 billion) in the first quarter of 2020, with over half of these sales occurring in March, according to The NPD Group, a market research firm. 

Sales of kids’ bikes went up 59% in March and adult bikes jumped a staggering 121%. In-home options also shot up, with a 171% increase in stationary bikes and more than 250% in trainers/rollers.

Bicycling is among a handful of exercises shown to decrease all-cause mortality. But, once stay-at-home orders are lifted, how much longer will this new, healthful bicycling boom last?

“Some speculate the craze will fizzle out when the weather turns cold and cities reopen parks, restaurants, movie theaters and other businesses,” wrote Emily Davies in The Washington Post. “Others say it is here to stay, as a recreational activity and a vital form of transportation, with ride-hail services and public transit less appealing than before.”