Abstract
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). 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). To assess delay or avoidance of urgent or emergency and routine medical care because of concerns about COVID-19, a web-based survey was administered by Qualtrics, LLC, during June 24-30, 2020, to a nationwide representative sample of U.S. adults aged ≥18 years. 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. The estimated prevalence of urgent or emergency care avoidance was significantly higher among the following groups: unpaid caregivers for adults* versus noncaregivers (adjusted prevalence ratio [aPR]=2.9); persons with two or more selected underlying medical conditions† versus those without those conditions (aPR=1.9); persons with health insurance versus those without health insurance (aPR=1.8); non-Hispanic Black (Black) adults (aPR=1.6) and Hispanic or Latino (Hispanic) adults (aPR=1.5) versus non-Hispanic White (White) adults; young adults aged 18-24 years versus adults aged 25-44 years (aPR=1.5); and persons with disabilities§ 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).
Highlights
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%)
Understanding factors associated with medical care avoidance can inform targeted care delivery approaches and communication efforts encouraging persons to safely seek timely routine, urgent, and emergency care
Even during the COVID-19 pandemic, persons experiencing a medical emergency should seek and be provided care without delay [3]
Summary
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, including 12% who reported having avoided urgent or emergency care. §§§ For this question, respondents were asked to select the following statement, if applicable: “I know someone who has tested positive for COVID-19.” 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. 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. Adjusted prevalence ratios*,† for characteristics§,¶,**,†† associated with delay or avoidance of urgent or emergency medical care because of concerns related to COVID-19 — United States, June 30, 2020. Education Less than high school diploma High school diploma Some college Bachelor’s degree Professional degree Essential workers vs others§§ Essential workers Other respondents (nonessential workers, retired persons, unemployed persons, and students) Unpaid caregiver status¶¶ Unpaid caregiver for adults Not unpaid caregiver for adults
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