• Natalie Lo

The unintended consequences of COVID policies

While COVID-19 lockdown policies have been implemented to keep us safe, they have some unintended harmful side effects on our physical health. Lockdowns have severely disrupted healthcare services, especially “non-essential” ophthalmological check ups. Additionally, patient related factors such as COVID fears play a role in the cancellation of these necessary check up appointments and as a result, delay medical diagnosis and treatment. For example, rhegmatogenous retinal detachment (RRD) is a significant cause of acute vision loss and is often classified as an emergency. Since it is easily diagnosed and has a clear treatment (surgery), it is perfect to use as an “index disease” to investigate the impact of COVID policy on healthcare accessibility and treatment.


Image: https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/finding-eye-doctor/talking-your-eye-doctor


Studies from the UK had reported less cases of RRD in the first 3 months of the pandemic. This can be explained easily using COVID-19 policies; the lockdowns limited patient access to healthcare services due to distancing measures and restrictions on elective appointments and surgeries. In the United States, emergency department visits declined by 45% in the first 3 months of the COVID pandemic.


Keeping these impacted statistics in mind, the Canadian Journal of Ophthalmology compared patients who presented with RRD pre and post-pandemic and noted significant findings; the patients who were diagnosed during COVID were more likely to present with severe RRD, and had worse visual acuity. Consistent results were also found at the Wills Eye Hospital in the United States. Therefore, it can be inferred that patients who presented with RRD during or post COVID sought treatment later, or were not able to easily access treatment due to the lockdown.

These studies provide evidence that COVID-19 safety policies have caused unintended consequences with RRD. Although further analysis is required, it is likely that similar outcomes have occurred with other eye diseases, such as glaucoma. Although vaccines have begun to roll out, there is a high likelihood of recurring waves of the outbreak and thus more lockdowns in which an increase in severe eye diseases may occur.


So, how can we prevent this from occurring? We must invest in and improve existing education infrastructure so that the public is more educated about various symptoms of diseases and are therefore encouraged to seek out earlier care. We must also alleviate patient concerns; many do not seek care because they are afraid of contracting COVID at the doctors. Therefore, we must ensure that there is proper distancing and sanitation, and that the public is aware of these safety measures in order to alleviate these concerns. COVID has impacted our health in so many ways - we should not let it discourage us from seeking out early treatment.


Sources:

https://www.canadianjournalofophthalmology.ca/article/S0008-4182(21)00038-7/fulltext

https://www.canadianjournalofophthalmology.ca/article/S0008-4182(20)30842-5/pdf

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