The on-going Coronavirus pandemic has impacted nearly every facet of our daily lives. From our healthcare infrastructure and economy to our grocery stores and schools, pretty much everything has changed. There have also been several unintended consequences that have arisen from both the virus and the subsequent shutdowns that are having a huge effect on public health. Below we explore 6 areas of public health that have been unexpectedly impacted by the Coronavirus pandemic.
1
Substance abuse treatment services
Social distancing has changed all of our day-to-day lives, including how we interact with ones and even strangers. For most people, this has been annoying, but for those in treatment for substance abuse disorder, social distancing has been especially difficult. In-person, group treatments such as AA and NA meetings have all been canceled in light of the pandemic, putting individuals who depend on them in grave danger for relapse. Additionally, social isolation, plus the inclusion of liquor stores in many states being deemed an essential business, could lead to an increased chance of relapse and difficulty in maintaining sobriety. To combat this, some local jurisdictions are offering online and virtual meetings and resources for addiction services. According to the NIH, “people with addiction [are] at greater risk for many illnesses, but if hospitals and clinics are pushed to their capacity, it could be that people with addiction—who are already stigmatized and underserved by the healthcare system—will experience even greater barriers to treatment for COVID-19.” Thus, not only are treatment services going to be more difficult to access, but those with on-going addiction issues may experience further hardship if they need treatment for COVID-19.
2
Domestic violence services
According to the American Public Health Association, violence, including domestic violence, is an important public health issue. With the ongoing “shelter in place” and stay at home orders, the risk for domestic violence has been heightened. The United Nations has announced this surge in domestic violence globally has been displayed through an increase in calls to domestic violence support lines during this time where people are at home more than ever. While orders to stay at home are of course essential public health guidelines to help “flatten the curve” of the Coronavirus, it’s important to consider the implications this can have on abusive situations at home.
3
Abortion services
Even though the World Health Organization classifies access to safe abortion as another important public health issue, Coronavirus could make getting the procedure more difficult. In-person medical appointments may be harder to attain due to COVID-19, as many providers are opting and mandating telehealth as a first line of defense. Of course, services like abortion and other family planning procedures cannot be done virtually, but individual states may deem abortion services as non-essential. This is a huge disadvantage and public health issue for women and families. Some states in the US are using this time to push for more restrictions on abortion services. For example, Tennessee Governor, Bill Lee, tried to order a state mandate on banning abortions, but was recently overturned by a Federal Judge. Additionally, Oklahoma Governor Kevin Stitt, banned all elective health services, which included abortion services where the mother’s health was not in immediate danger. Again, the purpose of issuing the public to stay home, including opting for telehealth when available, is all in line with helping stop the spread of the virus, but we must be mindful that we are still providing safe medical services for non-Coronavirus related issues.
4
Food & meal assistance
Food security and access to meals is another public health area that has been impacted by the pandemic. Many children rely on school to have a hot meal and with closures of schools nationwide, this puts some food security for children at risk. Some individual school districts are offering free meal service pick up for students and families but this is at the discretion of each school and not federally mandatory. The uncertainty, especially for those living in food deserts or those who attend a school further than their residence, can be a challenge when shut-downs have made food security less guaranteed for some vulnerable populations.
5
Prescription shortages
As scientists work endlessly to find a vaccine for the Coronavirus, researchers have been noticing that certain prescription medicines used to treat Lupus and Malaria can potentially be beneficial in treating the virus. However, this has unfortunately led to misinformation and a shortage in the medication hydroxychloroquine, leaving many pharmacies forced to deny patients who rely on hydroxychloroquine regularly. Congresswoman Diana DeGette of Colorado, called on the Food and Drug Administration to act against this. The CDC has also stated there is not enough research to “inform clinical guidance on the use, dosing, or duration of hydroxychloroquine for prophylaxis or treatment of [COVID-19].” While it’s essential to keep researching possible treatments and vaccines, it’s vital that this is not done in a way that harms people relying on life-saving medications for on-going chronic illnesses.
6
Non-infectious health initiatives
Finally, the resources and time being dedicated to other health initiatives unrelated to the Coronavirus has taken a back seat right now. While effectively dealing with this pandemic is the first priority in public health, we need to be mindful of all the work that needs to still continue for other public health issues, including preventative health management. For example, the CDC has advised rescheduling non-urgent medical care. This has led to measures such as cancer screenings, including mammography screenings, being put off or delayed.
As the Coronavirus pandemic continues, we will likely notice more changes in how we approach our public health initiatives to make dealing with this virus the ultimate priority. As important as it is to do all we can to flatten the curve, it’s just as important to keep in mind how other non-Coronavirus public health issues will be impacted and how we can find ways to make room for both.
