The pandemic made many Americans postpone health care: gunfire

Last month, Chelsea Titus, a 40-year-old mother of one in Boise, Idaho, had surgery to relieve severe pain Endometriosis pain. But the hospitals there are so full of unvaccinated COVID-19 patients that the doctors told her to wait.

According to a new survey by NPR, the Robert Wood Johnson Foundation, and the Harvard TH Chan School of Public Health, almost one in five American households has had to postpone treatment for serious illness in recent months.

Titus, who works for a tech company from the house she shares with her husband, daughter, and a Labradoodle named Winston, previously had endometriosis surgery, in which doctors removed her uterus and one ovary. When the condition flared up again in September, the pain was severe.

“Sometimes it feels like I’m in active work,” she says.

Endometriosis affects millions of women in the United States, when tissue that normally grows inside the uterus also grows outside.

When the first medication that Titus received did not help, she turned to her doctor on call.

“He said, ‘If the hospitals weren’t where they were, I would have you operated on today,'” she recalls.

The safety net is gone

The situation in Idaho hospitals is dire. The facilities are so full of mostly unvaccinated COVID-19 patients that many can no longer work normally. Several hospitals had to ration care.

Jim Souza, chief physician at Boise’s largest hospital, St. Luke’s, describes the high standards of care typical of his facility as the network that enables doctors to perform high-wire medical acts every day.

But now “the network is gone and people will fall off the wire,” says Souza.

Idaho has one of the lowest COVID-19 vaccination rates in the United States.

“As cancer clinicians, we are really frustrated,” says Dr. Dan Zuckerman, medical director of St. Luke’s Cancer Institute.

Zuckerman says his coworkers have delayed surgery on some types of breast cancers that hormones are likely to keep at an early and treatable stage.

“With that there are no guarantees,” he says, “and there will still be some cancers that can biologically break through.”

Zuckerman now spends half the day in the hospital helping his overworked colleagues and says he can only see half as many patients in the clinic.

Across town, in Saint Alphonsus, Boise’s slightly smaller hospital, another oncologist, Scott Pierson, says they haven’t had to postpone operations.

But standard cancer screening exams, such as colonoscopies, have been pushed back.

“We are already a state that, if you look at the statistics, is lagging behind in screening,” says Pierson.

The pulmonologists who normally perform lung biopsies in Saint Alphonsus, for example, are currently overwhelmed, he says, when trying to treat severe cases of COVID-19 in the intensive care unit.

Tight health systems mean delayed care

Many Americans are grappling with delays like those in Idaho, says Robert Blendon, a pollster at Harvard Chan School of Public Health.

“The numbers were much bigger than we expected,” says Blendon, “and the Delta variant changed the game.”

The survey he was involved in found that almost one in five US households has been unable to receive treatment for a serious illness in the past few months. most of them said they had negative health effects as a result.

“That’s the United States,” says Blendon. “You don’t expect people with serious illnesses to say they can’t be seen for care.”

These data, he says, show that health systems need to scale up before the next pandemic or major natural disaster.

As hospitals in the Boise area are teeming with COVID-19 patients, demand has also increased from people who were already delayed during the pandemic.

Pierson and Zuckerman say they saw more advanced than usual cancers that could have been discovered earlier; earlier detection of the malignancies would likely have given patients a much higher chance of survival, they say.

Pierson says he has suggested patients take a less intense form of chemotherapy so that they are less likely to need a hospital bed in the event of complications.

Although the immense pain Titus felt from her endometriosis was overwhelming, she says there was nowhere in Boise to operate on to remove her remaining ovary.

Her brother took the extraordinary step of chartered a private plane to instead take her to the California Bay Area for treatment.

“I guess I could have flown commercially, but it would have been really tough and embarrassing because I screamed in pain,” she says.

After landing, Titus went to an emergency room and emergency clinic and spoke to several doctors before finding a surgeon with an open calendar on her insurance network.

Hotel rooms, a rental car, and her flight home totaled thousands of dollars out of her own pocket – all for an operation she could have done at normal hours in a hospital just a few minutes’ drive from home.

She realizes that she has the privilege of being able to afford everything she did to get treatment.

“It breaks my heart that most of Idaho can’t,” says Titus.

Yet almost two weeks passed after she first felt the severe pain when she felt relief.

“It’s amazing how much better I feel,” she said two days after her surgery.

But the situation has made her question how much her friends and neighbors who refused to wear masks or get the COVID-19 vaccine really care about her community – and whether she still has a place in the state .

“My husband and I always said, ‘We’ll never leave Idaho,'” says Titus. “We love it here. It’s a great place to live, and we looked at properties in other states – because that’s just not okay. “