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Deferral of Care for Serious Non–COVID-19 ConditionsA Hidden Harm of COVID-19

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The harms of the coronavirus disease 2019 (COVID-19) pandemic have been innumerable, including illness, death and disability, unemployment and devastation of small businesses, hunger, educational losses, and amplification of racial and social inequities. In this issue of JAMA Internal Medicine, 2 articles shed light on another cost: deferral of care for serious non–COVID-19 conditions, such as myocardial infarction and stroke.

Blecker et al1 and Bhambhvani et al2 examined admissions to hospitals in New York and California during the pandemic and found dramatic reductions in presentations for non–COVID-19 conditions compared with prior years. These included medical emergencies, such as appendicitis, for which the true incidence was unlikely to have changed. There was also a decrease in admissions for exacerbations of chronic disease, such as heart failure. Bhambhvani et al2 found greater reductions at a hospital in New York than one in California, suggesting that deferral of care may be associated with the intensity of the surrounding epidemic.

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Article Information

Published Online: October 26, 2020. doi:10.1001/jamainternmed.2020.4016

Corresponding Author: Colette DeJong, MD, Department of Medicine, University of California, San Francisco, 505 Parnassus Ave, Room M-987, San Francisco, CA 94143 (colette.dejong@ucsf.edu).

Conflict of Interest Disclosures: Dr Covinsky reported receiving grants from the National Institute on Aging. No other disclosures were reported.

References
1.
Blecker  S , Jones  SA , Petrilli  CM ,  et al.  Hospitalizations for chronic disease and acute conditions in the time of COVID-19.   JAMA Intern Med. Published online October 26, 2020. doi:10.1001/jamainternmed.2020.3978Google Scholar
2.
Bhambhvani  HP , Rodrigues  AJ , Yu  JS , Carr  JB  II , Hayden Gephart  M .  Hospital volumes of 5 medical emergencies in the COVID-19 pandemic in 2 US medical centers.   JAMA Intern Med. Published online October 26, 2020. doi:10.1001/jamainternmed.2020.3982Google Scholar
3.
Asch  DA .  Opening hospitals to more patients during the COVID-19 pandemic—making it safe and making it feel safe.   JAMA Intern Med. 2020;180(8):1048-1049. doi:10.1001/jamainternmed.2020.2626PubMedGoogle ScholarCrossref
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