COVID Exacted Toll on Pace of Cancer Screening, Israelis' Mental Health, Study Finds

Non-COVID hospital visits dropped in the early months of the pandemic, in part because people were afraid of being infected at the hospital and because hospitals were forced to postpone nonurgent care, the National Institute for Health Policy finds

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A coronavirus ward set up in a parking garage at the Rambam Heathcare Campus in Haifa.
A coronavirus ward set up in a parking garage at the Rambam Heathcare Campus in Haifa, Oct. 5, 2020.Credit: Rami Shllush
Ido Efrati
Ido Efrati

The toll that the coronavirus pandemic has exacted on the Israeli public isn’t fully reflected in the number of fatalities, the number of infected patients or figures on those required to go into quarantine. COVID-19 also affected many chronically ill patients whose conditions require that they receive continuous monitoring, and fewer Israelis received preventative medical care.

A study published by the Israel National Institute for Health Policy on Tuesday found that in the course of the pandemic, the number of diagnostic tests for illnesses such as diabetes and cancer dropped markedly. The largest declines were seen during the first lockdown, in March and April of last year, but the ground lost at the time was never fully made up.

The data confirms hospitals’ reports of a sharp drop in hospital visits, including for critical testing, in the early months of the pandemic, for reasons other than COVID-19. That, in part, was because people were afraid of becoming infected in the hospital and partly because hospitals and other medical providers were forced to postpone nonurgent care at peak periods of the pandemic.

In 2020 as a whole, 363,569 mammograms to detect breast cancer were performed, the report stated, down 4.5 percent from 380,596 in 2019. During the first lockdown, the pace dropped by 81 percent, but much of the lost ground was regained in subsequent months. The drop was particularly steep among women from low socioeconomic backgrounds.

Fecal occult blood stool sampling to detect colon cancer in patients between the ages of 50 to 74 fell by 8.3 percent, from 412,363 in 2019 to 378,085 in 2020. The decline was particularly sizeable during the first lockdown, declining by 76 percent and, by this measure as well, was much larger among the poor than the wealthy. The number of colonoscopies fell by 6.5 percent.

The number of diabetes patients who underwent at least one test of their blood sugar levels in 2020 edged down by 2.2 percent – to 88 percent of diabetes patients in 2020 from 90.9 percent in 2019. Nevertheless, the number of diabetes patients whose sugar levels were not under control also fell, to 8.8 percent, down from 9 percent in 2019.

The pace of cholesterol testing for heart patients who had undergone a catheterization or surgery dropped by 6.8 percent, from 190,386 to 177,484. That included a 7.9 percent drop among the poor but only 1.9 percent among wealthy patients.

The virus also had a significant impact on Israelis’ mental health. Many elderly people experienced prolonged isolation. Children did not attend school for extended periods and didn’t meet up with friends, and many families faced the anxiety of financial problems. The number of visits to mental health clinics was up last year, although psychiatric hospitalizations fell. But in the first half of 2021, which isn’t covered by the report, many psychiatric institutions reported an unprecedented jump in the number of hospitalizations of adults and children.

Prof. Ronit Calderon-Margalit of the Hebrew University of Jerusalem, who directs the national program that evaluates the quality of medical care in the community, said the report’s findings aren’t dissimilar from what other countries have experienced.

“Fortunately, the declines narrowed significantly by the end of 2020, and some of the disaster forecasts regarding the effects of the coronavirus apparently haven’t come to pass in Israel, at least in the areas that were measured,” she said. “Nevertheless, according to our findings, socioeconomic gaps widened during the year of the coronavirus when it comes to screening for cancer and diabetes imbalances.”

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