Search

Temporary disruptions in routine and nonemergency medical care access and delivery have been observed during periods of considerable community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1). However, medical care delay or avoidance might increase morbidity and mortality risk associated with treatable and preventable health conditions and might contribute to reported excess deaths directly or indirectly related to COVID-19 (2). To assess delay or avoidance of urgent or emergency and routine medical care because of concerns about COVID-19, a web-based survey was administered by Qualtrics, LLC, during June 24-30, 2020, to a nationwide representative sample of U.S. adults aged ≥18 years. Overall, an estimated 40.9% of U.S. adults have avoided medical care during the pandemic because of concerns about COVID-19, including 12.0% who avoided urgent or emergency care and 31.5% who avoided routine care. The estimated prevalence of urgent or emergency care avoidance was significantly higher among the following groups: unpaid caregivers for adults* versus noncaregivers (adjusted prevalence ratio [aPR] = 2.9); persons with two or more selected underlying medical conditions † versus those without those conditions (aPR = 1.9); persons with health insurance versus those without health insurance (aPR = 1.8); non-Hispanic Black (Black) adults (aPR = 1.6) and Hispanic or Latino (Hispanic) adults (aPR = 1.5) versus non-Hispanic White (White) adults; young adults aged 18-24 years versus adults aged 25-44 years (aPR = 1.5); and persons with disabilities § versus those without disabilities (aPR = 1.3). Given this widespread reporting of medical care avoidance because of COVID-19 concerns, especially among persons at increased risk for severe COVID-19, urgent efforts are warranted to ensure delivery of services that, if deferred, could result in patient harm. Even during the COVID-19 pandemic, persons experiencing a medical emergency should seek and be provided care without delay (3)., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Charles A. Czeisler reports an endowed professorship provided to Harvard Medical School by Cephalon, Inc. and educational and research support to Harvard Medical School and Brigham and Women’s Hospital from Philips Respironics, Inc. and Alexandra Drane, which supported in part the survey administration and analysis. Mark É. Czeisler reports a grant from the Australian-American Fulbright Commission. Mark E. Howard reports a grant from the Institute for Breathing and Sleep, Austin Health, Australia. Shantha M.W. Rajaratnam reports a grant from the Turner Institute for Brain and Mental Health, Monash University, Australia. Charles A. Czeisler, Joshua F. Wiley, Matthew D. Weaver, Mark É. Czeisler, Mark E. Howard, and Shantha M.W. Rajaratnam report contributions by Archangels for the screener used to determine unpaid caregiver status in the survey and a grant to Monash University from Whoop, Inc. that supported in part the administration of the survey in June. No other potential conflicts of interest were disclosed.