In UK, Covid Has Made NHS Delays for Other Illnesses Much Worse

LONDON — Lara Wahab had been waiting for more than two years for a kidney and pancreas transplant, but months had passed without a word. So last month, she called the hospital and received heartbreaking news.

There had been a good match for her in October, the transplant coordinator told her, which the hospital would normally have accepted. But with Covid-19 patients filling beds, the transplant team couldn’t find a place for her in the intensive care unit for post-operative care. They had to refuse the organs.

“I was just in shock. I knew the NHS was under a lot of pressure, but you don’t really know until you expect something like this,” she said, referring to the National Health Service “It was there, but it kind of slipped through my fingers,” she added of the transplant opportunity.

Ms Wahab, 34, from north London, is part of a huge and growing backlog of patients in Britain’s free health service who have seen planned care delayed or diverted, in part because of the pandemic – a largely invisible crisis in a crisis. The problems are likely to have far-reaching consequences that will be felt for years.

The numbers are stark: In England nearly 6 million procedures are currently delayed, an increase from the pre-pandemic backlog of 4.6 million, according to the NHS Current delays most likely affect more than five million people – a single patient may have multiple cases pending for different conditions — representing almost a tenth of the population. Hundreds of thousands more have yet to be referred for treatment, and many illnesses have simply not been diagnosed.

There was already a huge and growing backlog of patients before the pandemic, but the relentless burden of the past two years, with healthcare staff and hospital capacity stretched even further by coronavirus cases, has seen it swell to highs. record proportions. The latest official figures are almost two months old and experts say severe staffing shortages this winter and the spread of Omicron-variant wildfires have almost certainly made the situation worse.

“Just because we have Omicron doesn’t mean other diseases have just stopped and aren’t emerging and growing in people, unfortunately,” said Saffron Cordery, deputy chief executive of NHS Providers, a membership organization for health workers. .

Public health experts worry that even if the pandemic alleviates and relieves some of the immediate burden, the pandemic and delayed care could cause lasting harm to the healthcare system, as well as to patients.

This month, a report by the Parliamentary Health Committee revealed a complex and disturbing picture of record waiting lists, high workloads and severe staff shortages. He warned that a major expansion of the workforce was needed, but the government was not doing enough to recruit and train health workers.

Generations of Britons have endured longer waits for treatment than many insured Americans, with most accepting this as the price of taking care of everyone else. But the problem has worsened for nearly a decade, with critics accusing Conservative governments of routinely underfunding the system.

In 2012, 2.5 million cases were awaiting specialist treatment in England. At the start of 2020, the backlog had grown to 4.6 million cases, according to the NHS

At the end of November 2021, the workload was six million. More than 300,000 cases have been waiting for more than a year for planned care. Ten years ago, there were less than 500.

The real backlog is likely much larger, experts and government officials say. As the health committee noted in its report, the pandemic has significantly disrupted normal patterns of assessments and referrals by primary care physicians, alienating people from official counts.

A recent National Audit Office report estimated that there were 7.8 million to 9.8 million “missing” referrals – those that would normally have happened but never did – by primary care doctors since the start of the pandemic until September 2021, including 240,000 to 740,000 for suspected cases of cancer.

“We’re likely to see ripple effects in people with other diseases, including but not limited to cancer, where treatment has been delayed or postponed or we’ve missed it,” Peter said. English, retired communicable disease control consultant. “And they died because they hadn’t received treatment that they otherwise would have received.”

By the time the pandemic hit Britain, Ms Wahab had been on the transplant list for months. In April 2019, her doctor told her that the type 1 diabetes she had since she was 7 had left her with kidney failure and that her best chance for recovery was a simultaneous pancreas and kidney transplant. .

Her doctors told her it would take about six months to get on the transplant list, and then usually about a year to be matched with a donor.

But in the spring of 2020, overwhelmed hospitals across the country halted non-emergency care, including transplants, diverting staff to the coronavirus response.

Since then, transplants have resumed and ceased, again and again. With each pandemic surge that filled intensive care units, the first treatments to be put on hold were planned procedures requiring intensive care beds – like transplants.

Because she managed to avoid dialysis despite her worsening condition, Ms. Wahab is a more desirable transplant candidate because her likelihood of a positive outcome is better. But she doesn’t know how much longer she can hold out.

“It has a devastating effect on my daily life,” she said. “I feel really hopeless as 2022 approaches – I’ve been waiting for this operation for almost three years.”

James Wilkinson, 46, was diagnosed with endocarditis, an inflammation of the lining of his heart caused by an infection that ate away at his aortic valve, and he was originally booked for surgery in May 2020. The operation was was canceled due to the pandemic. And then it was rescheduled and canceled three more times.

Mr Wilkinson, who gave evidence to a parliamentary committee late last year about his experience, said he eventually turned to private care for surgery, something few could afford.

“If it hadn’t been for the private health care, we don’t know when my operation would have taken place,” he said.

But it’s not just those waiting for care they know they need who have been injured. Cancer charities have warned that delays in diagnosis will also have devastating effects.

Macmillan Cancer Support, a charity, estimates that around 50,000 people across Britain have yet to be diagnosed with a form of cancer that should have been detected earlier, as a direct result of screenings and inconvenient referrals from the pandemic. The number of women diagnosed with stage 4 breast cancer – meaning the disease is advanced and very dangerous – has jumped 48% in recent months.

Danni Moore, now 31, found a breast lump in early 2020, just before the pandemic hit. Ms Moore, a mother of two, was still breastfeeding her youngest and thought she had a blocked milk duct. But her doctor referred her to a specialist clinic.

This meeting has been canceled due to the pandemic. She rescheduled, but then had to cancel because her partner had contracted the virus and their household had to self-isolate.

“The ripple effect of Covid made everything much more difficult, and I had the mass for much longer than I should have,” she said. “And it’s partly my fault. I should have left much earlier, but hindsight is also a wonderful thing.

Ms Moore said she postponed making another appointment, and the months passed. But then the lump got bigger and in the spring of 2021, a year after I first found it, it was diagnosed as breast cancer. The months that followed were a grueling whirlwind of chemotherapy treatments and complications, which she documented on her Instagram account.

Although her treatment this year continued without delay and she credits the doctors and nurses with saving her life, she knows her initial diagnosis would have come sooner had it not been for the pandemic.

The backlog of surgery also influenced her decisions on what comes next. Ms Moore opted to have a double mastectomy, scheduled for early February. She said she felt she could more easily live with the removal of both breasts than with the removal of just one and wait an unknown length of time to have reconstructive surgery to achieve a “new normal”.

“I have two young children,” she says. “I’ve already given up over a year of having cancer.”

She added: “I just don’t want to sit down and wait another two or three and make this process any longer than necessary.”