Delay or avoidance of routine, urgent and emergency medical care due to concerns about COVID‐19 in a region with low COVID‐19 prevalence: Victoria, Australia

• Published in: Respirology 2021-07, Vol.26 (7), p.707-712
• Main Authors: Czeisler, Mark É., Kennedy, Jessica L., Wiley, Joshua F., Facer‐Childs, Elise R., Robbins, Rebecca, Barger, Laura K., Czeisler, Charles A., Rajaratnam, Shantha M. W., Howard, Mark E.
• Format: Article
• Language: English
• Subjects: Australia; COVID-19; Emergency medical care; emergency medical services; FORUM AND DEBATE; Respiratory diseases; SARS‐CoV‐2, coronavirus disease; Scientific Letter
• ISSN: 1323-7799; 1440-1843
• DOI: 10.1111/resp.14094

To the Editors: In August 2020, the World Health Organization reported that 89% of 105 surveyed countries reported disruption to essential health services during the coronavirus disease 2019 (COVID-19) pandemic.1 In late June 2020, when there were 2.5 million cumulative confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the United States,2 40.9% of 4977 surveyed US adults reported having delayed or avoided medical care due to COVID-19 concerns.3 Given the potential short- and long-term consequences of medical care delay or avoidance, we sought to determine whether similar care avoidance was observed in a region with low SARS-CoV-2 prevalence. Demographic and health information were collected as covariates, including sex, age, ancestry, regional versus metropolitan postcode, education attainment, employment status, unpaid caregiver status (providing unpaid care for children only, for adults only, for both age groups [multigenerational] or not an unpaid caregiver), disability status and support through the National Disabilities Insurance Scheme (NDIS) and presence of underlying conditions known to increase the risk of severe COVID-19, including: obesity (BMI > 30 kg/m2), diabetes, hypertension, cardiovascular disease, chronic kidney disease, liver disease, chronic obstructive pulmonary disease and cancer. Adjusted prevalence ratios (aPRs) and 95% CIs for delay or avoidance of any medical care were estimated using Poisson regressions with robust SEs among respondents who had complete data for the following variables: sex, age, ancestry, regional or metropolitan residence, education attainment, employment status and unpaid caregiver status. For type of care avoided or delayed (Columns 4 through 9), percentages are reported based on the number of respondents who delayed or avoided care within that demographic group. aPRb b Multivariable Poisson regression models include all variables listed in table, except for disability status and health conditions, which were run in separate models that also included all demographic variables to avoid collinearity between these two variables.