Corona pandemic: massive increase in other diseases

By David Meiländer, SWR

–
–
–
–

These are not nice days for Peter Hollaus at the moment. The chief physician of the lung department at the Marienhaus Klinikum in Mainz is standing in an aisle in surgical clothing, his eyes down. “It’s really painful for us,” he says. “When we sit at the tumor conferences and see that we can no longer help a patient with our art because it has progressed too far. That is tough.”

In the past, they were able to operate on a good 41 percent of the patients at the Marienhaus Clinic – people with mostly smaller tumors in the lungs, often with a good chance of recovery. The numbers from this year are very different. There are significantly more severe cases. Doctors can now only operate on a quarter of the affected patients – in the others, according to chief physician Hollaus, the tumors are so large that the patients would not survive the operation.

Significantly worse chances of recovery

What is currently happening at the Marienhaus Clinic in Mainz is the reality in many clinics in Germany. Report Mainz asked the 20 hospitals with the most lung cancer patients. Of those who were able to provide information, 71 percent now see more patients with severe lung tumors than before Corona in 2019. Even if the numbers cannot be representative, they reflect a trend. At the Thorax Clinic in Heidelberg, for example, the increase amounts to 20 percent, and doctors at the Evangelical Lung Hospital in Berlin also see a fifth more severe cases.

For the patients this means: fear. Advanced lung cancer is difficult to treat. “That means we can gain time through our therapies,” says Peter Hollaus. “But we can no longer offer them a cure.” Some of the patients he sees now are old friends: “We just had a patient who was diagnosed with a suspicious change four months ago and he just went home.” Now he is back, the only difference is that one cannot help him anymore. That makes him crazy, so Hollaus.

Millions of failed treatments

The fear of corona, the risk of infection in the doctor’s office or in the hospital – it has had a dramatic impact in the past year. According to the figures from the Central Institute for Statutory Health Insurance, more than 20 million treatments were canceled. There was also a significant slump in early 2021. It was similar in the hospitals. According to the AOK Scientific Institute, the decline between October 2020 and February 2021 was 20 percent compared to the same period of the previous year, in spring 2020 it was even 27 percent less than in 2019.

The consequences are also felt by diabetes and pain clinics, here too Report Mainz 20 clinics each with the most patients asked. The results are not representative, but they also show a tendency: In the case of diabetes, 50 percent of the clinics that have figures see a significant increase in severe cases. When it comes to pain, 44 percent report a significant deterioration in their patients’ situation – mostly because they missed a doctor’s visit.

For Ruth Hecker, chairwoman of the Patient Safety Alliance, these are collateral damage from failed crisis communication in the past pandemic year. “We warned a year and a half ago against addressing politics separately,” she says. “I actually believe that the Federal Minister of Health, to whom everyone was looking, to whom everyone was guided, who was the figurehead in the crisis, should have assumed more responsibility to inform target groups specifically: Go back to the hospitals, go back to the practices, call them, have a look! They are sure, you could have backed it up with examples of best practice. ” All of this happened too little. We felt the consequences now.

The federal government sees no failures

The Federal Ministry of Health explains that it has always been made clear that only operations that are not medically urgent should be postponed. On May 30, 2020, the minister appealed to the population to go to the doctor more and in February 2021 promoted colorectal cancer screening. The head of the Federal Center for Health Education also pointed out the topic in August 2020, as did the Federal Government’s patient commissioner. Regardless of this, it should be pointed out “that the decision about what is medically and therapeutically necessary is made by the treating physicians who know their patients and can best assess the respective situation taking into account the overall circumstances.”

Ruth Hecker, chairwoman of the Patient Safety Action Alliance, accuses the ministry of having done too little: “You have to keep communicating something like that.” If the minister had broadcast security, then security would also have reached the broader population, she says.

How long the consequences of the treatment failure can be felt is still unclear. At the Marienhaus Klinikum in Mainz, however, the doctors fear that the current dramatic situation at their hospital is just the beginning. Lung cancer is often only discovered by chance – because of the failed treatments, the number of incidental discoveries has also decreased. “That is actually what torments you a lot more, is that there are a bunch of people who are walking around out there with lung cancer and don’t know it. And by the time they come up with it, it will be too late,” said chief physician Hollaus.

–