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1 in 5 avoided healthcare during COVID-19 lockdown, despite symptoms like chest pain and limb weakness

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A recent study published in PLOS Medicine on November 23rd by Silvan Licher of Erasmus University Medical Center Rotterdam, the Netherlands, and colleagues found that one in five people avoided healthcare during the COVID-19 pandemic lockdown, often for potentially critical symptoms.

Consultations in both primary and specialized care fell during the COVID-19 pandemic compared to pre-pandemic levels. It’s unclear how much healthcare avoidance on the part of the general public contributed to these declines.

In the new study, researchers distributed a paper questionnaire to 8,732 Rotterdam Study participants, a cohort study meant to explore chronic diseases in mid-to late-life, covering various COVID-19-related subjects such as healthcare avoidance.

Between April and July 2020, 73% of participants replied, and the final population for the study was 5,656 people living in the same district of Rotterdam, the Netherlands.

Approximately one-fifth (20.2 percent) of participants reported avoiding healthcare during the pandemic. Of those, 414 (36.3 percent of avoiders) experienced symptoms that could have required immediate medical attention, such as limb weakness (13.6 percent), palpitations (10.8 percent), and chest pain (10.2 percent ).

However, no information on the severity of symptoms was given. Females (adjusted odds ratio (OR) 1.58, 95 percent confidence interval (CI) 1.38-1.82), those with poor self-appreciated health (per level decrease 2.00, 95 percent CI 1.802.22), and those with high levels of depression (per point increase 1.13, 95 percent CI 1.11-1.14) and anxiety were the groups most likely to have avoided healthcare (per point increase 1.16, 95 percent CI 1.14-1.18). Healthcare avoidance was also connected with lower educational level, older age, unemployment, smoking, and worry about developing COVID-19.

The results of the study “suggest that healthcare avoidance during COVID-19 may be prevalent amongst those who are in greater need of it in the population, such as older individuals, those with low perceived health and those who report symptoms of poor mental health.”

“One in five avoided healthcare during COVID-19 lockdown, often with alarming symptoms like chest pain or limb weakness,” said the author.

“Vulnerable citizens were mainly affected, emphasising the urgent need for targeted public education.”

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