Chronic Conditions Magnified by COVID and the Impact to Mental Health

Written by: Stacey Cannizzo, United Helpers Vice President of Clinical and Quality Services, and Dr. Andrew Williams, CMO Community Health Center of the North Country, Associate Chief Medical Officer for the St. Lawrence Health System and President of the St. Lawrence County Board of Health

COVID-19 continues to impact our community and nation on a broad scale.  

Baby boomers comprise 26% of the population in the United States; this includes an age range from 56-76 and equates to an estimated 85.3 million people. Lets take this one cohort and analyze the impact COVID-19 could have on health outcomes and cost to the healthcare system. 

Baby boomers are in a position, through health literacy and healthy lifestyles, to live longer and remain fit. If impacted by a condition resulting in chronic disease, the outcome could be much different. Studies have demonstrated the following effects and the statistical prevalence of various diseases in conjunction with a COVID-19 diagnosis:

• 77% of infected individuals have acute respiratory conditions, those with an underlying pulmonary condition are debilitated;
• 38-76% of hospitalized patients in New York City experienced kidney failure;
• 21-30% of Intensive Care Unit patients develop blood clots, can travel through the body resulting in stroke, pulmonary embolism or heart attack;
• 1.6% of cases treated in the emergency department are diagnosed with a stroke, while 36-57% develop neurological symptoms which may persist;
• 78% infected, regardless of severity of illness, demonstrate cardiac inflammation after recovery.

Most would agree people aged 56-76 lead active lives, with many still in the workforce adding value to our  economy. Imagine the consequences if a group this large experienced widespread, chronic effects of COVID-19. To put this in perspective, Healthy People 2020 estimated $20.7 billion is spent on care and treatment of mild chronic pulmonary diseases annually, prior to COVID-19. The American Heart Association reports over $300 billion is spent to treat heart disease and strokes each year. The bullet-pointed adverse outcomes listed above will result in additional volume for already highly utilized healthcare services. The City University of New York (CUNY) Public School of Health published a report stating if 20% of our nation contracts the virus, the cost of post-hospitalization care could reach $50 billion. This study did not take into account long-term chronic care and treatment.  

As of August 6, 2020 the United States had confirmed 4,802,491 cases of COVID-19, and that number continues to climb daily at the rate of 75,000. St. Lawrence County, New York continues to fare well in the fight against COVID-19. To date, we have 260 diagnosed cases, 42 people hospitalized, and 4 deaths. Hand hygiene, social distancing, and face coverings are an integral part of breaking the chain of transmission.  However, limiting travel will keep the spread of  disease from entering our region from highly affected areas; stay home and stay healthy.  If you do travel please utilize all precautions and be aware of your environment. 

The Scars You Can’t Always See…

Lifestyle adaptations and limitations have resulted in an increase of social isolation, depression, anxiety and fear.  Changes in income, financial pressure, secure housing and access to community services compound the challenges. Mental health providers are already saturated, as the need for care exceeds availability. Michele Montroy, VP of Operations at United Helprs’ Behavioral Health Life Skills (BHLS), stated the waiver for telehealth (mental health) services has been extended. Our outpatient mental health program offers a full compliment of psychiatric services to children and adults living in the community.  This vital access provides a portal of entry and continuation of services  for this vulnerable population. Telehealth capabilities allow United Helpers to reach people despite the obstacles COVID-19 has created. In addition, United Helpers provides services through our transitional  housing program. Our housing division reaches an estimate 580 community members who rely on a safe, clean environment and assistance to bridge their individual needs.  

The Centers for Disease Control (CDC) offers some self-help tips including getting enough sleep, increased physical activity, healthy diet, meditation and relaxation. Other strategies include maintaining a regular routine, limiting  exposure to news media, remaining positive and setting priorities. Remaining engaged in the needs of others, helping people, and providing support are all activities that bind our community.