Bonn During the Corona pandemic, many patients avoided going to hospital and postponed having examinations and operations. This is now leading to a more severe progression of disease. Clinics are trying several approaches to address the problem.
Many patients avoided going to hospital during the Corona pandemic - with drastic consequences. “There were about 60 percent fewer examinations for bowel cancer screening,” says Yon-Dschun Ko, head physician for internal medicine, haematology and oncology at the Johanniter Hospital in Bonn. All diseases that have been recognised or treated too late will cause more severe progression in the years to come and could even become incurable. The risk of contracting coronavirus in a clinic, on the other hand, is very low, he says.
Cancer does not wait. The message of the new campaign for prevention is powerful. The Johanniter clinics have been running advertisements on social media for weeks due to the declining number of patients. Fewer and fewer people are coming for preventive medical check-ups. “Even short periods of time can be decisive,” Ko explains. Take the example of lung cancer: If you are operated on less than twelve weeks after detection, you have a five percent higher chance of survival. “That doesn't sound like much, but statistically it is a very high number.” If patients then wait another six months, this has a negative effect. “A longer duration in diagnostics is fatal,” says Ko.
Helios evaluates data from all its clinics
The Helios-Klinikum Bonn/Rhein-Sieg, the former Malteser Hospital, has also noticed a reluctance in the patients. The German-wide hospital network, which includes around 100 facilities, is evaluating the effect of the pandemic on its own clinics. “We can say on the basis of our data that the severity of diseases is increasing significantly,” says Klaus Friedhoff, head of the surgery ward in Bonn. He attributes this to the fact that people are afraid of going to hospital with what they see as harmless illnesses. “As a result, the progression of the disease becomes chronic and more severe.” And the more severe the progression of the disease, the higher the complication rate during surgery. Friedhoff cites gallstones as an example. “The sooner we operate, the sooner the patient gets better.” If there is a delay in treatment, chronic inflammation can occur. “The same applies to supposedly trivial hernias. An inguinal hernia should be operated on within the first month of diagnosis. This is then simple and quick. If you wait, the conditions of the local tissue change.”
Delay leads to worse healing
At Bonn University Hospital, Professor Christian Strassburg, Director of Medical Clinic I and President of the German Transplantation Society, is keeping a close eye on current developments. Standard procedures such as dialysis continued during the pandemic - that is, for those who had fixed appointments and knew that they had an illness requiring treatment. The problem is rather the patients with unspecific symptoms, he says. “Typical warning signals like blood in the stools or pain were reacted to quite differently.” Normally, you would go to the doctor. But people were more afraid of Covid-19. Strasbourg assumes that these effects will be felt in the next few years. “We have to fear that there will be more patients with more advanced stages of the respective disease and that danger levels will be reached that have not been reached before.” To put it simply: Diseases will have progressed to the point where they are no longer curable.
The clinics are trying several approaches to address the problem. The most important is probably the hygiene measures in hospitals, which have been refined more and more in recent months. “No one is treated without having a corona rapid test,” says Klaus Friedhoff. If an infection is detected, strict isolation measures take effect. Yon-Dschun Ko also believes that no one should be afraid of treatment in hospital. “All clinics have strict hygiene programmes. Certainly, infections are always brought in, but there is no longer a large spread.” Moreover, an increasing proportion of the public and the staff have been vaccinated. Friedhoff approaches the matter quite rationally: “If I wait, I will prolong the disease. This is offset by a really very low risk of infection in hospital.”
Listen to your body
There are no precise markers for when it is time to see the doctor. “An important indication is if I don't feel as well as usual,” Ko says. The complaints could be completely unspecific, but just a signal from the body. You don't have to go to hospital immediately, it is enough to inform your doctor. However, it is different with the recommended preventive check-ups. Breast cancer screening for women over the age of 50, colonoscopy or prostate examination by a urologist - these can detect cancer early. “If there are symptoms like blood in the stools, it is already no longer an early detection,” he says.
(Original text: Nicolas Ottersbach, Translation: Caroline Kusch)