Louisianans diagnosed with diseases before the coronavirus outbreak have had to wait weeks for follow-up care, and even with many medical clinics set to reopen next week, those who saw appointments canceled over the past month or so still have more waiting to do.

Gov. John Bel Edwards is letting many clinics reopen Monday, but the backlog of missed medical care won’t be cleared in a week. Experts fear that could cause some life-and-death situations depending on a person’s medical issues.

Though clinics and hospitals have been admitting emergency patients during the outbreak, doctors and medical officials expressed concerns that delays in receiving medical care could lead to worse outcomes for people who've suffered recent injuries or had to forgo screenings and surgeries for diseases like cancer.

“I wouldn’t be surprised that when this picks up we’ll see a blip of increased incidents of new cancer diagnosis,” said Dr. Vince Cataldo, an oncologist at the Mary Bird Perkins Cancer Center — Our Lady of the Lake Cancer Center in Baton Rouge, which treats around 100 patients each day.

Heart disease and cancer are the leading causes of death in Louisiana, according to the U.S. Centers for Disease Control and Prevention. Both are often discovered during routine doctor visits, especially in cases where a seemingly minor ailment leads to a diagnosis.

When caught early, breast, colon and other common cancers are easily treatable and don't require intensive surgeries in their early stages.

Cataldo said many of his patients have continued with their treatment, after giving the matter some thought. Both cancer and the treatments can weaken the immune system.

Even with clinics and hospitals given the green light to ramp back up services they’re delayed, observers say a number of patients still have anxiety about going to a hospital as the number of coronavirus cases continue to grow in the state.

Baton Rouge General COO Stephen Mumford points to the drop in hospital admissions for heart attack patients and those with complications from chronic illnesses as evidence of the public's fear of going to the hospital.

“We know they didn’t get cured of heart and kidney disease,” he said. “They’re suffering at home.”

Mumford added that while the term “elective” seems to imply procedures are optional, they include a range of operations like repairing a torn rotator cuff, heart surgery and removal of cancerous growths. All of which are riskier and harder to treat if they worsen, he said.

In preparing to resume timely procedures that have been pushed back, Baton Rouge General is creating has created separate entrances for non-coronavirus patients to seek care, with plans to find ways for supporting family members to be by their side.

The hospital also plans to use its rapid coronavirus tests that can deliver results in a few minutes for patients undergoing surgery to cut down on its use of protective equipment, Mumford said.

State leaders had asked medical facilities to hold off nonemergency surgeries to preserve protective equipment used to shield health care workers.

In recent days, the growth of new coronavirus cases and hospitalizations has slowed and data has suggested that the state won't run out of hospital beds and other resources as many had feared.

Some clinics have turned to alternatives like video doctor visits, but the profits made from surgeries and other operations had led to significant financial losses across the medical industry.

The Louisiana Hospital Association said hospitals across the state have lost roughly 40% of their revenue due to higher costs of buying protective equipment and high cost of treating patients with COVID-19, the respiratory illness caused by the new virus.

Ochsner, Louisiana’s largest health provider, announced last week it expects to lose $130 million dollars from delaying routine visits and elective procures. Baton Rouge General anticipated roughly $10 million in losses, its leaders said.

Now with the ability to resume some of those lucrative procedures, medical facilities will still have to measure how they allocate their staff and resources to care for coronavirus patients and those with other medical needs.

For smaller rural hospitals, it's a trickier undertaking because they don’t have nearly the same staff and available beds as larger facilities.

With a population of only about 22,000 people, St James Parish has logged more than 200 coronavirus cases and at least 17 deaths, according to state figures.

St. James Parish Hospital CEO Mary Ellen Pratt said the hospital's high cost of treating coronavirus patients and delays to other medical procedures has resulted in about a 50% profit reduction, though she says it should have little impact on patient care.

The 25-bed facility's plans to resume elective surgeries largely depends on the number of severe coronavirus cases and the facility's supply of protective equipment for workers. 

A second surge in COVID-19 cases could see them halt elective procedures again, and replenishing their supply of masks and gowns hasn’t come as quickly as they’d hoped, she said.

“It’s a balancing act,” Pratt said, adding the hospital plans to resume surgical services next week based on patients with the most need. “If we continue delays, it’ll cause more harm for the patients.”


Email Youssef Rddad at yrddad@theadvocate.com, and follow him on Twitter @youssefrddad