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Five ways the pandemic has affected routine medical care

Emerging evidence shows the COVID pandemic has seen fewer people receiving routine medical care across many areas. Here’s what we know about the impact…

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Jacob Lund/Shutterstock

Since the beginning of the pandemic, COVID has infected at least a third of the UK population and is estimated to have factored in the deaths of almost 200,000 people in the UK. But critically, COVID has also had a devastating impact on our healthcare systems. While this was expected, new evidence is beginning to reveal the scope of the issue – in particular the effects for people living with long-term health conditions.

Here are five ways the pandemic has affected access to routine medical care.

1. Heart disease

A 2022 review looked at evidence on the impact of the pandemic on heart disease and care, covering 158 studies across 49 countries.

Across all types of heart disease and all countries studied, there were fewer hospitalisations, treatments and healthcare appointments than before the pandemic. This might seem like a good thing, but actually it means that people delayed seeking medical attention when suffering from heart conditions. Indeed, this review found that the people who made it to hospital were more unwell than patients hospitalised with heart conditions before the pandemic.

The impact was the most severe in low and middle-income countries, where deaths from heart disease in hospital increased.

2. Diabetes

Diabetes care and services have been disrupted throughout the pandemic, from new diagnoses to critical screening and treatment programmes. A study published in May 2022 reveals that in England, death rates (excluding deaths caused by COVID) were higher among people with diabetes in 2021 compared with previous years. A recent analysis has linked this to disruptions in routine care caused by the pandemic.

People from the most deprived groups have had poorer outcomes compared with those from more advantaged groups. This plays out globally, too – people with access to sophisticated diabetes technology such as continuous blood glucose monitors appear to have had relatively stable blood sugar levels during the pandemic. But others have experienced serious declines in health and wellbeing, due in part to issues accessing insulin.


Read more: People who've had COVID appear more likely to develop diabetes – here's why that might be


3. Immunisation services

Another recent report brought together data from 170 countries and territories and showed that, compared to pre-pandemic, administration of vaccines for common childhood illnesses declined. Vaccine supply and demand were interrupted, and fewer healthcare professionals were available to deliver vaccines.

People may have also been hesitant to go and get their vaccinations because of fears around contracting COVID. Reductions spanned the different areas the researchers studied, but tended to be largest in lower and middle-income regions.

This introduces the possibility of future vaccine-preventable disease outbreaks, as we saw following disruptions caused by Ebola in parts of Africa. A risk-benefit analysis looking at re-opening vaccination clinics during the pandemic in African countries found that for every death from COVID acquired at the clinic, 84 deaths from vaccine-preventable diseases could be avoided.

4. Cancer diagnosis and care

2022 data from Cancer Research UK shows that cancer care provision declined across all areas. In the first year of the pandemic, one million fewer screening invitations were sent, 380,000 fewer people saw a specialist after an urgent suspected cancer referral, ten times more people were waiting six weeks or more for cancer tests, and almost 45,000 fewer people started cancer treatment.

This isn’t because fewer people had cancer. Cancers were less likely to be picked up, and once picked up, less likely to be promptly treated. By November 2021, cancer waiting time standards in the UK were missed by wider margins than ever before. Significant efforts are underway to rectify this, but there’s still a long way to go. Such disruptions to cancer care have been observed across the world.

A doctor gives a child, sitting on his mother's lap, a high five after receiving a vaccination.
The COVID pandemic has seen fewer routine vaccinations administered. Jacob Lund/Shutterstock

5. Waiting lists

Treatment backlogs – of people who should be receiving treatment, but haven’t yet – existed before the pandemic, but the pandemic made them much worse. A February 2022 report from the NHS in England showed that 6 million people were on the waiting list for elective care (care planned in advance, as opposed to emergency care), compared to 4.4 million prior to the pandemic.

This is, of course, not unique to England. In Finland, for example, elective surgery waiting times have increased by one-third since before the pandemic, even though the rate of elective surgeries increased by one-fifth after lockdown restrictions were lifted.

Delayed treatments, including surgeries, can increase preventable deaths and harm wellbeing. Delays in receiving healthcare are associated with anxiety, depression and poor quality of life among patients and caregivers.

What next?

It will be years until we can say for sure what the impacts of all of these disruptions will be. There is little doubt that they will be devastating on individual, national and global levels. There is also little doubt that some people will be much more affected than others – including those already living with long-term conditions, people from less advantaged backgrounds, and those living in areas with less equitable healthcare systems.

In our third year of the pandemic, prioritisation – of treatments, patients and services – continues to be both complex and necessary, and robust funding and support of healthcare services and staff are more critical than ever.


Read more: The NHS is having its worst winter ever – and the reasons run much deeper than COVID


On an individual level, if you’re due for a check-up or vaccine, do your best to ensure you receive it. If you have a worrying symptom, don’t let concerns of contracting COVID stop you from getting it checked out.

On a societal level, we’d do well to remember that the risks from COVID disruptions have not been equally distributed. When we make plans to address and recover from these disruptions, we need to acknowledge that digital advances won’t be a solution for all groups, and direct more resources to the people and areas who need them most.

Jamie Hartmann-Boyce receives or has received funding from the National Institute for Health and Care Research, the British Heart Foundation, Cancer Research UK, the University of Oxford, and the World Health Organization.

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Aging-US | Time makes histone H3 modifications drift in mouse liver

BUFFALO, NY- June 30, 2022 – A new research paper was published in Aging (Aging-US) on the cover of Volume 14, Issue 12, entitled, “Time makes histone…

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BUFFALO, NY- June 30, 2022 – A new research paper was published in Aging (Aging-US) on the cover of Volume 14, Issue 12, entitled, “Time makes histone H3 modifications drift in mouse liver.”

Credit: Hillje et al.

BUFFALO, NY- June 30, 2022 – A new research paper was published in Aging (Aging-US) on the cover of Volume 14, Issue 12, entitled, “Time makes histone H3 modifications drift in mouse liver.”

Aging is known to involve epigenetic histone modifications, which are associated with transcriptional changes, occurring throughout the entire lifespan of an individual.

“So far, no study discloses any drift of histone marks in mammals which is time-dependent or influenced by pro-longevity caloric restriction treatment.”

To detect the epigenetic drift of time passing, researchers—from Istituto di Ricovero e Cura a Carattere Scientifico, University of Urbino ‘Carlo Bo’, University of Milan, and University of Padua—determined the genome-wide distributions of mono- and tri-methylated lysine 4 and acetylated and tri-methylated lysine 27 of histone H3 in the livers of healthy 3, 6 and 12 months old C57BL/6 mice. 

“In this study, we used chromatin immunoprecipitation sequencing technology to acquire 108 high-resolution profiles of H3K4me3, H3K4me1, H3K27me3 and H3K27ac from the livers of mice aged between 3 months and 12 months and fed 30% caloric restriction diet (CR) or standard diet (SD).”

The comparison of different age profiles of histone H3 marks revealed global redistribution of histone H3 modifications with time, in particular in intergenic regions and near transcription start sites, as well as altered correlation between the profiles of different histone modifications. Moreover, feeding mice with caloric restriction diet, a treatment known to retard aging, reduced the extent of changes occurring during the first year of life in these genomic regions.

“In conclusion, while our data do not establish that the observed changes in H3 modification are causally involved in aging, they indicate age, buffered by caloric restriction, releases the histone H3 marking process of transcriptional suppression in gene desert regions of mouse liver genome most of which remain to be functionally understood.”

DOI: https://doi.org/10.18632/aging.204107 

Corresponding Author: Marco Giorgio – marco.giorgio@unipd.it 

Keywords: epigenetics, aging, histones, ChIP-seq, diet

Sign up for free Altmetric alerts about this article:  https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.204107

About Aging-US:

Launched in 2009, Aging (Aging-US) publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways.

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Government

FDA asks for COVID boosters to fight Omicron’s BA.4, BA.5 subvariants

The U.S. Food and Drug Administration on Thursday recommended booster doses of COVID-19 vaccines be modified beginning this fall to include components…

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FDA asks for COVID boosters to fight Omicron’s BA.4, BA.5 subvariants

By Michael Erman

June 30 (Reuters) – The U.S. Food and Drug Administration on Thursday recommended booster doses of COVID-19 vaccines be modified beginning this fall to include components tailored to combat the currently dominant Omicron BA.4 and BA.5 subvariants of the coronavirus.

The FDA said manufacturers would not need to change the vaccine for the primary vaccination series, saying the coming year will be “a transitional period when this modified booster vaccine may be introduced.”

FILE PHOTO: Signage is seen outside of the Food and Drug Administration (FDA) headquarters in White Oak, Maryland, U.S., August 29, 2020. REUTERS/Andrew Kelly/File Photo

The new booster shots would be bivalent vaccines, meaning doses would target both the original virus as well as the Omicron subvariants.

The decision follows a recommendation by the agency’s outside advisers to change the design of the shots this fall in order to combat more prevalent versions of the coronavirus. read more

BA.4 and BA.5 are now estimated to account for more than 50% of U.S. infections, according the U.S. Centers for Disease Control and Prevention, and have also become dominant elsewhere.

The FDA said in a statement on Thursday that it hoped the modified vaccines could be used in early to mid-fall.

Pfizer Inc (PFE.N) with partner BioNTech SE (22UAy.DE) and Moderna Inc (MRNA.O) have been testing versions of their vaccines modified to combat the BA.1 Omicron variant that caused the massive surge in cases last winter.

Although they have said those vaccines worked against BA.1 and the more recently circulating variants, they did see a lower immune response against BA.4 and BA.5.

The companies had already been manufacturing their BA.1 vaccines, and said on Tuesday that swapping to a BA.4/BA.5 version could slow the rollout.

Pfizer/BioNTech, which on Wednesday announced a $3.2 billion contract to supply more COVID vaccine doses to the United States, said they would have a substantial amount of BA.4/BA.5 vaccine ready for distribution by the first week of October. read more

Moderna said it would be late October or early November before it would have the newly modified vaccine ready.

Reporting by Michael Erman in New Jersey and Leroy Leo in Bengaluru; Editing by Jonathan Oatis and Bill Berkrot

Our Standards: The Thomson Reuters Trust Principles.

Source: Reuters

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Marketing automation startup Retail Rocket nabs $24M for expansion

Retail Rocket, a retention management platform for brands, today announced that it raised $24 million in a Series A round led by Cyprus-based private equity…

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Retail Rocket, a retention management platform for brands, today announced that it raised $24 million in a Series A round led by Cyprus-based private equity fund Flintera. In addition to the fundraising, Retail Rocket revealed that it acquired SailPlay, a startup developing software to help retailers build loyalty programs and send mass message campaigns.

New York-based SailPlay had raised $3.3 million prior to the acquisition. Founded in 2013 by Leonid Shangin and Yakov Filippenko, the company offered services to collect customer data and leverage it to create games, texts, and tasks designed to encourage repeat business.

As for Retail Rocket, it launched in 2012 headed by Moscow Business School of Management classmates, Nick Khlebinsky and Andrey Chizh, who’d attempted but failed to gain traction with several startups. The learnings from their previous efforts were the springboard for Retail Rocket, which after multiple pivots eventually grew its customer base to over 1,000 companies including Nintendo, Puma, and Decathlon.

“The digital marketing world is growing very fast and the demand for highly-skilled professionals is constantly increasing,” CEO Khlebinsky said. “The complexity of digital marketing tools is booming too — just several years ago we couldn’t imagine the technologies we use today.”

According to Khlebinsky, Retail Rocket uses a mathematical model to segment first-time buyers of a company’s product. By analyzing their actions — for example, the links they click on — the platform attempts to figure out their wants and preferences.

Image Credits: Retail Rocket

Retail Rocket also offers tools for campaign management like email marketing and web-based push notifications, as well as an engine that attempts to identify the best timing and communication channel (e.g., SMS) to make personalized offers. The goal is to create a “system of loyalty and retention management” for both online and offline customers, Khlebinsky said, that ultimately boosts business.

“We work with ecommerce on a performance-based pricing model,” Khlebinsky explained. “In most countries, the pandemic lockdowns spiked online sales, thus we experienced a temporary revenue increase. After the lockdown ended, there was a decrease, but to levels exceeding the pre-lockdown months, because a lot of people were forced to change their buying habits towards online shoppings.”

Absent independent reviews of Retail Rocket’s platform, it’s unclear whether its approach might beat out rivals like SalesForce, SAP, Bloomreach, and Dynamic Yield. But the promise of software that predictably drives repeat business is alluring. According to HubSpot, a mere 5% increase in customer retention can boost profits by 25% to 95%.

Retail Rocket has around 150 employees spread across offices in the Netherlands, Germany, Spain, Italy, and Chile, and it plans to double down on mergers and purchases in the coming months. Sources close to the company tell TechCrunch that Retail Rocket has $50 million set aside for acquisitions alone.

“Retail Rocket popped on our radars thanks to their international expansion and ability to set up sales teams in Europe and Latin America,” Flintera partner Sergey Vasin said in a statement. “We were impressed with the company’s results given the limited amount of investment they raised. The company was bootstrapping its growth after the seed round. Despite that, the efficiency of Retail Rocket products surpasses those of international competitors. We expect that the global e-commerce market will continue its growth at more than 10% per annum, with Latin America leading the race.”

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