An invisible patient: COVID-19’s third wave

This article was exclusively written for The European Sting by Ms. Nadua Apostólico and Ms. Marina Catharino Rodrigues, two medical students at Universidade Nove de Julho, Brazil. They are affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

The disease caused by the SARS-CoV-2 virus, popularized as COVID 19, has disrupted health care systems around the world, causing a worldwide socioeconomic crisis, affecting all aspects of human life. Margaret Harris, spokesman for the World Health Organization, when asked about the re-acceleration of the pandemic in places where the contagion curve was regressing, on July 28, 2020, categorically replied “at the moment—first, second, third wave—these things don’t really make sense and we’re not really defining it that way.”.

It is believed that we are now about to experience a third wave. According to the World Economic Forum, we can likely attribute this consequence to a reduction in care to other health conditions. Due to the stress that the current pandemic causes on the healthcare system, important treatments and activities in primary health, outpatient and hospital care have been discontinued or paralyzed due to the detriment of the intensification of interventions related to COVID-19. This third wave has been called by scholars as “invisible patient”, that is, due to the attention totally focused on patients infected by the virus, individuals who have not been affected by the disease, but have other comorbidities or chronic diseases, have become invisible to the health system.

Brazilian government regulations were established at the beginning of the pandemic in which people should remain at home and should only seek health services in cases of respiratory distress or other respiratory symptoms. As a result, many people stopped seeking health units for different treatments and elective procedures were suspended, leaving the available hospital beds to receive patients severely affected by the virus. The same can be observed in relation to service providers, resources and health professionals who had their attention turned to infected patients and away from those with non-Covid related ailments. In this way, a portion of the population has become invisible to the health system and that, even though they were not infected by the virus, they ended up being affected by the pandemic.

Such evidence is considered to be a side consequence of COVID-19, causing an increase in the severity of cases of patients with pre-existing conditions who were infected by the virus and possibly suffered a worsening of the chronic disease and, thus, potentiating morbidity and mortality. In addition, due to the current pandemic scenario in the country, the relaxation of health restrictions, the difficulty of mass vaccination and the spread of fake news about the treatment for COVID-19 do not allow us to have an optimistic view.

It is necessary to intensify Government actions aimed at strengthening the health system to improve these conditions. Actions should be taken to make ICU beds available, expand hospital structures mainly in non-urban areas, administer rapid vaccination coverage, and cover as many people as possible and thus aiming to limit the spread of the pandemic and seeking to reverse the epidemiological growth, and thereby reducing the number of cases.

About the authors

Nadua Apostólico, 30 years old, medical student at Universidade Nove de Julho (2020-2025), local coordinator – IFMSA BRAZIL UNINOVE. Full member of the Critical Care Medicine Academic League and Cardiovascular Surgery League at UNINOVE. She is member of the European Respiratory Society (Silver membership).

Marina Catharino Rodrigues, 21 years old, medical student at Universidade Nove de Julho (2020-2025), Local Coordinator – IFMSA BRAZIL UNINOVE, Local Secretary – IFMSA BRAZIL UNINOVE, member of the secretary department at A.A.A.C.T.I (Associação Atlética Acadêmica César Timo-Iaria). Member of the Dermatology League at UNINOVE.

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