The Coronavirus’s Less Visible Effects on Public Health

If the characteristic soundtrack of this pandemic is the ambulance siren, its distinguishing visual feature is the face mask. Nearly everyone here in NYC wears one, even to run or bike. We’ve been required to since mid-April, and those who fail to comply are given as wide a berth as possible. Surgical masks are ubiquitous, as are cloth masks of varying hues and prints. My own masks are made from a red-flowered fabric that I bought in high school and never used; my mom rescued it from storage, sewed masks with a pattern she found online, and sent several to me. I find I can still recognize acquaintances and people from the neighborhood underneath their masks; what’s more difficult is to know when someone is smiling.

The pandemic’s health repercussions will reverberate throughout our society for decades. There are, of course, the direct effects on those who have been sick and are now considered to have recovered. We’re hearing of lingering weakness and respiratory issues in this population, and the long-term health consequences of SARS-CoV-2 infection will continue to emerge. Those who have lost income and medical coverage will have a harder time accessing care, which could produce or exacerbate chronic health conditions. The death toll persists in its grim trajectory upward; each person we have lost died in isolation, cut off from the comfort of family and loved ones, who in turn remain sequestered in their grief. Many health care workers, as well as any number of those in confinement, will need mental health assistance in the coming months and years.

Across the country, people are foregoing checkups, elective procedures, dental work, and necessary medical care, including cancer treatments, out of a desire to avoid medical settings right now. Parents are postponing vaccinations of their children, which will skew immunization schedules. In March, a number of states, including Texas, Oklahoma, and Tennessee, attempted to ban surgical and some medication abortions, claiming that such procedures were “non-essential” and scarce medical equipment should be reserved for first responders. The restrictions have since been blocked by court order everywhere except Alaska and Arkansas.

There have been other, less publicized measures that could have public health implications. In Georgia, nearly 20,000 teenagers have received their driver’s licenses without a road test, with Wisconsin to follow in temporarily suspending the requirement. The new drivers are supposed to have fulfilled all other conditions for a license, including a certain number of hours of supervised driving. But the road test serves as a kind of final check, a state-sanctioned approval that someone shows a minimal level of competence behind the wheel. The upshot of waiving the requirement for a road test may turn out to be inconsequential in the long run. But it’s one more example of the ways, both large and small, in which the coronavirus is affecting and will continue to affect the nation’s health.