As COVID-19 continues to rage around the world, extended quarantine measures have been responsible for saving innumerable lives. Fighting this dangerous and highly transmissible virus by staying indoors — away from our neighbors, coworkers, and loved ones — was unquestionably the most valuable method to stem the tide of this pandemic. Now, as we slowly catch glimpses of light at the end of the tunnel, or face the possibility of rising cases returning us to the heights of the pandemic, it is important to examine the long-term side effects of our self-prescribed quarantine treatment.
Namely, the lifestyle and social changes we made over the past year will serve as major risk factors for heart disease and other associated conditions. These risk factors will become highly prevalent, presumably more so than other common lifestyle or genetic factors that influence likelihood of disease. By understanding these long-term effects, we can modify public health protocols should the pandemic worsen and optimize medical care once we reach post-pandemic life.
The psychological harm of extended quarantine has been well-documented, leading to unprecedented rates of depression, loneliness and anxiety. The sudden, unexpected change inflicted upon our daily routines and future plans caused distress for many. Moreover, we were, and remain, in the midst of an inescapable traumatic event; the virus was not contained to a small geographic area or short timeframe.
We developed severe anxiety, fearing we could easily be infected by any person next to us. We felt uncertainty in the face of an invisible enemy and its associated economic shutdown. As we lost our jobs and faced economic insecurity, we wondered how we would pay rent, feed ourselves or pursue our future plans. At work and school, we saw sudden daily changes in our routines and the methods by which we worked and learned. We were confined to our homes and lacked human contact, depending only on computers for connection to the world.
Our perfectly imperfect quarantine solution to this pandemic increased our loneliness. Humans are social beings. In traumatic situations, we often find comfort in togetherness. The emotional stresses caused by isolation, economic anxiety and the fear of a silent killer will likely affect our well-being for years to come. This type of emotional stress is a major risk factor for various psychological diagnoses, including depression, psychosis, anxiety disorders and post-traumatic stress disorder.
Once we finally emerge from the acute emergency that our medical experts bravely fought, mental health professionals will be left to deal with the long-term effects. However, it’s not only our minds that have been affected. In the coming years, health care professionals will no doubt see physical manifestations of our quarantine as well.
To start, our collective physical health will suffer in the short term. Patients with medical needs classified as “non-urgent” saw their appointments, surgeries and routine screenings cancelled as health care institutions redirected resources towards COVID-19. Many other patients voluntarily postponed their appointments out of fear of contracting the virus in waiting rooms and doctors’ offices.
These delays in care will presumably worsen patient outcomes, as lack of screening can prevent us from catching early signs of disease. Resulting delays in treatments could mean upstaging of cancers and unchecked chronic diseases. For example, while the pandemic directly took hundreds of thousands of lives, an additional 50,000 deaths in 2020 occurred due to people not getting medical help for severe cardiovascular conditions. Two-thirds of radiation oncologists stated that their patients were presenting with more advanced cancers.
The drastic and unexpected lifestyle changes associated with quarantine also set us up for long-term health detriments. Studies have found numerous noteworthy changes to our daily habits as a result of quarantine. As we were holed up inside our homes, we adopted a more sedentary lifestyle.
Remote work arrangements forced us to sit at our desks at home for hours on end, without in-person meetings to attend or coworkers to meet. Exercise routines were shattered by closed gyms, cancelled team sports and stay-at-home orders. Bored and stressed at home, we began snacking and drinking alcohol more frequently, relying on stockpiles of packaged food to avoid frequent grocery trips for fresh produce. These sustained changes to our daily habits will lead to long-term detriments to our cardiovascular health.
COVID-19 has acute effects on our respiratory tracts, and new evidence demonstrates that it may affect the heart, causing myocardial inflammation or scarring. Longitudinal studies will determine whether either of these effects, resulting from the actual viral infection, will cause protracted health issues in those who contracted COVID-19. However, the COVID-related lifestyle changes affecting us all, not just those who were infected, are less obvious yet more prevalent and worrisome.
While it is difficult to isolate the direct effects of quarantine on heart health, the combination of our decreased exercise, unhealthy diets, lack of routine medical care and psychological distress suggests a likely increase in obesity and cardiovascular disease over the coming years. Although we may slowly return to our pre-pandemic lifestyles, it is safe to say that our daily routines will never be the same. In the short-term, we have already seen a rise in cardiovascular-related deaths, yet this number can only be expected to grow as quarantine has become a risk-factor for us all. Quarantine may have saved us from this deadly virus, but it also pushed us towards new, unhealthy habits. Future doctors should be aware of this new, widespread risk factor.
Image credit: COVID Heart (CC BY 2.0) by Editor B
Columnist and Medical Student Editor
Sidney Kimmel Medical College at Thomas Jefferson University
Yash attends Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, PA. He pursued a Bachelor of Science in premedicine at Penn State University. Prior to attending medical school, Yash worked on clinical and translational oncology research at the Children's Hospital of Philadelphia. He has long-standing interests in contributing to medical education, advancing health policy, and working with cancer patients. He enjoys playing tennis, rooting for the Eagles, reading, and traveling in his free time.
COVID Chronicles
The COVID-19 pandemic posed a tremendous challenge to our community – certainly from a health perspective, but also in nearly every other aspect of daily lives. Our daily routines were upended – from the way we work, play, learn, socialize and travel. Numerous times, the unimaginable happened, and it is safe to say we will never see the world in the same way again. As future physicians, it is important that we recognize the challenges faced by the health care space during the pandemic, and perhaps more importantly, the everlasting transformations that our future medical students, physicians and patients will encounter. This column explores the countless obstacles we overcame and their everlasting effects, along with emerging trends that we will see in health care for the years to come.