By Robert W. Amler, M.D., M.B.A.
If you never test positive for COVID-19, even if you completely escape this deadly viral infection, your health could still be the biggest casualty of the global health crisis. During this pandemic—amidst the dictates to shelter in place and government directed lockdowns, maintaining good health goes beyond staying clear of exposure to COVID through social distancing, masks, and hand hygiene.
Months into the crisis, we now know COVID is extra perilous for people with underlying health problems, especially diabetes, high blood pressure, heart disease, and obesity. So, if you have one or more of these problems you must look out for Number One by getting any of these underlying conditions under the best possible control to improve your odds if the COVID virus comes knocking. That’s an obvious necessity. But what other COVID threat affects us all? It turns out, looking out for Number One is important in another way. Taking good care of yourself, through basic preventive measures and regular health care is not a new concept—but one that seems to have been forgotten in the wake of our recent global health threat. Now, as we emerge from lockdown, medical and public health experts agree it’s time to return to regular healthy activities, resume scheduled screenings and other preventive care, and follow up any pending medical issues that might have been postponed because of recent disruptions caused by response to the virus.
As a young medical epidemiologist at the Centers for Disease Control and Prevention (CDC), my first nationwide health study estimated that up to 60 percent of deaths and severe illnesses in the United States were potentially preventable by reducing risk factors such as high blood pressure, diabetes, obesity, tobacco use, motor vehicle injuries, alcohol overuse, drug overdose, and diabetes. The CDC confirms this percent persists today, estimating more than 1.5 million deaths per year, more than ten times the current COVID-19 deaths, and $2 trillion in health care costs. Some of the same risk factors also predict severe COVID-19 disease and need to be brought under control as well. Fortunately, many risks can be self-managed and in many cases can be reduced or even eliminated. Therefore, we should not let the COVID-19 pandemic interrupt preventive health care anymore than necessary.
A reoccurring concern, echoed by many of my colleagues—including my colleague Renee Gerrick, M.D., the vice dean at New York Medical College School of Medicine and chief medical officer at Westchester Medical Center Health Network, “Heart disease didn’t disappear in this country; unfortunately, cancer didn’t go away.” Yet some people are fearful of exposure to COVID-19 if they seek medical care, despite telemedicine options, careful sanitizing of waiting areas and exam rooms, personal protective equipment (PPE) for providers and clients, reduced-capacity scheduling, and other safety procedures in medical facilities. Loss of jobs and health insurance have compounded the problem for many.
With or without COVID-19, both longevity and quality of life are better with essential preventive health care. Among the lifesaving measures are vaccines, tobacco cessation, exercise, alcohol/drug rehabilitation, dietary guidance, driver safety, reproductive health, cancer screening and prompt detection of other conditions. These are tried and true steps to better health that add years to life and also add better life to years. The flip side, if regular health care is suspended for too long, could be a regrettable increase in major medical crises and deaths from heart disease, stroke, cancer, and chronic diseases.
Looking out for Number One, by taking care of yourself and any medical issues, will help block COVID-19 from severely harming you, but also from the harm in delaying the essential health care and medical follow up you need.
Dr. Amler, a former CDC medical epidemiologist and HHS regional health administrator, is vice president for government affairs at New York Medical College, and dean of the School of Health Sciences and Practice, and Institute of Public Health.
 Amler RW, Dull HB (editors). Closing the Gap: the Burden of Unnecessary Illness. New York: Oxford University Press. 1987.
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