Table 3.

Some effects of the COVID-19 response on public health in mostly high-income countries (97–119).

Effect of COVID-19 response	Some details
Delayed/avoided/disrupted medical care	Visits to emergency departments for myocardial infarction or stroke declined in USA by ≥20–48%
	Delayed cancer care and “non-urgent” procedures - weekly presentations with cancer diagnoses down 46% in USA and UK - 90% reduction in non-cancer surgeries in Ontario in March/April - surgery backlog in Ontario March 15 to June 13: 148,000; clearance time estimated to take 84 weeks - in Canada at least $1.3 billion additional funding is required to return to pre-pandemic wait times for six procedures (CABG, cataract surgeries, hip and knee replacements, MRI and CT scans) within 1 year
	Of excess deaths in high-income countries during pandemic, 20-50% are not from COVID-19
	Unexplained 83% increase (10,000 excess) deaths from dementia in England/Wales in April (lack of social contact causing a deterioration in health and wellbeing)
Violence against women (household stress; disrupted livelihoods, social/protective networks, support services)	Intimate Partner Violence: estimated effect from 3 months lockdown is 20% increase (>15 Million additional cases) Female Genital Mutilation: 2 Million more cases over next decade Child Marriages: 13 Million more cases over next decade Increased police reports (France, UK, Ontario) and support line calls (China, Italy, Spain, Vancouver, Alberta) by 20–50%
Deaths of despair (related to unemployment, and due to drugs, alcohol, and suicide)	In USA alone: 68,000 (from 27,000–154,000) suicide deaths predicted
	Mental Health effects of 3 months (suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status, social isolation): Years of Life Lost in USA 67.58 Million, Canada 7.79 Million, UK 13.62 Million, etc. Surge in Canada in opioid deaths (by 40–50%), alcohol consumption (by 19%), cannabis use (by 8%), tobacco smoking (by 4%), and suicidal thoughts.