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Since the onslaught of COVID-19 pandemic healthcare professionals have been at the forefront, working tirelessly to deliver the best possible care to patients in both inpatient and outpatient settings. While the insurgence of COVID-19 cases pushed the hospital systems to the brink, family physicians and specialists working in the ambulatory environment also rose up to the challenge. They improvised and adapted to the world of virtual medicine to maintain continuity of care. Unfortunately, despite these efforts, access to healthcare, patient hesitancy, and lapses in follow-up persists. This disruption of care may have long-lasting impact on chronic health outcomes that would likely surpass the duration of COVID-19 pandemic.

Since March 2020 isolation measures to decrease the risk of COVID19 exposure and spread have been widely implemented in health institutions. Although a necessity of the time, these measures have resulted in a significant reduction in elective and non-emergent services being offered. Ambulatory care physicians have been challenged with prioritizing the provision of care to patients through telemedicine. This, augmented with the fear of contracting COVID-19 has deterred patients from seeking in-person care in a time-sensitive manner. As a result, many chronic medical conditions may have gone undiagnosed and unmonitored. We do not have data to analyze and assess the magnanimity of the impact of COVID-19 on chronic illnesses. However, anecdotally, it has been reported that we are already seeing a rise in complications secondary to poorly controlled diabetes, kidney disease and cardiovascular disease. Similarly, we are also seeing more patients presenting with advanced stages of cancer; lung cancer being the most aggressive. Reduced patient volumes and implementation of staggered visits, to minimize COVID-19 exposure has created a backlog of patients who are waiting for their screening and surveillance testing. Hence, there is a growing concern that we may end up detecting cancers at a much later stage where treatment options will be limited and prognosis poor.

It has been a year since COVID-19 was declared a pandemic. We have come a long way and have learned how to safely provide medical care during such unprecedented times. With the majority of ambulatory procedures returning to pre-pandemic levels, we must maximize our efforts to reach out to patients with chronic illnesses. It is critical to raise awareness about the harrowing consequences of not seeking care in a timely manner. Despite the COVID-19 pandemic cancer, heart attacks, stroke, and diabetic complications remain life-altering and life-threatening conditions, so it is crucial to keep appointments for screening tests and follow-ups. Early diagnosis and treatment can make all the difference.

Similarly, its important to reassure patients that our hospitals are proactively instituting measures to ensure the safety of in-person care. Screening at entrances, strict masking, physical distancing, and enhanced cleaning are all part of the protocols.

With vaccine distribution, we have begun to see the light at the end of the tunnel. It is about time we start focusing on the optimization of routine care delivery in ambulatory settings. Hopefully this way, we can curtail the detrimental impact of delayed care on health outcomes for vulnerable patient groups.