Global Perspective on the Impact of the COVID‐19 Pandemic on Rheumatology and Health Equity

Abstract

Although the public health emergency associated with the COVID‐19 pandemic has ended, challenges remain, especially for individuals with rheumatic diseases. We aimed to assess the historical and ongoing effects of COVID‐19 on individuals with rheumatic diseases and rheumatology practices globally, with specific attention to vulnerable communities and lessons learned. We reviewed literature from several countries and regions, including Africa, Australia and New Zealand, China, Europe, Latin America, and the US. In this review, we summarize literature that not only examines the impact of the pandemic on individuals with rheumatic diseases, but also research that reports the lasting changes to rheumatology patient care and practice, and health service use. Across countries, challenges faced by individuals with rheumatic diseases during the pandemic included disruptions in health care and medication supply shortages. These challenges were associated with worse disease and mental health outcomes in some studies, particularly among those who had social vulnerabilities defined by socioeconomic, race, or rurality. Moreover, rheumatology practice was impacted in all regions, with the uptake of telemedicine and changes in health care utilization. While many regions developed rapid guidelines to disseminate scientific information, misinformation and disinformation remained widespread. Finally, vaccine uptake among individuals with rheumatic diseases has been uneven across the world. As the acute phase of the pandemic wanes, ongoing efforts are needed to improve health care access, stabilize rheumatology drug supplies, improve public health communication, and implement evidence‐based vaccination practices to reduce COVID‐19 morbidity and mortality among individuals with rheumatic diseases.

Impact of a pandemic shock on unmet medical needs of middle-aged and older adults in 10 countries

“…25 And a review summarising literature from Africa, Australia and New Zealand, China, Europe, Latin America and the USA showed that individuals with rheumatic diseases during the pandemic faced disruptions in healthcare and medication supply shortages. 26 However, many of these studies rely on small local samples or people with certain diseases and do not explore whether the decline in service utilisation is a result of reduced or unmet demand. Additionally, most studies only observe changes in outcomes before and after the pandemic, without differentiating whether these changes are specifically attributed to the effects of the pandemic or reflect general temporal trends over the same period due to other factors.…”