Pandemic iatrogenesis: exclusion and lag in non-COVID medical care in Mexico City

Abstract

The paper analyzes, from a qualitative perspective, how the COVID-19 pandemic has significantly reduced medical care for chronic patients at the three levels of the Mexico City health sector due to community mitigation strategies, the perceived risk of infection of health personnel and patients, the focus on pandemic care, and how these processes are articulated with the previous underfunding conditions of the public health system. Thus, we adopted the Grounded Theory approach based on the description and analysis of the experiences of 42 doctors interviewed at the three care levels. The pandemic iatrogenesis concept is proposed to address the interrelation between the material and symbolic organization of the dominant model of medical care and specific structural and cultural dimensions of massive and systemic neglect since the arrival of the pandemic. We point out some strategies and possibilities to avoid similar future settings based on this theoretical proposal and the experiences of the doctors interviewed.

Coping of Chronically-Ill Patients during the COVID-19 Pandemic: Comparison between Four Groups

“…Among these factors are (1) personnel shortage stemming from exposure to SARS-CoV-2 and following quarantines and/or infections; (2) reorganization of clinical wards, with medical professionals being transferred to temporary COVID-19 wards and thereby decreased number of professionals remaining at their standard placement and (3) necessity to secure back-up hospital beds in case of a rising incidence during following COVID-19 waves. These factors required additional effort from patients and eventually resulted in a transient reduction of planned appointments, administered procedures, and check-ups [ 6 , 7 , 8 , 9 ]. On the other hand, anxiety related to medical institution visits and potential SARS-CoV-2 infection disabled another group of patients from obtaining regular professional medical care.…”