The Covid-19 pandemic has left a lasting and disproportionate impact on diagnosis rates for several major health conditions, including depression, asthma, and osteoporosis. According to a recent study by King’s College London, published in the British Medical Journal, diagnosis rates for these conditions have not returned to pre-pandemic levels, with depression being the most severely affected.
The study, which is the first to assess the recovery of diagnosis rates post-pandemic, utilized anonymized data from over 29 million individuals in England. It highlights a significant decrease in diagnosis rates for depression, which are nearly a third lower than expected based on pre-pandemic trends.
Impact on Healthcare Systems
The pandemic caused unprecedented disruptions to healthcare systems globally, leading to sharp declines in diagnosis rates across a range of diseases. Of the 19 major conditions analyzed, depression diagnoses were 27.7% lower than expected. Similarly, diagnoses for asthma, chronic obstructive pulmonary disease (COPD), and osteoporosis were also significantly lower, at 16.4%, 15.8%, and 11.5% respectively.
The study also uncovered disparities in diagnosis recovery across different ethnic and socioeconomic groups. While dementia diagnoses returned to pre-pandemic levels for white individuals and those in less deprived areas, they remained below expected levels for other ethnic groups and in more deprived communities.
Expert Insights and Analysis
Professor Sam Norton, a co-author of the study and Professor of Medical Statistics at King’s College London, noted the puzzling nature of the deficits in depression diagnoses. “After an initial decrease during the early pandemic, diagnosis rates partially recovered by late 2021 but have declined markedly since 2022,” he said. This trend was most noticeable among younger adults aged 20 to 39 and individuals of white or mixed ethnicity.
“This is difficult to reconcile with other indicators of mental health need. Disability benefit claims for mental health conditions have increased substantially over the same period, suggesting these declining diagnosis rates may not reflect improving mental health,” Professor Norton explained.
The study suggests that increasing pressures on the NHS might be contributing to longer wait times for formal diagnoses. Additionally, more individuals may be accessing mental health support without receiving a formal depression diagnosis. With a national initiative to expand access to psychological therapies, referrals to NHS Talking Therapies services have increased by nearly two-thirds since 2013, with self-referrals making up almost 70% of all referrals.
Broader Implications and Future Directions
The research team also posits that pandemic-related disruptions could explain the decline in diagnoses for asthma, COPD, and osteoporosis. Backlogs in diagnostic testing during the pandemic are likely a significant factor, and the NHS has identified this as a priority for improvement.
Interestingly, the study found that diagnoses of chronic kidney disease (CKD) have increased by 34.8% compared to expected levels. Dr. Mark Russell, the lead author and a consultant rheumatologist and epidemiologist at King’s College London, suggested that this rise may be due to increased testing and awareness following changes in guidelines and the introduction of new treatments.
“It is also possible that the pandemic itself has contributed to an increase in CKD, either through the direct effects of Covid-19 infection or through delays in diagnosing related conditions such as diabetes,” Dr. Russell noted.
The research utilized OpenSAFELY, a secure and anonymized NHS data platform, to analyze disease trends among 29 million people from April 2016 to November 2024. Dr. Russell emphasized the significance of such health data resources within the NHS, pointing out their potential to transform disease monitoring and enable earlier identification of inequities in healthcare delivery.
The OpenSAFELY platform is funded by grants from NHS England, the Wellcome Trust, and the Medical Research Council, showcasing the collaborative effort to leverage data for public health improvement.
This study underscores the ongoing challenges and complexities in healthcare post-pandemic, highlighting the need for continued vigilance and adaptation in medical diagnosis and treatment strategies.
