b'14%4of US adults would avoid seeking health care for common COVID-19 symptoms due to cost.Early in the pandemic (April 2020), 14 percent of US adultsCOVID-19:I mpact on Mental Healthreported they would avoid seeking health care for the twoMore than 8 million adults aged 50 or older are affected by most common symptoms of COVID-19 (fever and dry cough)isolation. The health risks of prolonged isolation are equivalent to due to concerns about their ability to pay for it.4 smoking 15 cigarettes a day.11 Nearly two-thirds of community-based organizations providingJust over 70 percent of those who screened at risk for moderate viral hepatitis services have received inadequate or no fundingto severe anxiety or depression said they experienced loneliness, to adapt services during COVID-19. The percentage of clinicsa figure that jumped to 78 percent among children ages 11-17. offering hepatitis vaccinations and treatments dropped from 95Children 11-17 also screened at higher rates for moderate to percent to 80 percent during the pandemic. More than half (52severe symptoms of depression and anxiety in general, and more percent) of community-based organizations had to furlough or layfrequent suicidal ideation, than other age groups.12off staff or reduce operations due to COVID-19. The percentage ofDuring the COVID-19 pandemic, the general population community-based organizations offering hepatitis B/C screeningworldwide reported relatively high rates of symptoms of:13dropped by nearly 60 percent.5 Anxiety (6.33%50.9%) Depression (14.6%48.3%)45%PTSD (7%53.8%) Psychological distress (34.4%38%)of US adults may have higher risk for COVID-19 complications Stress (8%81.9%)because of chronic conditions.6About 16 percent of adults in the general population have severe More than 43 percent of working-age adults had inadequate healthCOVID Stress Syndrome (characterized by danger and contam-insurance when the COVID-19 pandemic hit. Thirty-five percent ofination fears, socioeconomic concerns, xenophobia, traumatic adults reported at least one cost-related problem getting neededstress, and compulsive checking and reassurance seeking14).health care in 2020, including not filling a prescription; skippingMore than 50 percent of the population reported considerably a recommended test, treatment, or follow-up visit; not going toelevated levels of distress specific to the pandemic.14the doctor when sick; or not getting needed specialist care.7 One-third of adults were unable to get medical care unrelated to the coronavirus in March 2020. Twenty-four percent were unable to41%access prescription medications. By the end of June 2020, 4 in 10 adults reported delaying or avoiding medical care because of theof college students reported symptoms of depression pandemic. In June, 55 percent of adults living with multiple chronicfrom the end of March through May 2020.15conditions reported delays or avoidance of medical care attributableSixty-three percent of parents said the pandemic made the 2019-to the pandemic. Sixty-nine percent reported that COVID-19 has2020 school year extremely stressful. Seventy-seven percent affected their ability to manage their chronic condition.8of parents of 8- to 12-year-olds said uncertainty about the 2020-2021 school year was causing them stress.9 1 in 5 COVID-19 was a blow to all of us, disproportionately impacting many already facing physical and mental health care challenges.adults said their mental health was worse in 2020HealthWell recognizes and seeks to address such scary realities than in 2019.9 before and during COVID-19 and will continue doing so after.Outpatient pediatric visits dropped 24 percent in 2020."The things you do for yourself are gone when you are gone,Pulmonology visits dropped 11 percent, as did otolaryngologybut the things you do for others remain as your legacy."visits.10 Kalu Ndukwe KaluPAGE 7|HEALTHWELL FOUNDATION 2020 ANNUAL REPORT'