Despite fears surrounding the new coronavirus, Hawaii health officials are urging the public to go to the doctor for routine checkups, vaccinations and to manage chronic diseases to prevent a spike in other ailments.

The Department of Health warns that there are “lots of other disease threats out there” and that “people with chronic diseases are more vulnerable to serious illness from COVID-19.” Health officials are worried that other medical conditions will increase if people do not get back into their health care routines.

“It is a big problem. We have heard from physicians who are telling us people are canceling their visits. We have heard of people who have withheld going to the doctor’s office even when they have some symptoms that should be alarming,” said Lola Irvin, DOH administrator of the Chronic Disease Prevention and Health Promotion Division. “If they delay, they could end up in catastrophic situations.”

Chronic disease is a big problem in Hawaii, particularly for Native Hawaiians, who die from these conditions at a higher rate than other ethnicities, she said.

“They may not be getting diagnosed early enough and are also not getting the kind of care they need,” Irvin said, adding that about a third of adults in Hawaii have two or more chronic conditions — roughly 390,000 people — which is why preventive health care is critical.

Dr. Randall Suzuka, a 35-year private-practice physician with The Queens Health Care Centers in Mililani and Haleiwa, has seen a 20% drop in patients at the two clinics since the start of the pandemic. Other Queen’s clinics have seen as much as a 50% decrease in patients, he said.

If people aren’t getting their blood pressure or diabetes under control and are delaying preventive screenings such as colonoscopies, mammograms and Pap smears, Hawaii could see a significant increase in people dying of cancer and other illnesses over the next few years, Suzuka said.

Dr. Kelley Withy, executive director of the University of Hawaii John A. Burns School of Medicine Hawaii/Pacific Basin Area Health Education Center, estimates about 20% of doctors have closed their practices over the past few months.

“This is an opportunity for them to move, whether to retire or go to the mainland,” said Dr. Christopher Flanders, executive director of the Hawaii Medical Association, adding that patient numbers haven’t come back to the same levels seen prior to Hawaii’s stay-at-home order in March. “We attribute that to people being nervous about going into a doctor’s office where they might be exposed to the COVID-19 virus. It is critical that they go back because … the people who have chronic diseases, they’re only going to get worse.”

Doctors are taking precautions to make sure their offices are as sanitary as possible, disinfecting between each patient, Flanders said.

“When possible they are trying to group patients who are being seen for exposure to coronavirus in separate time slots than people who are there for their routine care,” he said.

Of 1,018 Hawaii physicians surveyed by the HMA, more than 70% reported a drop of 50% or more in patient care, with nearly a third seeing decreases of 75% or more as of March 1. In addition, 98.7% recorded lower revenue.

Besides physicians being able to manage chronic conditions and diagnose illnesses such as cancer, the Health Department is concerned about lower numbers of children being vaccinated for infectious diseases.

There was a 46% year-over-year reduction in doses ordered for vaccines for children since the beginning of April and a decrease of about 35% in May — an indicator that “many children may have missed vaccination appointments.”

“COVID-19 is right in front of us, so we see the immediate threat right in front of us. There are other threats and they’re controllable. There are some things we can do about it,” Irvin said. “If we have the opportunity to prevent really bad consequences, then we should. Just like working on not going to mass gatherings, making sure we wear a mask, likewise make sure we go to the doctor’s office to get diagnosed (and prevent disease).”