The impact of the COVID-19 pandemic on self-reported access to health and social services among patients with high health and social support needs in British Columbia, Canada

Introduction: The COVID-19 pandemic disrupted healthcare and support services, posing new challenges for people with complex health and social needs. People diagnosed with hepatitis C virus (HCV) often represent a group with particular healthcare and social service needs. This study assessed changes in key health and social outcomes before and after the onset of the COVID-19 pandemic among a cohort of clients recently treated for HCV in British Columbia (BC), Canada. Method: We conducted a pre-post analysis using data from the Per-SVR cohort, which is a prospective study of individuals who achieved sustained virologic response (SVR) following successful completion of direct-acting antiviral (DAA) therapy for HCV. For this analysis, we included results of participants’ surveys completed from April 1, 2017, to April 1, 2020 (pre-COVID-19) and those completed July and December 2020 (post-COVID-19). We present descriptive statistics on psychosocial and behavioral outcomes across these two time periods. Results: A total of 130 participants were included in this analysis. The cohort was predominantly male (67.7%) with a median age of 54 (Q1, Q3: 46, 60) years old. Self-reported access to some health services worsened. Comparing pre-and COVID-19 time, the proportion of clients reporting accessing primary care dropped from 10.0% to 3.8% (p-value: 0.032). Similar trends were found in specialty care (6.9% to 1.5%, p-value: 0.035) and dental care from 20.8% to 11.5% (p-value: 0.023) in the pre- and COVID-19 time periods, respectively. However, there were no significant changes to the proportion of clients reporting recent homelessness (8.5% to 10.8%, p-value: 0.439), accessing harm reduction (30.0% to 36.1%, p-value:0.808), and indications of depressive symptoms (p-value:0.369). Overall, most participants reported that COVID-19 had no impact on their ability to access healthcare (59.3%) or on their mental health (67.7%). Conclusion: Reflecting widespread service disruptions during COVID-19, participants reported less utilization of certain healthcare services specifically for primary care, speciality care and dental care, although access of harm reduction services was quite similar. Results highlight ensuring continuity of care and access to essential services for populations with complex needs must remain a priority in both routine and emergency public health planning.