key: cord-353254-8xa0is5g authors: Katzman, Joanna G; Katzman, Jeffrey W title: COVID-19 Has Provided 20/20 Vision Illuminating Our Nation’s Health Crises date: 2020-09-28 journal: Pain Med DOI: 10.1093/pm/pnaa357 sha: doc_id: 353254 cord_uid: 8xa0is5g nan Loneliness, another emerging health crisis, particularly impacts the Western world, with severe health consequences. (6) These include diabetes, dementia, and heart disease with a risk approximating that of smoking 15 cigarettes/day. (7) Loneliness exacerbates mental health and substance use issues, including psychosis and suicide. (7, 8) Health care utilization is far greater for individuals over 60 experiencing loneliness, escalating the cost to the health care system as individuals seek social contact through clinician visits. (9) Approximately 42 Million Americans suffer from loneliness, which significantly worsened across the country as the COVID-19 pandemic forced more Americans to stay at home.(9) Most continue to rightfully shelter in place when possible, and others have rigid restrictions imposed on those who may come to visit them. Individuals confined to congregant settings: nursing home residents, hospitalized patients and those incarcerated have regulations preventing their loved ones from visiting and often isolating them from anyone else in the facility. Even individuals with a wealth of friendships or family around them may suffer from the subjective experience of loneliness, due in part to a need for presence, empathic understanding, and lack of experience in perspective taking. (10) Not surprisingly, people experiencing homelessness, poverty, and healthcare disparities are at increased risk to suffer from one or more of these healthcare crises. Zoom, to sign on from the comfort of their living room for a primary care, chronic pain or mental health appointment. (22) However, even today, many barriers to these innovative technologies still exist since broadband is not available in many rural and urban underserved regions of nation. So the very patients that we are most concerned about-the impoverished, people of color, marginalized populations and those experiencing homelessness and racial health inequities-do not get to experience these new connection points to the same extent. (23) We desperately need a national strategy to stop the community spread of the COVID-19 pandemic. It is clear that our priority needs to remain the successful elimination of the coronavirus. At the same time, we need to have a cohesive national strategy that is thinking proactively about the hundreds of millions that continue to suffer from the public health epidemics of chronic pain, opioid overdose, suicide and loneliness while also addressing the drop in cancer screenings, and vascular disease prevention and treatment. Many Americans, especially for the most vulnerable among us, will be in worse physical and mental health condition when COVID-19 subsides. We are a nation that has the fortitude to tackle many difficult problems at once. We have overcome wars, terror attacks, economic instabilities, street riots and pandemics in prior decades. The medical and public health communities are already working together to improve the lives of all Americans related to the COVID-19 pandemic. This collaborative work will need to involve adequate resources, federal and state support, along with deep consideration to identify, prevent, and treat what might be the common drivers of our nation's other health crises. Poverty and a sense of not belonging remain some of the main drivers facing so many in Official Journal of the American Academy of Pain Medicine 7 our nation. They are both underlying forces tying many health crises together. Any intervention that not only improves the social determinants of health, but could enhance a feeling of community or purpose, along with genuine perspective taking should be given serious consideration in program development aimed at solving these multiple health crises. 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Telemedicine for COVID-19 Addressing Equity in Telemedicine for Chronic Disease Management During the Covid-19 Pandemic The authors would like to gratefully acknowledge the editing support from Chamron Martin and the partial extramural funding support by Kinesio Holding Corporation.Official Journal of the American Academy of Pain Medicine