Health professionals reconsider importance of routine physicals after numbers drop during COVID

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Posted at 2:11 PM, Aug 09, 2021

During the pandemic, certain types of routine and preventative care--like mammograms, pap smears, and physicals--decreased by as much as 80%, according to the Health Care Cost Institute.

Contributing to that decline was the cancellation of several high school sports, which often require its athlete to undergo routine physicals to make sure they are healthy and fit to compete.

“There’s a recommendation that every athlete undergo a preparticipation physical on an annual basis,” said Dr. Reginald Washington, the chief medical officer at Presbyterian/St. Luke’s Medical Center and Rocky Mountain Hospital for Children in Denver. “That’s not based on symptoms; that’s based on what they should be doing because their history may have changed, their physical findings may have changed, so everyone should do that.”

That was the case for Mateo Casados, an 18-year-old high school track athlete who found his season influx last summer.

While regulations and safety measures were being discussed, Mateo was able to lock down a physical with a physician in case the season happened, and what doctors found led to the largest hurdle Mateo had faced in his entire life.

“Yeah, it was terrifying to not know what that meant for the future or even just for your child’s life,” said Mateo’s mother, Shawna.

Doctors had diagnosed Mateo with an anomalous coronary artery, a congenital heart defect that meant oxygen and nutrients were not getting to Mateo’s heart the same way they do most. In high school athletes, the condition can mean sudden and unpredictable death.

“I was lifting in the basement with my dad, and we had noticed I got through like 50 sit-ups and like 15 push-ups and I was just dying,” said Mateo. “I thought I was going to throw up, pass out, like my arms were numb.”

“You never know what’s going to happen,” added Mateo’s father, Leland. “Going into surgery there is a lot of risks, but fixing it was our concern, and whether he ran again or not we didn’t know. It was a risk we all had to take.”

Doctors gave the family two options: limit Mateo’s activity, which meant no track, no hiking, no strenuous activity of any kind, or open-heart surgery. For a young adult who aspired to get a scholarship, win nationals, and compete at the highest level of his craft, the decision, no matter how risky, was obvious.

“I just wanted to get it out of the way and get back to what I wanted to do. I guess you could say that was my attitude going into it,” said Mateo. "Ever since I was little, I loved playing soccer and doing those things. Giving it up would’ve been unimaginable. I didn’t really want to live life where I wasn’t able to be active, go work out, or go on a hike.”

Laps around a track turned into laps up and down a hallway, but bit by bit and day by day Mateo started to simultaneously overcome the smallest, yet largest hurdles of his life.

By month one, he could walk his first mile. By month two, he could pick up weights more than five pounds.

By February, seven months after his open-heart surgery, Mateo was ready to compete in his first race back at state, a race where he logged a personal record in the 60-meter hurdles. He finished second.

“To see him finish his first race, and to see his face,” said Leland, choking up. “It was good. It was a highlight.”

Now, Mateo is two weeks away from leaving for the South Dakota School of Mines on a track scholarship, healthier than ever, all because of a routine physical that allowed this 18-year-old to prove he had more heart, a stronger heart, than a diagnosis that tried to prove otherwise.

“[We are] so lucky we saw that different doctor that we’d never seen before for a physical in the middle of COVID,” said Shawna.

“He’s living proof that if you put your mind to something there are no limits to what you can do,” added Leland.

Doctors and physicians are split on the necessity of physicals after the pandemic slowed care and made telehealth more common. But the American Medical Association endorses annual health screenings.

Dr. Washington says physicals should be prioritized now, especially after COVID-19, since those who have been infected might experience long-term effects that could affect other symptoms and diagnoses.

Editor's note: We have removed a phrase saying the U.S. Preventive Services Task Force endorses routine screenings. The Task Force does not give recommendations, rather, it provides guidance for physicians through a grading system.