Emma Burke stands near Back Cove Trail in late May. Burke is one year removed from being diagnosed with multiple sclerosis, and has had MRI imaging appointments delayed due to the pandemic. Credit: Nick Schroeder

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PORTLAND, Maine — When Emma Burke was diagnosed with multiple sclerosis at age 29 Memorial Day weekend in 2019, her condition was aggressive. She was put on a steady regimen of medication that has put her in a tentative remission.

She still needs regular checkups and MRIs every three months to ensure the medication she takes is working. Her last MRI was supposed to occur in mid-March, but the hospital delayed it to focus efforts on the coronavirus. Burke is now scheduled to see her neurologist in early July — three months behind schedule — and is managing the threat of relapse herself.

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“You’re essentially blind without an MRI,” said Burke, who lives in Portland and works for the state’s campaign finance regulator. “Any new, weird thing that your body is experiencing could be a sign of relapse.”

Almost 47 percent of Maine’s adult population has delayed medical care since the start of the coronavirus pandemic in mid-March, according to a recent survey by the U.S. Census Bureau. That rate is third-highest among states, behind only Oregon and Virginia. It is a side effect of business restrictions put into place by the state and health providers because of the virus.

Routine and elective medical procedures were allowed to resume May 1, but there have been backlogs and the pandemic has also led providers to furlough or lay off employees amid a financial crunch. Last week, Maine allowed routine dental care to resume. Any delay has an outsized impact in the state with the oldest median age in the nation.

A number of other factors have prevented Mainers from seeking medical care, such as anxiety over the contagion, lack of access to health care or inability to pay. The census survey found that 44.4 percent of Mainers reported loss of income as a result of the coronavirus-induced economic downturn.

Providers are concerned that a delay in treatment for chronic conditions will cause a “second wave” of people seeking medical treatments because of pent-up demand, said Dan Morin, a spokesperson for the Maine Medical Association, an advocacy group for doctors.

“People are out there with a lot of stress,” Morin said. “These people have real long-term health problems aside from COVID if they don’t seek care. A lot of them are afraid of going to the doctor’s office.”

The Mills administration and many other states have expanded access to telehealth — or virtual doctor visits — by rolling back restrictions. Patients across the nation have complained about the billing practices under their existing health insurance, however, after policymakers touted plans to make copays for telehealth free during the pandemic.

Telehealth may help, but it is not a perfect replacement for in-person care. Burke has been on virtual visits with a neurologist, but proper treatment can only be done with imaging, which cannot be done remotely. She now has to track symptoms, like if her hand falls asleep while she’s laying down.

Consumers for Affordable Health Care, a group that advocates for increased accessibility to health care, said that they’ve heard through their helpline from many people who have lost coverage through their employer since the pandemic hit.

“The good news is that many of the people we talk to are eligible for free or lower-cost coverage through either a subsidized private insurance plan on the marketplace or MaineCare,” said Kate Ende, a policy director for the advocacy group. She said many people do not realize they are eligible.

MaineCare, the state’s Medicaid program, uses point-in-time monthly income eligibility, which factors in any loss of income related to the coronavirus. Those seeking coverage through the federal Affordable Care Act marketplace face eligibility thresholds that use projected 2020 income based on prior years and count the $600 in weekly federal unemployment benefits.

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Holly Brennan, a Waterville teacher and mother of two, was diagnosed with a herniated disc in her back months ago. Her primary care physician gave her a cortisone injection then, telling her that he wanted to schedule her for spinal surgery in early April.

Weeks later, Brennan is still waiting to get into the hospital. Her husband, a lab technician, leaves at 7:30 a.m. for a 12-hour shift, while Brennan has been teaching students remotely while taking care of her young kids.

“It’s hard mentally and physically,” she said. “I’m supposed to be working from home, but I can’t sit up for very long.”

Watch: Maine gets funding for coronavirus testing

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