It doesn’t just seem like emergency departments are seeing fewer patients than usual during the COVID-19 pandemic. According to Dr. William Jaquis, president of the American College of Emergency Physicians (ACEP), ERs across the country actually are seeing around 40 to 50 percent fewer patients.
Most physicians expected fewer people to come to the ER with minor illnesses and even motor vehicle accidents and other injuries since so many people have been living under stay-at-home orders. But what they didn’t expect were fewer patients suffering from more serious illnesses and conditions. Where were the patients with chest and abdominal pain? Where were the patients suffering from strokes and heart attacks?
“We know the number of heart attacks isn’t going to go down in a pandemic. It really shouldn’t,” says Dr. David Tashman, medical director of the ER at USC Verdugo Hills Hospital in Glendale, Calif.
Why They’ve Stayed Away
According to a recent ACEP poll, the reasons patients are staying home, even during emergencies, are many. Nearly three-quarters said they are worried about wait times and overcrowding (74 percent) or are concerned about overstressing the health care system (73 percent). Around 60 percent (59) are concerned about being turned away from the hospital (a concern apparently stronger among lower income adults), and not surprisingly, as many as 80 percent are concerned about contracting COVID-19 if they seek treatment in the emergency department.
Emergency physicians see this as a worrisome trend, knowing that foregoing essential medical care will eventually create a public health crisis beyond the effects of COVID-19 itself.
“I’ve never seen the number of delays that I have in the last month or so,” says Dr. Andrea Austin, an ER physician in downtown Los Angeles.
She recently told NPR affiliate KPCC that she is now treating more serious cases because patients waited for care. “That’s really one of the tragedies of COVID-19,” Austin says. “They’re staying at home and trying to diagnose themselves or really playing down their symptoms.”
Helping Them Know When to Go
ACEP recently published an article called “Know When to Go,” offering guidelines for patients who may be wondering whether they should visit the ER even during the COVID-19 pandemic. Another article in Consumer Reports walks potential patients through “What to Expect If You End Up in the ER During COVID-19.”
“Much about life in the U.S. has changed because of COVID-19, but some things haven’t,” writes Consumer Reports’ Laura Entis. “If you experience a serious injury or health crisis, such as a potential stroke or heart attack, you should still call 911 right away.”
The article highlights new screening procedures for COVID-19, the potential for isolation, particularly for respiratory symptoms, the likelihood that patients will need to wear masks, and the “no visitors” policies that most hospitals have implemented.
The primary message ER physicians hope to communicate, however, is this: “Don’t delay. You’re not bothering us. You’re not imposing on us,” says Tashman from USC Verdugo Hills ER. “We’re not incredibly busy with everything else at the moment.”
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Review all the findings from the recent ACEP Poll in their helpful infographic, “PUBLIC POLL: EMERGENCY CARE CONCERNS AMIDST COVID-19.”