Viewpoint: Pandemic will take toll on acutely ill deterred from seeking ER care


Hospitals across the country are being overwhelmed with COVID-19, and they are missing the acutely ill patients they usually cater to, such as heart attack and stroke patients, a physician wrote in an opinion article for The New York Times.

Penned by Harlan M. Krumholz, MD, professor of medicine at Yale School of Medicine and director of the Yale New Haven (Conn.) Hospital's Center for Outcomes Research and Evaluation, the article states that across the country physicians are wondering, "Where are all the patients with heart attacks and strokes?"

Though Yale New Haven Hospital has nearly 300 new coronavirus patients with so many of the typical ER patients staying away, the hospital still has empty beds. Dr. Krumholz suggests this is partly a result of actions taken to free up space for coronavirus patients, such as canceling elective procedures and providing more care via telehealth services.

But patients with acute illnesses cannot be adequately cared for via telemedicine, Dr. Krumholz said.

"What is striking is that many of the emergencies have disappeared. Heart attack and stroke teams, always poised to rush in and save lives, are mostly idle," he wrote.

Dr. Krumholz said his colleagues in other specialties also have reported reductions in emergency cases, such as acute appendicitis and acute gall bladder disease.

One explanation for this sudden disappearance of emergencies is that people who require immediate medical attention are just staying home and suffering to avoid coming into the hospital and risking contracting COVID-19.

"And when they do finally seek medical attention, it is often only after their condition has worsened," Dr. Krumholz wrote.

Another explanation could be that the lifestyle changes driven by the pandemic may have helped remove triggers for heart attacks and strokes.

It is important that patients not delay seeking the care they need, which could lead to a higher death toll, Dr. Krumholz wrote. They need to know that hospitals are still able to care for patients with life-threatening conditions in addition to COVID-19 cases.

"As we fight coronavirus, we need to combat perceptions that everyone else must stay away from the hospital. The pandemic toll will be much worse if it leads people to avoid care for life-threatening, yet treatable, conditions like heart attacks and strokes," he wrote.


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