What happened to non-COVID-19 emergencies?
In our medical teleconference, Gus, 46, said his glucose ran high. He was up several times at night to urinate. He needed insulin adjustment. Easy-peasy, we formulated a plan and were mighty pleased with ourselves.
Then he related an episode, by prefacing: “My wife said I must tell you this.” She, apparently, had been sitting quietly by the phone. Weeks ago, Gus experienced a sudden severe right arm pain that knocked him to the ground. The arm stayed numb for hours, and he’s been short of breath since.
I resisted an urge to shout, “Put your wife on the phone, Gus!” This could be anything from muscle spasm to heart attack. The first opportunity to do something had passed. Now we play catch up.
Months ago, Gus probably would’ve gone to the emergency room. Today, many “regular” ER patients are MIA. The reasons are unclear but could be COVID-19-related: loss of health insurance, perception that hospitals are too busy – or crawling with corona viruses.
And not just diarrhea, back pains, cuts and bruises have gone missing. ERs notice record low visits for emergencies like strokes, hearts attacks and surgical emergencies like acute appendix or gallbladder.
Last month, the University Hospitals system suspended seven ERs across the area. Volumes are down 50% to 70%.
In an April 6 New York Times article, Dr. Harlan M. Krumholz, a Yale New Haven Hospital cardiologist, shared the result of an informal Twitter poll among his national colleagues: Half noted a significant drop in heart attack admissions (40% to 60%). A study from Spain noted a 40% drop in emergency heart procedures.
The concern: People are toughing it out at home. Conditions like heart attacks and strokes, where time – measured in minutes from event to treatment – is critical to outcome, are not properly triaged.
Another alarming stat: Routine well-child care is lagging. Comparing to February, April data showed administration of major childhood vaccines – MMR (measles, mumps and rubella), diphtheria, whooping cough, HPV – are down by half or more.
I believe our primary care system is robust; our children are, in general, safe. But the global trend portends a five-alarm fire. WHO estimates 117 million children are at risk of missing lifesaving vaccines. Measles, for example, kills hundreds of thousands each year, mostly babies and children. It’s the leading cause of blindness in African children.
Honestly, I’m all for staying out of doctors’ offices – with or without a pandemic. Doctors do not make their living delivering good news. But waiting out urgent matters can turn catastrophic. Ask yourself: Can my (belly pain, shortness of breath, procedure, etc.) wait another few months or year(s)? That’s how long this pandemic will last; spikes in new infections will come in waves.
Remember: Hospitals specialize in infection control. Healthcare workers are at high-risk because of extended, high-contact exposure, but you’ll probably be OK. So, don’t shy away from the hospital in an emergency.
And – if you ever quote me, I’ll categorically deny the following sexist, stereotyped statement – listen to your mother/wife/daughter.