The number of emergency room visits declined during the coronavirus pandemic, according to a new study on data from different health systems.
Information from five health systems in Colorado, Connecticut, Massachussetts, North Carolina and New York showed declines in emergency department visits between 40 and 60 percent in the first four months of 2020.
According to the Centers for Disease Control and Prevention (CDC), emergency room visits “declined 23% for heart attack, 20% for stroke, and 10% for hyperglycemic crisis" in the 10 weeks after Covid-19 was considered a national emergency.
The Department of Veterans Affairs disclosed similar results about a precipitous drop in emergency room visits.
Some believe that more patients with minor ailments chose to remain home to avoid exposure to the coronavirus. However, the researchers predict there is a lot more to it than that.
“The thing that’s suspicious is that the proportion of visits that resulted in a patient stay did not go up,” said Molly Jeffery, an assistant professor of health sciences research at the Mayo Clinic, citing hospitals in New York.
“If people with minor issues stayed home and only the most severely sick went to the hospital, you’d expect the proportion of people being admitted to go up," he noted.
Jeffery believes that some people who stayed home were severely ill. Some might have even had experienced heart attacks and strokes.
Dr. Harlan Krumbolz, a cardiologist and the director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation, notes that care avoidance is the reason for about 80% of the decline in emergency room visits. Within that 80%, “half may be appropriate and half placing people at risk,” he said.
Researchers asserted that patients were scared of going to hospitals in the spring, when there were a lot of uncertainties about the coronavirus.
“I had a virtual telemedicine consult with a woman who’d had a urinary tract infection for days, with fever, flank plain and vomiting,” said Dr. Nick Genes, an associate professor at Mount Sinai Health System, specializing in Emergency Medicine. “I told her to come into the emergency room to get her an IV antibiotic, but she was adamantly refusing.”
Meanwhile, Krumbolz thinks that the other 20% of the decline “may represent a change in the triggers for acute events, leading to fewer events.”
People had fewer accidents as they stayed home. “We saw very few orthopedic injuries,” according to Genes.
Studies also revealed that the Covid-19 pandemic contributed to different kinds of stress. Many people were scared of losing their jobs, and find it difficult to manage work with school-age kids at home.
“It certainly could have contributed, but I’m not paying too much credence in the idea of stress levels going down,” said Melnick.
Medical experts recommend more research to answer questions regarding the impact of the Covid-19 pandemic. “Without evidence it’s hard to hang your hat on any one of these explanations,” said Dr. Kenneth Mandl, who directs the Computational Health Informatics Program at Boston Children’s Hospital.
“This lays bare the problems of a country that is far behind in its reporting structures,” said Krumholz. “We should have leading health indicators, just like we have leading economic indicators, but it’s hard for us to grasp what’s happening beyond yesterday.”
