Docs fear health impact of 41% fall in ER visits

A dramatic drop-off in emergency room visits in Alberta hospitals in recent weeks could be causing wider health problems among those reluctant to check in, say physicians.

Fears of the novel coronavirus and a mistaken belief hospitals can’t handle NON-COVID-19 patients contributed to a 41-per-cent decrease in visits at Alberta’s busiest emergency rooms, Alberta Health Services says.

Included in those are Calgary’s Foothills Medical Centre, South Health Campus, Rockyview General Hospital and Peter Lougheed Centre. Visits to those emergency rooms decreased from 81,918 in March to 61,168 last month, when the pandemic was well-established, a much steeper monthto-month decrease than recorded a year earlier.

Looking year over year, last month’s ER numbers were considerably lower than the 103,796 patients seen in April 2019 — a 41 per cent reduction.

Physicians have noticed a number of patients making delayed visits to emergency rooms, worsening their medical conditions and outcomes, said Dr. Eddy Lang, the AHS’S department head for emergency medicine in Calgary.

“We’ve seen examples of appendicitis and they chose not to come and when they did arrive, had a ruptured appendix,” he said, adding the same has happened with cardiac arrest patients.

“Those have been sporadic but we’d like to see if those delays are having a measurable impact on a system level.”

It’s ironic that some patients avoided emergency care for fear hospitals were already overwhelmed by COVID-19 patients, when the exact opposite has been true, said Lang. “We’ve been able to get patients upstairs to spaces created for COVID -19 patients; things are not being blocked,” he said.

“The flow through the ER has never been better.”

The COVID-19 demand on Alberta hospitals has been a small fraction of what was initially feared and what models suggested, noted Lang.

As of Friday, there were 62 COVID -19 patients in Alberta hospitals, with nine of those needing intensive care. Also, the number of those showing up with trauma injuries has fallen sharply due to the pandemic lockdown, he added.

Cases of communicable diseases have also dropped due to the household isolations, he said, showing the pandemic protocols are having an effect far beyond controlling the novel coronavirus’s spread. “We’ve now become a society of germaphobes,” said Lang. “This is the largest natural human experiment in health that’s ever been conducted.”

As COVID-19 has become more of a public routine, emergency room visits have begun to bounce back in recent days, though not to normal levels, said the physician.

AHS officials said there’s no heightened risk of COVID-19 infection at emergency rooms, where health care workers are clad in personal protective equipment.

“Any patient with symptoms, or who has tested positive for COVID-19, is isolated away from other patients,” said an AHS statement. “And, stringent visitor restrictions are in place, minimizing any risk of transmission from outside of the hospital.”

Housekeeping staff continually wipe down and disinfect surfaces in hospitals, said the AHS.

On May 4, Alberta’s medical system resumed elective surgeries postponed to make way for an expected rush of COVID -19 cases.

To eliminate a backlog of procedures, AHS says it hopes to perform up to 30,000 urgent and non-urgent surgeries in the next six weeks.