Is fear of COVID keeping you away from the ER?
Doctors have noted that emergency wards, have grown oddly quiet during pandemic
A question being asked by emergency-room physicians in Montreal and beyond is: Where are all the patients with heart attacks, strokes and busted bones?
Apart from patients being treated for COVID-19, doctors have noted that hospitals, particularly ERS, have become strangely quiet.
Gone for now, it seems, are the days when overcrowding was the norm, stretchers lined halls and medical personnel were hard-pressed to keep up with the ever-mounting volume.
A major reason being cited now is that prospective patients fear contracting the coronavirus by going to the hospital.
“This is a major concern,” says Dr. Alan Drummond, the past-president of the Canadian Association of Emergency Physicians. “With the coronavirus, there has also been some pretty strong public messaging that you have to own this, you need to socially distance, you basically need to stay at home, and if you’re not in any particular distress, you probably shouldn’t come to the emergency department unless absolutely necessary.”
Bottom line: We’re seeing emergency wards with far less volumes due to people embracing their social responsibility and not wishing to over-burden the health-care system.
“Or you have people who are scared to death of coming to hospitals for fear they will catch COVID or give COVID,” explains Drummond, a native Montrealer now practising in Perth, Ont.
“But this is not the time to risk your own health. Heart attacks and strokes don’t stop because of the pandemic. People still get fractures. We’re now seeing people who’ve delayed treatment for heart attacks and people hobbling in with two-week-old fractures.
“That can’t be good. The reality is emergency departments have more capacity than they’ve probably ever had, with volumes down almost 60 per cent of what they are normally. Wait times are dramatically reduced. Furthermore, emergency departments are safe. You’re not going to get COVID by coming to emergency, because you will be actively and aggressively screened on arrival. If there is any COVID concern, you are sequestered, gowned and masked.”
Dr. Rob Drummond, an emergency-room physician at St-mary’s Hospital, has drawn the same conclusions. Alan Drummond happens to be Rob’s older brother.
“If you were to come to St-mary’s on the walk-in side — as opposed to the ambulance side — of emergency, you would see the room is pretty spartan,” Rob Drummond says. “Ambulatory volume is down dramatically, easily more than 50 per cent.
“My impression is people are concerned sitting in a waiting room, surrounded by people they think may have COVID. I can say this from my experience with my own patients, who have expressed that concern.”
He points out that the acute side of emergency-room intake is the true barometer of volume, and it is significantly down as well, with those often on stretchers now being placed in rooms that have become more available. Plus, there are those reluctant to call an ambulance, due to their coronavirus fears.
“It’s a multi-factorial thing,” Rob Drummond says. “Low volumes can also be attributed to people not being on the roads as much and thus less likely to be involved in a collision. Also, less people at work are resulting in less industrial accidents. But fear is definitely a major element at play.”
Like his brother, Rob Drummond feels that pretty much most hygiene precautions are being taken at hospital emergency wards. And he feels safer there than at a supermarket.
“If I know I’m going into the dragon’s den, I will put on my suit of armour. I will wash my hands, put my gloves on, have the appropriate mask and eye protection and have others monitor me,” he says. “My guard is always up.
“And if you walk into our hospital and any whiff of danger is smelled, you’re immediately re-directed to be triaged by a nurse in the garage. Otherwise, you have to wash your hands thoroughly with antiseptic solution in front of an agent before proceeding. So, if you need to come in, please come in, because if you wait too long, it will take us longer to make you better.”
Dr. Mitch Shulman, who does emergency at the Royal Victoria and Montreal General hospitals, confirms volumes there have been “dramatically reduced.”
“But we don’t know if people are having their heart attacks at home. We assume it. That’s the hypothesis. But until the dust settles, we can speculate that (fear of contracting or transmitting the coronavirus) is the reason for lower volumes, but we don’t know for sure.”
Shulman, who has been working emergency medicine for over 40 years, also seeks to allay people’s safety worries:
“Hospitals have done everything within their powers to protect staff, patients and people coming into emergency. Without question, extraordinary efforts have been taken to make our environment as safe as we can.”