Don’t avoid seeking medical treatment due to fear
At the hospital where I practice, a man was recently admitted with excruciating stomach pain. We quickly diagnosed him with a bowel blockage that would require emergency surgery. What made this relatively common scenario unusual was the extent to which this patient’s condition had progressed. He had been having painful symptoms for weeks, and with each day his stomach had grown larger. By the time he came to us, his midsection was the size of a full-term pregnancy. His reason for not coming to the hospital sooner? He was scared of catching COVID-19.
Coming in sooner could have helped this man avoid surgery and prevent weeks of discomfort and increasing risk. Unfortunately, ever since this pandemic started, I am seeing many more people also delaying problems that should have been treated sooner, because they were scared of catching the novel coronavirus in emergency rooms and hospitals. I’ve seeing people who let chest pain carry on for many days, leading to full blown heart attacks. I’ve seen individuals with strokes whose only window for treatment is in the first 4 1/2 hours of onset, instead coming for care 24 or even 48 hours later. When treatment is delayed, otherwise manageable situations can lead to permanent disability and even death.
Public health guidance has advised us all to avoid nonessential travel and unnecessary visits to doctors. Although no major U.S. studies have yet shown the effect of COVID-19 on inpatient hospital volumes, there are many anecdotal reports of significantly decreased numbers of non-COVID-19-related emergency room visits and hospital admissions across the country. Also, according to the Journal of the American College of Cardiology, treatment of serious heart attacks at a segment of studied hospitals was down 40%, which is in line with other hard-hit countries, like Spain. It is unlikely that the number of heart attacks truly decreased because of the pandemic. Some emergency rooms are even closing because of the decreased number of patient visits. Since late March, it has been much quieter in the hospital wards where I work than any spring in recent memory.
For the most part, it seems people are listening to the guidance to protect their own health. But let the guidance be clear: only non-urgent care can be delayed. Fear of contracting COVID-19 should not stop you from seeking medical care when you need it. It is easier than ever to make an appointment with your doctor through telephone visits and video chats. In-person visits are still being arranged in many clinics.
Hospitals are acutely aware of the need for isolating anyone confirmed or suspected of COVID-19 infections (socalled PUIs — persons under investigation), to protect staff and other patients. Emergency rooms and hospitals often have a wing or ward dedicated to treating PUIs, complete with increased sanitation and protective protocols.
The fear of contracting this terrible virus is understandable, especially with death tolls continuing to rise. But fear must be balanced with reason and caution. Other afflictions will not stop during this pandemic. Do not wait until it is too late to seek medical attention if you develop a serious illness. Talk to a doctor before such maladies progress too far. Calling your doctor’s office (or 911 if the emergency is more serious) is the first step in the right direction and will help you understand if your condition requires an in-person visit.
As doctors, we’ve taken a Hippocratic oath that says: First do no harm. Now, as in any other time, we will do our best to protect you and treat you.