Hamiltonians afraid to go to hospital

Ambulance, ER and mental health volumes down during COVID-19

Fewer people are seeking emergency health care in Hamilton, raising concern a fear of hospitals during COVID-19 is preventing people from getting the treatment they need.

The number of 911 calls ambulances respond to are down nine per cent. Even more concerning is the 30 per cent drop in the number of patients paramedics take to hospital after a call because so many are refusing to go.

“That’s a significant reduction,” said Michael Sanderson, Hamilton paramedic chief. “They’re fearful if they go to the hospitals there is going to be COVID there — and of course there may be.”

But he said paramedics and hospitals have protocols in place to stop the spread of COVID-19.

“They shouldn’t be afraid to call for assistance and they shouldn’t be afraid to go to the hospitals,” he said.

As of Wednesday, 55 people had been hospitalized in Hamilton for COVID-19 with 17 currently at Hamilton Health Sciences and 11 at St. Joseph’s Healthcare. It’s a far cry from the expected spike, with physical distancing getting most of the credit.

“It’s become more and more clear that we probably will not get a massive wave of medical admissions,” said Peter Bieling, vice-president of mental health and addictions at St. Joseph’s.

A decrease in emergency room visits has also been seen at St. Joseph’s Hospital.

“I think there is a general sense of

anxiety about coming to the hospital because you are going to centres where a lot of COVID potentially could be happening around you,” said Dr. Anthony Adili, chief of surgery. “I think there is that sentiment of a lot people saying, ‘Geez I’d like to avoid the hospital if I can.’ ”

Adili says people are always wary of hospitals during flu season but this is “heightened anxiety.”

“I would hope that people who need to come to hospital are coming,” he said, noting that he doesn’t know of any cases so far where complications arose because a patient waited too long to seek treatment.

Even mental-health care, which was prepared for a potential surge in patients from those having trouble coping with physical distancing, has had 35 per cent fewer visits to its psychiatric emergency service at St. Joseph’s.

“Demand for mental-health admissions right now is very low,” said Bieling. “I know that doesn’t necessarily fit with all of us feeling incredibly frustrated by this lockdown, burned out and saying, ‘We’ve had it.’ ”

He’s said the decrease in those seeking emergency health care is being seen in countries all over the world.

“It’s not just in Hamilton,” he said. “Of course, that is where your mind goes: Are people putting off seeking out help who truly are in a crisis?”

He guesses at least part of the reason for the drop is a fear of hospitals during the pandemic.

“They probably are thinking ... ‘Can they take care of me right now, do they have the capacity and what are my risks in going to hospital?’ ” said Bieling. “I’d tell you the risks are pretty low because we have careful screening and we have lots of testing, so we do want people who need the help to come.”

He said: “We’d want to send out the message that the hospital is a safe place, we’re open and we’re ready to provide care.”

Bieling says mental-health care providers are starting to turn their attention to the aftermath of physical distancing.

“In the long run, our mentalhealth volume is likely to return to normal levels if not more, so we have to be ready for the postpandemic world,” said Bieling. “We’re working ... to create a network of care providers.”

St. Joseph’s is also preparing to return mental-health patients to the hospital on Charlton Avenue East after two units were temporarily moved to the West 5th site to make room for COVID-19.

“We don’t have a date,” he said. “But we can think about that in terms of weeks rather than months.”

Right now, between seven and nine patients are having to share rooms made for one at West 5th because of the changes put in place to clear space. It’s a fraction of the 304 patients at the mental-health hospital and the rooms are large. But some of those sharing are having to sleep on air mattresses.

“When we were looking for temporary beds, similar to other things like PPE (personal protective equipment), it was incredibly hard to get anything,” said Bieling. “There are more temporary beds due to arrive on our loading dock, but I don’t think they’ve come. That’s pretty typical of the supply chain.”

A van from St. Joseph’s started going out into the community Wednesday to provide injected mental-health drugs, so patients don’t have to come to the hospital like they usually would.

Paramedics are also going out into the community to do tests for those who can’t get to an assessment centre or live in long-term care and other congregate settings. The additional help was originally put in place in December to do influenza testing, but it was quickly changed to COVID and ramped up from two paramedics to six.

Remote patient monitoring by paramedics has also increased to its maximum during COVID-19. This programs sees paramedics virtually monitor those with conditions such as congestive heart failure and diabetes using units in the patients’ homes. They measure key indicators like blood pressure and blood glucose levels. Demand has gone up so significantly — as doctors try to keep their patients out of hospitals — that there is no more capacity to add more.

“Our paramedics have really risen to the occasion,” said Sanderson. “This has been challenging times.”

Paramedics starting going to potential COVID-19 calls March 9 and have now attended 1,037, with the majority of those turning out not to have the virus. Hamilton’s first official case was March 12.

There are now 420 confirmed and five probable cases in Hamilton as of Wednesday. Many of those would not have involved an ambulance call.

Halton had 508 confirmed and probable cases Wednesday, including 106 in Burlington. Ontario has 15,728 confirmed cases, including 11 in Six Nations and 190 in Haldimand and Norfolk.

The province has had 996 deaths, including 19 in Hamilton, seven in Burlington, one at Six Nations and 30 in Haldimand and Norfolk.