How’s your pandemic going everybody? Yeah, mine, too. Sheesh….. we’ll get through it, I hope. It’s been a rough ride for everybody. So much so that even people with straight up legitimate emergencies are NOT going to seek care. How do we know that? Some of the evidence is data driven and some observational. The CDC released numbers from the beginning of the year that showed the number of NON COVID-19 deaths this year is up by over 30,000. In New York City, the number of NON COVID-19 deaths for last week was 5000 greater than would be expected in a non-pandemic year. Those numbers with the observation that our ERs are empty and our hospitals are empty tells us something. People are not seeking appropriate care for their emergencies most likely out of fear of contracting COVID-19 in the ER or hospital.
That is indeed a shame. There is no evidence that getting infected in the hospital setting (nosocomial infections) is in any way a source of COVID transmission in non-health care workers. As stated in my last post, in Austin/Travis County there are 6 people that die each day of heart disease and cancer compared to, at the time, 6 people a WEEK that had died of COVID-19. So we must not risk our lives when we have symptoms of a heart attack being worried about getting COVID. The risk/benefit ratio clearly weighs in favor of going to the ER.
It is not easy to get admitted to the hospital. (Some of my hospitalist friends and my GI colleagues may cough into their hands reading that). But it’s overall true. You have to go through the wall of an ER physician who has to deem that ER therapy with outpatient follow up puts the patient at risk of an adverse outcome. Of course there is some subjectivity to that approach. But the point I am making is that this time last year, the hospitals were FULL of patients. Now they are not. It isn’t because the ER physicians became more selective. It isn’t because people stopped getting sick. The numbers add up—people are not going to the hospital even when they need to.
So as Travis County Medical Society and Austin Public Health is promoting: An Emergency is Still and Emergency. If you are really sick, go to the ER! Especially if you have chest pain, shortness of breath, nausea with a history of heart disease, focal weakness, or fainting. Please go.