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COVID-19 Fears May Be Causing People To Ignore Medical Emergencies

NOEL KING, HOST:

Doctors across the country are noticing an alarming trend. Hospital visits for serious medical emergencies like heart attacks and strokes are way down. There's a growing sense that patients are afraid to come into the hospital for help because of the pandemic. Already, there are cases of patients who have postponed getting care and ended up with serious damage or even death. Joining us to talk about this are health reporters Will Stone in Seattle and Elly Yu of member station KPCC in Los Angeles. Hi, guys.

ELLY YU, BYLINE: Hi.

WILL STONE, BYLINE: Glad to be here.

KING: OK. Elly, let me start with you. You've been looking at what the situation is like in emergency rooms across the country. They, I would imagine, are very busy with coronavirus.

YU: Yes, ERs are busy with coronavirus in some cities. But nationwide, ER doctors are saying they're seeing this overall big drop in patients coming in, including here in Los Angeles. They say they've never seen anything like this, and they use words like eerie and shocking. One estimate says ER visits are down 40% to 50% nationwide. Now, this isn't totally surprising since it was part of the plan. Early in the pandemic, hospitals started clearing out. Officials have been telling people to stay home as much as possible so that ERs could be ready to absorb coronavirus patients. Dr. David Tashman runs the ER at the University of Southern California's Verdugo Hills Hospital. Here's what he told me.

DAVID TASHMAN: The first few weeks of the pandemic, it was very scary because it was so quiet. We would normally see a hundred patients a day, and then, you know, overnight, we were down to 30 or 40. And all of us were just, like, waiting for the tidal wave to hit.

YU: The thing is, that tidal wave has not hit LA or a lot of the country the way it did New York. So these ERs are even quieter than before the pandemic. Now, doctors did expect to see fewer traumas from things like car accidents because there's less driving going on, but they've been sort of perplexed about these missing patients who are having strokes and heart attacks.

KING: And, Will, it's worth noting that heart attacks and strokes are some of the most common medical problems in the United States. These are not things that you can put off for a week. And yet you're reporting that those patients who would normally be calling 911 are not. What's going on?

STONE: Doctors and nurses are wondering the same thing. They say this kind of drop-off in heart attack and stroke patients is just unprecedented. Some 911 data show calls for these types of emergencies started declining in mid-March. At the University of Washington here in Seattle, the hospital saw a 60% decline in patients admitted for stroke in the first half of April compared to last year. There's a similar trend with heart attacks, according to another study.

As to why people aren't calling the ambulance, it's hard to be sure, but most doctors believe people are afraid of getting infected at the hospital. For example, I spoke with Dustin Domzalski here in Washington state. He's 35 and has a traumatic brain injury and epilepsy. He wasn't able to get his seizure medication refilled on time. He ended up having a major seizure. He fell and was brought to the ER. He says the patient next to him there was coughing a bunch, and it was so unnerving that he now plans to stay home instead of going to the hospital in the future.

DUSTIN DOMZALSKI: Still not going to be going, you know, to the hospital if I have a seizure unless I injure myself. Rather stay here and deal with that than potentially have problems from the virus, whereas, typically, if had had one and wasn't feeling right, I probably would have went to the hospital.

STONE: This echoes what doctors are hearing - that patients, even those who are vulnerable, are reluctant to go to the hospital.

KING: Yeah, because they think that the hospital isn't safe, which raises an interesting question. Elly, what's being done to change that, to convince people it is safe to come in if you've got an emergency?

YU: Well, recently, groups like the American Heart Association have been running ads to urge patients not to ignore symptoms. Here's a clip of one.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PERSON: Heart attacks, strokes and cardiac arrests don't stop during the coronavirus pandemic. Call 911 at the first sign to save lives.

YU: Doctors are trying to assure patients that ERs are still open, are safe and have the capacity to help people in serious need. But it's been confusing. Officials have been telling people to stay home and help flatten the curve. So doctors are trying to strike a balance with the message - avoid ERs for minor problems, but come in if there is a sign of an emergency. Here's how Larry Stock, an ER doctor in Lancaster, Calif., put it.

LARRY STOCK: The message has to be slightly more nuanced for people to get it right so they don't get hurt by just listening to one message, which is stay home.

YU: And doctors tell us that when they are seeing patients, they're often really sick because they've put off care for days.

KING: Which sounds like it could potentially lead to another public health crisis which is quieter than COVID-19 but happening at the same time. Will, what happens to patients who are having strokes or heart attacks but who don't call an ambulance right away?

STONE: Some doctors have told us they are already seeing tragic consequences because people are avoiding the hospital. You see, for an emergency like a stroke, acting quickly when you first notice symptoms is absolutely crucial. I spoke to Dr. Abhineet Chowdhary. He's a neurosurgeon at Overlake Medical Center in Bellevue, Wash. And he shared the story of a patient in her mid-50s who had what felt like the worst headache of her life. But she waited to get help. She stayed home.

ABHINEET CHOWDHARY: She was afraid if she came into the hospital that she would catch COVID-19. And she unfortunately came a week after her symptoms started. We discovered that she did have a brain bleed from an aneurysm. As a result of that, she had multiple other strokes and ended up passing away. This is something that most of the time we're able to prevent.

STONE: And I talked to doctors in other parts of the country; they're also seeing patients showing up at the hospital days after first noticing symptoms. It's suspected that some of these patients just never make it in. They may be dying at home. So it's an evolving situation. But doctors say the trends are very worrisome, and we probably will hear more about this problem in the coming months.

KING: It sounds like we will. Reporter Will Stone in Seattle, and we also talked to Elly Yu at KPCC in Los Angeles. Thanks for your reporting, guys.

STONE: Glad to do it.

YU: Thank you.

(SOUNDBITE OF HELIOS' "VAINGLORY") Transcript provided by NPR, Copyright NPR.