In a new study, it was shown that emergency department visits during the early months of the COVID-19 pandemic decreased by 40 to 60 percent. These findings were published in the Journal of American Medical Association (Internal Medicine).
The study also showed that initially the number of hospital admissions remained steady even with decreasing emergency department visits, but then they began to increase as the number of COVID-19 cases began to increase as well.
These findings are important as they show that people not getting emergency care may suffer negative health outcomes and even death and a decline in emergency visits can also mean a drop in revenue for the hospitals that are already financially suffering due to the high burden of coronavirus cases.
ED visits dropped immediately as #COVID19 intensified in the US, but admissions did not rise until COVID-19 cases increased locally. In future waves of COVID-19, #publichealth messaging should emphasize appropriate use of EDs for non-COVID-19 conditions https://t.co/WJtgRvcWjG
— JAMA Internal Medicine (@JAMAInternalMed) August 3, 2020
In this new cross-sectional study, the scientists looked at data from 24 emergency departments in five different health systems in different states, for four months since start of this year.
Data was collected from Mount Sinai Health System in New York, Baystate Health in Massachusetts, University of Colorado Health, University of North Carolina Health, and Yale New Haven Health in Connecticut.
After accumulating all this data, the scientists found out that the largest decrease (63.5 percent) in number of emergency visits occurred in the state of New York and the smallest decrease (41.5 percent) occurred in the state of Colorado. Other states like Massachusetts, Connecticut and North Carolina, saw decreases of 57.4%, 48.9% and 46.5% respectively.
When the researchers analyzed the number of hospital admissions, they saw that the sharpest increase (149 percent) in these admissions occurred in the State of
New York as well. This was followed by 51.7% increase in Massachusetts, 36.2% in Connecticut, 29.4% in Colorado, and 22% in North Carolina.
This is not the first time that a decrease in emergency visits was reported in United States. A Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention had also previously reported a 42% decline in emergency department visits from April 2019 to April 2020.
Another study showed that the use of healthcare professional services decreased by 68% and there was a 48% decrease in revenue based on total estimated in-network amounts compared to the last year.
According to the research team, the reduction in emergency hospital visits could have been because of people avoiding the hospitals in fear of exposure to the coronavirus in emergency rooms. Other reasons could have been the concerns regarding the long waiting durations and to avoid seeking healthcare services that others might need.
The researchers highlighted three areas that require attention from public health policy makers right now.
First, people should be made aware about the importance of utilizing emergency medical services for serious symptoms, illnesses, and injuries that cannot be managed otherwise.
Second, hospitals should ensure infection control measures that protect patients and staff in the emergency department and other clinical settings. Lastly, public health authorities should make information public that guides people on where they should seek emergency healthcare services if they are in need.
If you have signs of a heart attack or stroke while staying at home during #COVID19, call 9-1-1 right away. Emergency responders & emergency departments have plans in place to help protect you from COVID-19. Learn more: https://t.co/MTWoINOyZL pic.twitter.com/tSpO5hyY7B
— CDC Emergency (@CDCemergency) June 5, 2020
‘Really Bad Situation’
These three guidelines are essential to take care of people who need emergency health, especially now that the COVID-19 pandemic situation is worsening in United States.
Anthony Fauci, the country’s top infectious disease expert, has said that United States could end up in “really bad situation” if the number of daily new coronavirus cases do not drop to 10,000 by next month.
Fauci explained that this number is based on the assumption that as colder weather will return, so will the cases increase as the weather will force people indoors, where the virus spreads more easily.
— The Hill (@thehill) August 3, 2020
Right now, America has more than 4.6 million confirmed cases of coronavirus in the country and at least 155,196 deaths, according to data from Johns Hopkins University. States like Arkansas, California, Florida, Montana, Oregon and Texas also reported their highest single-day death tolls last week.
The New York Times data shows that right now the country is seeing between 50,000 and 70,000 new COVID-19 cases of coronavirus per day, with a seven-day average of above 61,000.
According to Fauci, this is alarming because the virus follows a “real and potential pattern” where percentage of positive tests rises first and then the number of cases. Now, states such as Tennessee, Kentucky, Ohio and Minnesota are starting to see surges in the percentage of positive tests.
However, he suggests that the country needs to hit pause and wait for the number to drop but this does not mean that there is a need to “necessarily have to revert to going all the way back to closing”.