Hospitals Gearing Up for COVID Rush, Emergency Admissions Decrease

"Before that trip [visit to New York] we were obviously all hearing about COVID, but everything was mostly business as usual. Now, going into the hospital, COVID is everywhere."
"I am hearing this is fairly similar across other emergency rooms in the Toronto area. We are seeing way, way, lower volumes of admissions overall."
"We're certainly hearing stories of people with abdominal pains and chest pains and all sorts of bad symptoms, like stroke symptoms, who are just not coming to the hospital because they're too afraid. It's actually somewhat of a tragedy."
Dr.Brett Belchetz, Emergency Room doctor, Scarborough, Ontario

An emergency department in Toronto prepared to screen patients who could be infected with COVID-19 earlier this month. (Craig Chivers/CBC)

"Emergency volumes have plummeted all over the country. People are so fearful of hospitals, understandably, they just aren't coming in."
"I'd be scared as a lay person to come in to the hospital with something unrelated to COVID. I'm very concerned that there are people who are having heart attacks and strokes and significant injuries at  home -- deep cuts that aren't getting sutured."
"I think this crisis is going to [cause] huge collateral damage to the medical system for non-COVID-positive patients."
"Very fortunately, we haven't seen this big surge in the super sick, which we were prepared for, and have been expecting. God willing, we'll never see it, but the next two weeks will tell."
Dr.Daniel Kalla, head, emergency department, St.Paul's Hospital, Vancouver

"There are less heart attacks coming to the emergency department now."
"And I don't know why, but I presume that some of the people who are having heart attacks are just not coming in."
"We can't help you with your heart attack if you stay home. Similarly, if you'r ehaving your severe abdominal pain, you're vomiting, you [have] shortness of breath, and you stay at home, we're not going to be able to help you."
Dr.Ari Greenwald, emergency medicine, Toronto and Hamilton

'We just know we have to be ready,' said Dr. Carolyn Snider, medical director of the emergency department at Toronto's St. Michael's Hospital. (Michael Wilson/CBC)

There is plenty of fallout and to spare, from the sudden emergency situation that hospitals and their medical staff are now facing. Although hospitals are any society's first line of defence against the onset of an epidemic, this global pandemic has proven an arduously, mysteriously difficult one to handle; too much is as yet unknown about it, and its indomitably sinister spread alongside the novel coronavirus's death rate has shaken both the confidence of the medical community and the trust of the public.

A disease of this virulent nature ensures a hospital setting will have an even greater teeming of communicable pathogens than usual. And where hospitals' vital role in diagnosing and treating calamitous maladies is acknowledged, entering one in a medically vulnerable condition, and thus exposing oneself to a potentially deadly infection on top of the medical condition that might have spurred a visit to a hospital emergency room becomes infinitely less palatable as a first choice, even at the cost of self-harm, the fear is that great.

The health community has made no secret of its trepidation and concern over a firestorm of emergency admissions with people suffering grievous consequences of having contracted COVID-19. and nor have their concerns over a shortfall of essential medical equipment such as ventilators and personal protection equipment for medical staff been kept from the public, much less the health communities' own fears respecting their personal safety, given that quite a number have now been diagnosed with the coronavirus.

Dr.Belchetz had been away to New York on a trip before COVID-19 had fully descended on the city to mark it out as the central point of infections in the U.S. He had gone into self-isolation at home following his two-week trip, and in the interim the hospital he works an emergency shift in had undergone a sea change, where reworked triage procedures had been designed, and his colleagues were in a state of deep anxiety. Yet, to his astonishment, he discovered that the emergency department itself was uncharacteristically quiet.

Quiet ERs could be a sign that social isolation is working. But doctors warn it could also foreshadow a significant problem to come. Getty Images

All over the country -- and this phenomenon could fairly be considered representative of hospitals globally, given similar conditions prevailing -- hospitals have been seeing a significant decrease in emergency admissions. Word of mouth between emergency room physicians appears to validate that startling new situation where, with the arrival of the pandemic, as in Seattle, Washington State, admissions to emergency rooms have fallen between ten and 20 percent at six large hospitals. In one there was a 40 percent drop while the pandemic savaged the region.

There could be several interpretations; the good-news optimistic one is that fewer admissions reflect people diligently practising social distancing, as required to stem the tide of infection. Fewer people out and about equates with fewer vehicle accidents, drunken fights and other social dysfunctions that often bring victims to a hospital ER. Most doctors, however, attribute the drop in admissions to stark fear of contracting the coronavirus; that in the current climate, the last thing anyone wants to do is go to a hospital.

With serious health collapses such as heart attack, stroke and appendicitis, early intervention is critical to a hoped-for outcome. Hospitals have done their best to separate COVID treatment areas from low-risk treatment areas, to lower chances of an opportunistic virus rampaging through hospital departments, infecting the already ill and vulnerable. On the other hand, quieter emergency rooms translates as a respite and the chance for medical personnel to breathe a little easier before the anticipated flood begins to overwhelm the system everyone depends upon.

A B.C. ambulance paramedic is seen outside the Lions Gate Hospital in North Vancouver on Monday. Contrary to what one might think, several emergency room doctors report relatively quiet ERs these days. (Jonathan Hayward/The Canadian Press)