Mount Sinai cardiovascular surgeon, John Puskas repurposed his 60-bed cardiac unit to accommodate COVID-19 patients. He was stumped to see that nearly all the beds were now occupied by victims of the coronavirus, but where had all the heart patients gone? Patients with crushing chest pain weren’t coming through the ER.
Variations on that question have puzzled the clinicians in New York, the most severe area of the U.S. outbreak, also across the country and in the United Kingdom, Spain and China. After five weeks into a nationwide coronavirus lockdown, doctors say the pandemic has led to a silent sub-epidemic of people who are in need of care at hospitals, but they don’t dare to come in.
These people suffer from inflamed appendixes, infected gall bladders, bowel obstructions and more ominously, chest pains and stroke symptoms. Puskas says that everyone is frightened to come into the ER.
Some doctors are worried that illness and mortality from unaddressed health issues could rival the carnage produced in regions less affected by COVID-19. Some say that they will soon see patients who have dangerously delayed seeking care.
Evert Eriksson, trauma medical director at the Medical University of South Carolina said that 70 percent of the appendicitis patients now being treated by him are late presentations. When you present late with appendicitis it cannot be operated safely.
In severe heart attack cases, evidence reveals that a large percentage of patients with symptoms that need urgent intervention are not showing up.
It might be possible that patients may be suffering and even dying at home, rather than going to the hospital.
This has led the American College of Cardiology to launch a “Cardiosmart” campaign last week. It is to reassure a wary population and encourage people with symptoms to dial 911 to access urgent care and continue their routine appointments by using telemedicine when practical.