Montefiore in the News
Doctors Express Concern About People Avoiding Medical Help
- April 30, 2020
It's a mysterious consequence of the coronavirus crisis. Fewer people are going to hospital emergency rooms in the city with problems like heart attacks and strokes.
"Trauma numbers definitely went down," said Dr. Shi-Wen Lee, vice chair of the Emergency Department at Jamaica Hospital Medical Center. "We are a Level 1 trauma center. Those numbers went down. We didn’t have a lot of car accidents, gunshot wounds."
Dr. David Esses is the vice chair of the Emergency Department at Montefiore Medical Center in the Bronx, one of the busiest emergency departments in the country. He reports overall volume is down by about 60 percent of what it usually is.
"Where is everyone?" said Dr. Esses. "Are people staying home and getting sicker? Are more people dying at home because they’re not coming to the hospital?"
Manhattan’s Lenox Hill Hospital shows overall emergency department volume is down by about 40 percent when compared to this same time last year, with a 50 percent drop in heart attacks and a 60 percent drop in cases of stroke-like symptoms for April.
"I suspect that a lot of our neighbors here that utilize the emergency department at Lenox Hill Hospital perhaps migrated outside of the city out of fear," said Dr. Brandon Godbout, vice chairman of Emergency Medicine at Lenox Hill. "Where we really worry the most is, are these patients actually at home but choosing to not come into the emergency department because they are afraid? They’re afraid of getting coronavirus?
"I think people are afraid. They are afraid to come out of their house. They're afraid to come to the emergency department because they are afraid of being exposed. And as a result of that, you know, some patients who need to come in, perhaps are not coming in," Dr. Esses said.
It’s hard to know in real time why fewer non-COVID patients sought assistance from hospital emergency departments, Dr. Lee of Jamaica Hospital.
“How many patients did not come to the hospital because they are too afraid to suffer the ultimate consequences? We’re not going to know that now,” said Dr. Lee.
But there are some indications that perhaps patients with non-COVID emergency conditions sought treatment elsewhere.
CityMD, an outpatient urgent care provider with about 125 locations, reports increased volume that it usually sees during flu season.
“We were probably seeing a lot more chest pain, a lot more shortness of breath, t,hings that normally people would have called 911 for or headed to the emergency room," said Dr. Katharine Miao, regional medical director for CityMD.
Emergency departments are able to treat non-COVID and COVID patients. Some have tents that provide triage space. Others have designated zones inside the hospital to group non-COVID patients away from suspected COVID cases.
Staten Island University Hospital recently treated a non-COVID cardiac patient with emergency surgery.
"I waited longer than I would have under normal circumstances to call an ambulance," said admitted patient Vincent Brescia.
SIUH converted the operating room into an intensive care unit so Brescia's surgical treatment and post-operation recovery would be limited to only that room, minimizing the risk of contracting COVID.
His surgeon and emergency room doctors around the city say no one should delay calling 911 if they experience chest pain, light-headedness, or shortness of breath.
"The risk of dying at home from these problems is just as a high, or if not higher, than if you contract COVID," said Dr. Mohammed Imam, Brescia's doctor and chairman of the department of cardiothoracic surgery at SIUH.