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People are dying of illnesses other than COVID-19 because they wait too long to seek help

Cardiologist worried non-coronavirus patients could die by waiting too long for help
Calgary cardiologist and internal medicine specialist, Dr. Jeff Shaw, is urging anyone experiencing serious medical conditions unrelated to COVID-19 to seek immediate medical attention.

Doctors are sounding alarm bells over what they see as a growing trend of people with serious and life-threatening illnesses avoiding hospitals during the novel coronavirus pandemic.

It’s unclear if people are staying away from hospitals because they’re scared of catching the virus or because they want to lessen the burden on the healthcare system — or both — but frontline medical workers say there’s been a big drop in the number of hospital visits since the outbreak began.

READ MORE: Patients worry delaying routine care during COVID-19 could have lasting impact

“I lost the battle to save a patient last night because they waited too long to come to the hospital,” said Calgary cardiologist and internal medicine specialist Dr. Jeff Shaw on Twitter earlier this week.

“I know there is a lot of fear of hospitals now and concern about being turned away. If you are sick and need help, hospitals are safe and are ready to look after you.”

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Shaw works at Calgary’s Foothills Medical Centre. He says the hospital is prepared and well equipped to deal with the threat of COVID-19, plus any other urgent and serious health issues people may be experiencing.

But he’s worried patients are staying at home — even when they’re very sick — and avoiding treatment because they don’t want to visit hospitals or because they think it’s unsafe.

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“I’m afraid there could be patients who could have treatable issues that come in too late or get complications from issues that could have been prevented had they shown up earlier,” he said.

As of Thursday, there were 28,884 confirmed cases of COVID-19 in Canada and 1,048 associated deaths. According to government data, 1,923 people have been hospitalized, including 512 in intensive care.

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Since the first positive case was reported on Jan. 15, government and health officials have implemented increasingly strict self-isolation and social distancing requirements, including urging people to stay home whenever possible, and mandatory 14-day quarantines for anyone returning from abroad.

Still, Shaw says anyone who’s sick with issues unrelated to COVID-19 shouldn’t be afraid to seek help.

“[The] bottom line is, please call an ambulance if you’re really in trouble, and get to the hospital,” he said.
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‘He should not have stayed home’

Shaw isn’t the only doctor concerned about patients waiting too long to seek treatment.

Dr. Anmol Kapoor, another Calgary cardiologist, says there’s been a decline in the number of patients suffering heart attacks showing up at hospitals, both in Canada and the United States.

Like Shaw, he’s urging anyone experiencing symptoms that could be associated with a heart attack to seek help immediately.

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“Worst case scenario is death,” he said. “People are dying, people could die from heart attacks and staying at home.”

Kapoor recently had a patient who had a heart attack at home and waited to receive treatment. By the time the patient arrived at the hospital he was in heart failure, he said.

“He should have gone to the emergency room. He should have sought medical help immediately. He should not have stayed home,” Kapoor said.

Researching the ‘severity’ of illness

Dan Lane, a third-year medical student and epidemiologist, is leading a study looking at whether patients are sicker at the time they arrive at the hospital than they were prior to the pandemic.

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He said there’s been a roughly 30 to 40 per cent decline in the total number of hospital visits in the Calgary area over the past month, but patients are, according to the doctors he’s spoken with, sicker and further along in the progression of their illnesses when compared to the pre-pandemic period.

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“If you had a patient with appendicitis, they may be coming in at a state where the appendix has already ruptured, as opposed to just sort of the beginning stages of the disease where it’s just causing abdominal pain and discomfort,” he said.

“The implications of that are that the worse the patient is, then the more serious the interventions are in order to treat them.”

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It’s too soon to know for sure, Lane said, but he and fellow researchers expect to see an increase in the mortality rate for certain illnesses because patients waited too long to seek medical attention during the pandemic.

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Lane’s study won’t look at the reasons why people have stayed away from hospitals, but he says it’s important to understand all the consequences of health official’s efforts to slow and stop the spread of the new coronavirus.

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And that isn’t to say Lane thinks the government’s efforts have been misguided — he thinks physical distancing is essential to slowing the spread of the pandemic — just that there are consequences, both good and bad, to every decision that’s made.

“In medicine, almost everything we do involves some sort of a tradeoff,” he said.