People experiencing cardiovascular emergencies seem to be avoiding hospital emergency rooms due to fears of COVID-19, putting their health at risk, according to a new report.
Data compiled by Heart and Stroke and the Canadian Cardiovascular Society found that visits to Ontario emergency departments for ST-Elevation Myocardial Infarctions (STEMI) — a very serious type of heart attack — fell by nearly 30 per cent in the period between March 16 and April 12, compared to the same period a year earlier.
Similar numbers from Vancouver Coastal Health show a 40 per cent drop in STEMI patients over the same time last year.
“This last weekend was a good example,” said Dr. Andrew Krahn, a cardiologist and president of the Canadian Cardiovascular Society.
“In downtown Vancouver, there’s an on-call group that looks after acute heart attacks. And they for one weekend actually had none, which was the first time in 11 years.”
According to data from the Canadian Institute for Health Information, there were 26,950 emergency department visits for heart attacks in the 2018-19 fiscal year, corresponding to an average of about 74 visits per day across Canada.
“This data is distressing because there is no reason to believe that fewer events are happening,” Krahn said.
“There’s no plausible reason why COVID-19 should make for less heart attacks or strokes, for example. So what’s happening is we’re seeing less and less of these because people stay home when they happen.”
Delaying medical care can have huge implications for someone’s health, Krahn said.
If you have a stroke, for example, “You have two or three hours, after which you’re going to be disabled.”
“Many of these things that involve in particular acute heart problems, they have treatments that need to be delivered within hours or a day, quickly, to try to prevent the damage that is going to happen.”
Delaying treatment also means that when patients do arrive at the hospital, they’re often sicker and there’s less that doctors can do to help, he said.
Because of this, he worries that there will be a “surge” in very sick patients down the line, which could overwhelm hospital resources — particularly when added to the growing backlog of elective and non-emergent surgeries that were postponed due to COVID-19.
“It’ll create a burden on our ability to diagnose and see and manage those people who are sicker.”
Dr. Jeff Shaw, a Calgary cardiologist and internal medicine specialist, tweeted earlier in April that he was unable to save a patient who didn’t come to the hospital until it was too late.
“I lost the battle to save a patient last night because they waited too long to come to the hospital,” he wrote.
“I’m afraid that there could be patients who have treatable issues who come in too late or get complications from the issues that could have been prevented had they shown up earlier,” he told Global News.
Krahn says he understands that people are nervous about going to a hospital at a time when health authorities are urging people to stay home to avoid getting sick. But going to hospital doesn’t mean that you will catch the novel coronavirus, he said.
“People might forget that 80 to 90 per cent of COVID-19 patients are in the community, most of them are isolated in their homes,” he said.
Hospitals have protection systems to “wall off” suspected COVID-19 patients from those who are coming in with other ailments, he said, “so hospitals and emergency rooms are safe.”
Emergency rooms have also planned for the pandemic, Shaw said, so patients shouldn’t fear being turned away.
If you suspect that you’re having a major cardiac problem, like a heart attack or a stroke, Krahn urges you to go to the emergency room or call 911 as you normally might.
“The reality is the risk of contracting COVID-19 and then being so sick that it has a terrible outcome and so on is extraordinarily small compared to having an acute medical emergency where the consequences are real and personal and warrant attention.”
Questions about COVID-19? Here are some things you need to know:
Health officials caution against all international travel. Returning travellers are legally obligated to self-isolate for 14 days, beginning March 26, in case they develop symptoms and to prevent spreading the virus to others. Some provinces and territories have also implemented additional recommendations or enforcement measures to ensure those returning to the area self-isolate.
Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.
To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.
For full COVID-19 coverage from Global News, click here.
— with files from Brian Hill, Global News