Visits to the Halifax emergency department rise to ‘pre-COVID-19’ numbers

Halifax Infirmary emergency sees drastic reduction in low-acuity visits during first wave
WATCH: The Halifax Infirmary emergency department chief says patients are still screening positive for being at risk of COVID-19, despite low transmission rates in the community.

The number of emergency department visits in Halifax is on the rise as cases of the novel coronavirus in the province remain low.

When the first reported cases of COVID-19 began trickling into Nova Scotia, the Halifax Infirmary emergency department had thorough screening protocols put into place to help reduce the risk of transmission for anyone who came through the doors.

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But for the most part, those who weren’t in need of emergency care stayed home.

“Patients with lower acuity illness, or, injuries, probably stayed away from the emergency department because they didn’t want to be exposed to COVID-19,” said Dr. Janet MacIntyre, the chief of the Halifax Infirmary department.

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“There’s also a significant change in our lifestyle.

“So, people weren’t out maybe doing some of the activities that they had done before, that might expose them to injury.”

Dr. Janet MacIntyre
Dr. Janet MacIntyre says the first wave of COVID-19 came with a significant reduction in low-acuity emergency department visits. Alexa MacLean/Global Halifax

Dr. MacIntyre estimated there was between a 45 to 50 per cent reduction in daily emergency department visits.

However, there wasn’t much of a change in the number of visits for patients presenting significant illnesses or injuries.

“Our higher acuity patients, our sicker patients, were still coming to the emergency department. So, we didn’t have a drastic drop in that patient population. It seemed to be more of the lower acuity patients,” she said.

N.S. father advocating for changes to hospital visitor policy
N.S. father advocating for changes to hospital visitor policy

COVID-19 cases have been steadily declining in Nova Scotia over the past month. As those figures drop the number of visits to the Halifax Infirmary emergency department is starting to rise again.

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“Things now are back to probably the registration numbers that we saw pre-COVID-19. So, we are busy and we’ve pretty much returned back to that same patient volume,” Dr. MacIntyre said.

Read more: Doctors worry Canadians skipping appointments, creating backlog amid COVID-19

She added that while community cases remain low, lots of patients who come through the emergency department still screen positive for being at risk of COVID-19 and therefore, stringent public health protocols remain in place to protect them and others.

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“That’s everything from making sure patients are safe in the waiting room, making sure that we’re using the proper personal protective equipment when we’re seeing patients and that does slow things down. It takes time to get in and out of that equipment and to make sure that adequate cleaning has been done,” she said.

Emergency department waiting room
Plexiglass separates waiting room chairs at the Halifax Infirmary emergency department. Alexa MacLean/Global Halifax

The largest provincial union representing health-care workers says the resurgence in emergency department visits is a symptom of the underlying need to hire and retain more family doctors in the province.

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NSGEU President Jason MacLean says more health-care professionals need to be hired in the emergency departments to help alleviate the pressures of a system that has slowed due to increase infection control protocols.

Some Atlantic Canada ERs open with limited hours
Some Atlantic Canada ERs open with limited hours

“Now that people are getting out again and people are less afraid like they were months ago, they’re going back to the emergency department,” MacLean said.

“This is something that has been ongoing for years and what we need is immediate action by government to incentivize people to go into the fields that work in the emergency departments.”

Read more: Nova Scotia doctor shortage forces ongoing emergency department closures

Provincial health minister, Randy Delorey, says work is ongoing to divert patients who don’t have emergency health needs away from the emergency departments.

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He says that’s being done, in part, through the expansion of other health-care services.

“Many people reported that they were going in just to have their prescriptions renewed if they didn’t have a family physician,” Delorey said.

“Well, I want to remind Nova Scotians that they don’t have to go to the [emergency department], they can go to their local pharmacist if they have a chronic condition.”

Delorey adds that virtual care has expanded as a result of COVID-19, bringing a lot of positives to the realm of primary care medicine.

“There’s more opportunities and flexibilities for primary health-care providers to be there and available to provide those services to patients in the province,” he said.