As the world faces the COVID-19 pandemic, Alaskans are looking out for each other and trying to stay healthy. When an emergency happens, however, it’s vital to seek medical attention quickly, both for the patient and their community.
Nationwide, hospitals are reporting dramatic decreases in patients presenting themselves in emergency rooms for heart problems or other life-threatening conditions. Dr. David Scordino, an Emergency Department Physician at Alaska Regional Hospital, says that is terrifying.
At first blush, it might seem like the number of people having heart attacks or strokes or other medical emergencies are down. But, Scordino said, that’s just not the case.
“Those medical issues are still happening, they don’t go away because we’re in a pandemic,” Scordino said. “So the fact that we’re not seeing those, means that a lot of people are going without care.”
Over the month of April, Alaska Regional Hospital saw about 47 percent of normal volume, which Scordino said is consistent with hospitals both locally and nationally.
While it’s one thing to see a decrease in visits for minor medical needs, such as an ankle sprain, there shouldn’t be a decrease in admissions for major events such as heart attacks, strokes, gallbladder disease and appendicitis.
During the last month, patients have told Scordino that they waited to come in for emergency treatment because they were afraid of potentially catching COVID-19. Stories of those concerns, he says, aren’t anecdotal – a poll conducted by the American College of Emergency Physicians found that roughly 80 percent of people surveyed expressed fear of getting the disease if they came to the hospital.
But Scordino said all area hospitals are doing everything possible to minimize risk of spreading the disease – contracting it while at your hospital is unlikely. Alaska Regional Hospital has undertaken a number of new protocols to keep patients (and themselves) safe, ranging from making sure all staff members are wearing masks or shields to increased hand washing to creating a specific area (with specific medical personnel) for confirmed or likely COVID-19 cases. They’ve even offered to let patients wait in their cars if they’d feel safer and call them when their rooms are ready.
“The likelihood that you’re going to get exposed to another patient is a lot less,” Scordino said.
Steve Compton, a cardiologist with the Alaska Heart Institute, said the state’s hospitals have a long history of rigorously sanitizing and separating those who have viral infections – Alaska was a hotbed of tuberculosis cases in the ‘40s and ‘50s and has seen other viral diseases, so they’ve learned to be prepared.
Waiting makes worse
Though despite working with other health officials and politicians to get the word out that residents shouldn’t be scared about going to the hospital for emergencies, numbers are still worryingly low.
What has increased, Compton said, is the number of patients who are in the later stages of cardiogenic shock and heart attacks in the last month. This, he thinks, is due to people being afraid they’ll come down with a viral infection, so they try to ride it out.
“We’ve had a number of people show up in the ER, close to death and not survive what would normally be an easily treatable problem,” Compton said. “We realized that the deaths related to COVID fear that we’ve seen are comparable to the number of COVID deaths in the state. Those two problems are competing with each other.”
Compton added that fear has meant that a number of patients who are sick enough to be offered in patient management of their heart conditions have refused the treatment and have sought to go home instead, a move that means they’re further away from care if their conditions worsened.
“If you’re having an emergency, it’s just that, an emergency,” Scordino said. “You should go and get treated appropriately.”
Going in at the first sign of irregularity or trouble, both doctors said, can make the difference between a night in the hospital or weeks in intensive care, or even death.
“For example, during an appendicitis case, if an abscess forms, your recovery is so much more complicated because of that delay,” Scordino said, adding that often those who wait require weeks of antibiotics and delays often lead to additional problems down the road. “By putting stuff off, it makes it more difficult for the patient.”
Similarly, Compton said those who experience an abrupt onset of chest pain and come in immediately are rushed to the cardiac cath lab, where their doctors are able to try to open up the blocked artery and restore blood flow before the heart muscle dies.
“In that sort of situation, time is muscle,” Compton said. “If a patient waits six hours or a day or two, by the time they show up for treatment, we can’t really solve the problem. So many of these problems require timely intervention.”
Having patients longer also makes it harder on the hospital – while one patient occupies a bed, fewer patients can be admitted and helped, which could prove particularly problematic if Anchorage sees a big increase in COVID-19 cases.
Caring for community
If there’s one thing Scordino wants local residents to know it’s that their hospitals are still safe places to be and seeking care at the first signs of trouble makes it easier for everyone involved.
“We want to make sure that we’re continuing to take care of our community,” Scordino said. “The last thing we want is to have people suffering needlessly at home because they’re afraid. We’re here, ready to do our part to keep everyone safe and healthy.”
This story was produced by the creative services department of the Anchorage Daily News in collaboration with the Sponsor. The ADN newsroom was not involved in its production.