E.R. visits are dropping as patients fret virus, and that worries this Canton-Potsdam Hospital doctor – North Country Public Radio

Source: Doyle Dean

Apr 29, 2020

Emergency rooms across the country are reporting steep drops in patient visits during the pandemic. With more people at home thats meant fewer traumatic injuries like car accidents, but thats not the whole story.

The decline has also included things like strokes and heart attacks. And that has some doctors worried that patients are avoiding urgent care.

Dr. Julie Viethwants to assure people they can get medical care safely. Shes the director of the emergency department at Canton-Potsdam Hospital. She told NCPR theyve seen emergency room visits cut in half.

This transcript has been edited for length and clarity.

Julia RitcheyE.R. visits are dropping, and that worries this Canton-Potsdam Hospital doctor

Dr. Julie Vieth: We have actually seen a drop in everything. Which is interesting and remarkable in its own way. So we have seen a drop in strokes and heart attacks [and] in those trauma evaluations that you just mentioned for obvious reasons. But some of the other reasons for the drops are really unclear to us.

Q: What steps have you taken specifically to create a firewall between treating COVID-19 patients and treating all other types of patients in the emergency room?

Dr. Vieth: So St. Lawrence Health System started putting into place multiple measures weeks and weeks and weeks before our first case in St. Lawrence County. And that preparation was key.

What we have done in all three of our emergency departments throughout St. Lawrence Health System is create rooms or areas that we identify as safe for COVID-19 suspect or confirmed patients. What that means is those rooms have above and beyond what the normal patient would have for personal protective equipment that the staff uses.

A lot of those rooms are under something called negative pressure, which controls the airflow through that room and the air is then filtered. And we identify patients very early on that need to be in those rooms so that other patients who are coming into the emergency department can appropriately be separated into those kind of non- or normal emergency department rooms.

Dr. Julie Vieth, head of CPH's emergency department. Source: St. Lawrence Health System

Q: So if I had an emergency and I went up [to] the entrance, what would I expect to be asked?

Dr. Vieth: So you'll be greeted by one of our screeners. And some of the questions that we are asking are, first, if we want to identify that you are seeking care. And so that's one of the first questions.

And then a couple of the medical questions that will follow include some questions about your symptoms. So do you have a cough, fever, shortness of breath? Do you have loss of taste or loss of smell? As we know, those can be features of COVID-19 as well. And then from there, we can determine what other questions we need to ask you. We are also asking about a travel history outside of St. Lawrence County.

Q: In a recent Gallup survey, 80% of respondents said they would be very or somewhat concerned about visiting a doctor's office right now or hospital. Should they be?

Dr. Vieth: I think their concerns are completely valid, given that all of this has happened very quickly and day to day information is changing about the virus.

However, what I can reassure your listeners is that we have taken every step possible, both recommended by the CDC and our state guidance, as well as our local experts in infection control and infectious disease to make the process as safe as possible.

We do understand that that fear is there and we want our patients to feel safe coming to the emergency department. We have exceptional cleaning services, the filtration of air [and] the proper personal protective equipment all ready so that we can keep everybody safe.

Q: In a Boston Globe article, they quoted an emergency doctor who said strokes and heart attacks don't take a vacation during pandemics. So are you concerned that people may be ignoring serious symptoms?

Dr. Vieth: We are really concerned about that. And that's one of the reasons why we are wanting to get the message out, that if you are having symptoms of a heart attack, stroke, something that cannot wait.

We do not want people waiting at home. We don't want diseases to be ongoing at home without appropriate care because people may be fearful of coming into the emergency department.And you're exactly right. These disease entities, they don't take a vacation during a pandemic.

Q: If a person is experiencing, let's say, symptoms of a stroke or a heart attack and they ignore those, what are they risking by not going into the emergency department?

Dr. Vieth: There are a lot of diseases that are very time sensitive. And you just mentioned two of them.

We know that heart attacks and strokes, we actually have quotes for them saying, 'time is muscle and time is brain.'We know that the longer those disease entities go on, the less choices we have to be able to halt or even reverse a disease process. So we really do not want patients waiting at home with symptoms that are concerning.

Please come see us. Let us do our jobs. Let us do what we do best. Our doors are still open. We are fully staffed. We are ready. And we are here to keep you safe so that your care can still be completed even during a pandemic.

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E.R. visits are dropping as patients fret virus, and that worries this Canton-Potsdam Hospital doctor - North Country Public Radio