Too many people suffering symptoms of heart attack and stroke are waiting longer than usual to call their physician or 911, sustaining worse damage — and sometimes risking death, they said.
“We’re seeing fewer people come in, but we’re seeing sicker people,” said Dr. Andrew Lim, director of Bristol Hospital’s emergency department.
“We’re definitely seeing people who are waiting too long to come in,” said Dr. Peter Jacoby, chairman of emergency medicine at St. Mary’s Hospital in Waterbury.
Some Connecticut hospitals this winter are seeing a second wave of deep reluctance to get medical treatment, at least partly because concerns about the second wave of coronavirus infections.
Often, it’s the patients most at risk of COVID-19 complications who are staying home too long: diabetics, the elderly, the obese and people with high blood pressure.
That’s alarming to physicians because those are the same people at most risk from their treatable conditions. Those can be managed with routine medical care, but deteriorate — sometimes dangerously — when regular physician visits and medication management appointments are canceled for whole seasons at a time.
“We’re particularly concerned about the people who are more vulnerable — the elderly, the people with diabetes, the people who are smoking. That’s exactly what we’re seeing — those are the people who aren’t coming in,” said Dr. Basmah Safdar, director of the chest pain center at Yale New Haven Hospital.
After the pandemic started early last year, physicians around the country began noticing that emergency room visits were down. COVID-19 cases were soaring, but there was a steep drop in most others.
“There was this eerie silence in the emergency department. We were all wondering what happened to the heart attacks and strokes,” Safdar said.
At least in Connecticut, that seemed to level out a bit by late summer, when the state was in a reopening mode and optimism abounded, according to doctors at several hospitals.
But late this fall, as infection rates shot back up, many people again started skipping checkups and medication management visits. Some with warning signs of major trouble have been trying to ride it out, hoping the condition will go away.
“Both our ER visits and the primary care and preventive care visits are down,” said Dr. Justin Lundbye, chief medical officer at Waterbury Hospital. “The primary anecdote we hear is that they’re afraid of COVID.
“There were younger people breaking the rules, and that led to a resurgence of the scare that older people will be exposed. When they do come in, they tend to be a lot sicker from the same conditions than they would have been a year ago. More of them have to be admitted.”
Lundbye, Lim, Safdar and Jacoby all stressed that Connecticut hospitals this winter are actually pretty safe places to be. They’ve refined cleaning procedures and have developed rigorous systems to divert potential COVID-19 sufferers away from the rest of the hospital population.
The physicians also noted that hospitals have instituted telehealth options so patients can get initial consultations over the internet without ever entering a doctor’s office or hospital. And in situations where the telehealth conclusion is that an in-person visit is needed, then the patient knows the condition can’t be ignored.
“It’s a balance people have to strike. Are you concerned about being potentially exposed to a potentially deadly disease, or are you concerned about a disease we know is deadly,” Safdar said.
Noting that drug overdoses are on the rise, Jacoby said people suffering depression should also reach out for help. Diabetics who are dehydrated or suffering other symptoms should get help.
Repeatedly postponing routine medical visits runs other risks, Lim said.
“There are the silent killers like high blood pressure where you can walk around and not feel symptoms. People feel OK, they don’t get the medication refilled, and that feeds a falsehood that they don’t need it,” Lim said. “But we’re prescribing them to prevent bad outcomes down the road.”
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