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Delayed checkups, health care resulting in sicker ER patients, longer stays

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Posted at 10:23 AM, Nov 03, 2021

Hospital emergency rooms have been overwhelmed with COVID-19 patients for over a year, but other emergencies are still happening too. Doctors are seeing patients who are sicker and more in need.

“We have seen a lot of patients come in sicker than they ever had before and the reason is that so many of them are fearful of coming to a place where COVID patients are, that they are delaying care for other life-threatening conditions. So, we’ve seen a lot of people come in after having their stroke instead of while they're having a stroke we can intervene on,” said Dr. Don Stader, an emergency physician at Swedish Medical Center.

People are delaying care for their emergencies.

“That anxiety of coming to a place with lots of COVID has kept a lot of people away inappropriately and to the detriment of their health,” Dr. Stader said.

While emergency departments have been battling waves of COVID-19, patients have been foregoing emergency care for conditions and illnesses they may have otherwise gone in for. Now, that backlog is catching up to emergency centers across the U.S.

“During COVID, we had this tremendous decrease in our volume initially, and since that time, what you've seen is a tremendous increase back to, I’d say, baseline numbers,” Dr. Stader said.

The number of patients may be returning to normal, but hospital conditions have not. There are fewer nurses and other hospital staff. And the coronavirus is lingering, affecting thousands of Americans every week.

“It’s the busiest it’s been in emergency medicine and emergency departments in over a decade,” said Dr. Richard Zane, an expert in emergency medicine at UCHealth. “We’re seeing what I believe to be almost two years of neglected health care. So, we’re seeing lots of car accidents, lots and lots of strokes, heart attacks, cancer, skin infections, the routine things that we see in emergency departments except we’re seeing much more of them...and we’re seeing increased severity.”

Dr. Zane said the backlog of regular care has caused this rush of sicker patients.

“We’re finding more advanced stages of everything,” he said. “Every condition when it manifests in an emergency condition gets more severe when that underlying condition is more severe.”

“We are seeing an increase in the number of patients who are having exacerbations of chronic illnesses,” said Dr. Bryce Snow, an emergency medicine physician at Providence Regional Medical Center in Washington.

He said due to shutdowns during the pandemic, regular checkups might also be backlogged.

“There’s a little bit of a backlog in appointments and procedures and screening tests because of everything being shut down temporarily.”

Another factor: life is slowly returning to normal. People are out and more prone to accidents.

“The more the people are out and about, the more their chances are of having a medical emergency,” said Akin Demehin, the Director of Policy at the American Hospital Association.

The association represents thousands of health facilities from small regional hospitals to big medical centers. Demehin said those who might be afraid to seek medical help shouldn’t be.

“Patients that need to come to the emergency department should feel confident in doing so,” he said.

“Don't delay seeking care because you're scared of COVID. We have protocols in hospitals to keep people safe,” Dr. Stader added.

As emergency physicians balance COVID-19 patients and other increasingly severe emergencies, Dr. Stader said continuing regular checkups and seeking help when needed is important.

“Go do it, please do. Because that's how we find and intervene on medical issues before they become emergencies,” he said.