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Avoiding emergency care during pandemic a dangerous trend, Edmonton ER doctor warns


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Emergency rooms are seeing concerning numbers of patients who have waited dangerously long to seek medical care amid the COVID-19 pandemic, says an Edmonton physician. 

Dr. Shazma Mithani, who works in the emergency department of the Royal Alexandra Hospital, says patients in medical distress have avoided the hospital during the COVID-19 pandemic are now turning up at the ER. 

Mithani said some dire cases were seen this week, including patients with potentially life-threatening illnesses. 

A couple of patients had suffered heart attacks but waited several days before seeking medical care.

Other patients have shown up at hospital with appendicitis that should have been treated earlier. Appendicitis left untreated can lead to serious infection, even death.

“It’s dangerous,” Mithani said in an interview Friday with CBC Radio’s Edmonton AM.

“For a heart attack, the saying is, time is muscle. And so the quicker these patients come in, the better outcomes they tend to have. 

“And for the example of appendicitis, the longer patients wait to come in before surgery, the higher chance they have of complications. For example, a ruptured appendix.”

As public health directives urge the public to keep their distance and conserve precious health-care resources, many people have been reluctant, even wary to enter an ER, Mithani said. 

But with restrictions on businesses and public outings beginning to lift, patients who have been suffering for days, even weeks at home, are starting to turn up at hospital. 

She worries about patients who may still be putting off seeking care. 

“We are noticing that patients are coming in quite a bit sicker than what would normally be seen,” she said. 

“And I think that’s going to continue over the next several weeks.” 

Two months ago, Mithani’s department, like others across the province and country, began bracing for an anticipated wave of COVID-19 patients.

However, in the ER where Mithani works north of downtown Edmonton, the surge of infected patients never materialized. The department remained quiet until this week. 

“Edmonton hasn’t really seen very many COVID-19 cases thankfully and that’s translating to what we’re seeing in the emergency department,” she said.

Mithani is not alone in her concerns. Alberta Health Services said the number of emergency room visits has been on a steady decline amid the height of the pandemic.

According to data tracking some of Alberta’s busiest ER departments, visits fell from around 106,000 in January of 2020 to only 61,000 visits last month. In April of last year, the same list of ERs dealt with more than 103,000 patient admissions.

“If anyone needs urgent, emergency healthcare, they will receive it,” AHS said in a statement to CBC News.

“We understand that some people may feel anxious about visiting a hospital during the COVID-19 pandemic. However, our hospitals and emergency departments remain a safe place to come and to receive care — there is no increased risk to patients coming to hospital.

“Any patient with symptoms, or who has tested positive for COVID-19, is isolated away from other patients and, stringent visitor restrictions are in place, minimizing any risk of transmission from outside of the hospital.

“If someone thinks they have a serious or life-threatening injury or illness, they should go straight to an emergency department or call 911 immediately.” 

As of Thursday, 65 people were being treated in Alberta hospitals for COVID-19, 10 of them in intensive care. The Edmonton zone had 63 active cases, with 441 recovered.  

While some hospitals are under increased strain from COVID-19 patients, people should not hesitate going to hospital if they are in medical distress, Mithani said. 

She said many weeks of planning for the pandemic means health-care providers are ready for whoever — and whatever — may come.

“I do hope that patients who need to come into the emergency department for their medical illness will come in.

“We are still open, we want to see patients and help them when they’re in need of medical help and I hope that people do come in when they need to.”

www.cbc.ca 2020-05-15 17:12:20

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