How Many People Will Healthcare Avoidance Kill?

People are getting the message – #StayHome. But unfortunately hashtag communication is a blunt instrument. This message is having an unintended effect in the form of extreme healthcare avoidance. People are not seeking care, even in emergencies. And thus we see a huge potential for lost lives.

Strokes, Heart Attacks, and Appendicitis

So far, the documentation for this problem is observational. A new study in the Journal of the American College of Cardiology provides us with some hard numbers. When people have a blockage in one of the major coronary arteries, they need attention quickly. The standard of care is something called a PPCI to get the blood flowing again. Acting fast is critical to avoid damage to the heart.

The new study documents a 38 percent reduction in the number of people presenting for this procedure after the pandemic lockdown began. These heart problems did not disappear with the pandemic. If anything, one might anticipate an increase. But the numbers from this study suggest people are likely avoiding the hospital and harming their health.

Likewise physicians report seeing many more patients now who are delaying care in critical situations. Evert Eriksson at the Medical University of South Carolina told the Washington Post:

What we’re seeing is late presentation,” he said. “I would say 70 percent of the appendicitis on my service right now are late presentations. What happens when you present late with appendicitis is, we can’t operate on you safely.

MUSC has also even seen emergency telehealth consultations for stroke drop my more than half since the lockdown.

People Dying at Home

At the same time, several cities are reporting many more people dying at home. For example, the number of people dying at home has spiked in New York City from 20 per day to 200. Many of these deaths are the result of COVID-19. But some are undoubtedly people with other critical condition who did not get care in time to avoid this fate.

Doctors thus worry that the toll of death from healthcare avoidance might rival the toll from COVID-19 itself.

Care for Chronic Diseases

Unfortunately, acute emergencies are not the end of this problem. That’s because chronic disease are common and they, too, require attention. Someone with hypertension, diabetes, or asthma who delays routine care can quickly find themselves in a life-threatening situation.

The bottom line here is quite simple. Medical care is more than an essential service. It’s often life saving. Healthcare providers are ready to help, despite the pandemic. So it’s not wise to delay needed care. We’re learning the hard way that delays cause great harm and suffering.

Click here for more from the Washington Post, here for more from Everyday Health, and here for more from Stat.

No Entry, photograph © Anton Strogonoff/ flickr

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April 21, 2020