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Non-COVID patients delaying treatment

Copyright © 2020 Albuquerque Journal

The symptoms were classic: pressure and heaviness in the chest and difficulty breathing.

In normal times, such feelings often would lead to a prompt trip to the emergency room. But in the middle of a pandemic, Albuquerque doctors have seen patients with those symptoms wait 12 to 24 hours in some cases to go to the emergency room, said Dr. Mark Sheldon, interim chief of the Division of Cardiology at the University of New Mexico Hospital.

“And unfortunately, many times the ship has already sailed, so to speak, on their heart,” he said. “Most of the damage is done in the first couple of hours.”

Patients waiting to seek treatment for serious complications is a trend at hospitals all over the country, including Albuquerque, according to health officials at local hospitals and national surveys.

Nationwide, 80% of adults said they are concerned about getting COVID-19 from another person in an emergency room and 29% said they have delayed or avoided medical treatment, according to a late April survey by the American College of Emergency Physicians and Morning Consult.

It appears some of those concerns are present in Albuquerque.

The ambulance service for Presbyterian Healthcare Services in recent weeks made about 25% to 30% fewer runs than the service was projecting, said Scott Kasper, chief of Albuquerque Ambulance Services.

“We’re still seeing the normal spread of types of calls. Car crashes are still happening. People are still getting sick,” Kasper said. “But what we’re seeing is that … it seems like patients are waiting longer.”

The longer wait leads to more complications.

“The patients that we are seeing are tending to be sicker,” he said. “Our case mix is a much higher percentage of sicker patients, and what we’re hearing anecdotally is, ‘I waited before I called because I just didn’t want to go the hospital.’ ”

With certain conditions, a quick response is crucial.

Failure to act quickly on a stroke or a heart attack can lead to long-term problems or death. For example, Sheldon said, waiting too long to seek treatment for a heart attack, even if the patient survives, can increase the patient’s chances of having congestive heart failure or irregular rhythm, increasing the odds of a sudden death later.

Physicians say there are a couple of possible reasons people are avoiding emergency rooms. One is fear that going to a hospital will increase their risk of contracting coronavirus. The other is a result of the incessant messaging about stay-at-home orders.

“We’ve been messaging for over two months that we don’t want you to come in for your appointment. We’re going to call you or do a Zoom visit with you,” Sheldon said. “But at the same time, we certainly don’t want them to ignore significant symptoms.”

As for the risk of catching coronavirus at a health care facility, officials said they are taking precautions to minimize it.

Kasper said Presbyterian ambulance crews are wearing protective gear for every call and they’re wearing masks and taking other precautions when crew members are around one another and waiting to be dispatched. They are also putting masks on patients they transport.

At the hospital, Sheldon said, COVID and suspected-COVID patients are isolated from other patients in special rooms where the air doesn’t flow into the rest of the hospital.

“People are waiting until they are so sick that they are near death because they are afraid to go to the hospital,” Kasper said. “And they shouldn’t be.”

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