Well, the likelihood is people that are dying of traditional causes are now getting labeled as COVID-19 coronavirus.
Heart attack and stroke teams, always ready to rush in and save lives, are mostly idle in hospitals across the country. Cardiology consultations have shrunk, except those related to Covid-19.
In an informal Twitter poll by @angioplastyorg, an online community of cardiologists, almost 50% of the respondents reported that they are seeing a 40 to 60% reduction in admissions for heart attacks, and about 20% reported more than a 60% reduction.
This is not a phenom specific to the United States. Investigators from Spain reported a 40% reduction in emergency procedures for heart attacks during the last week of March compared with the frame just before the cronavirus pandemic hit.
And it may not just be heart attacks and strokes.
Doctors on Twitter report a decline in many other emergencies, including acute appendicitis and acute gallbladder disease.
The most concerning explanation is that people stay home and suffer rather than risk coming to the hospital and getting infected with coronavirus.
This theory suggests that Covid-19 has instilled fear of face-to-face medical care.
As a result, people with urgent health problems may be opting to remain at home rather than call for help. And when they do finally seek medical attention, it is often only after their condition has worsened.
Doctors from Hong Kong report an increase in patients coming to the hospital late in the course of their heart attack, when treatment is less likely to be lifesaving.
There are other possible explanations for the missing patients. In this time of social distancing, our meals, social interactions and physical activity patterns have become very different.
Perhaps, people have removed some of the triggers for heart attacks and strokes, like excessive drinking and eating drinking or unusual periods of physical exertion. This theory merits research but seems unlikely to explain the dramatic changes doctors and hospitals are observing.
Experts are bringing together data to confirm these patterns in the hope of gaining a greater understanding of their causes and consequences.
The immediate message to patients is clear, do not delay needed treatment.
If fear of the pandemic leads people to delay or avoid care, then the death rate will extend far beyond those directly infected by the virus.
I have learned that Time to Treatment dictates the outcomes for people with heart attacks and strokes. These deaths may not be labeled Covid-19 coronavirus deaths, but they are collateral damage.
The public needs to know that hospitals are equipped not only to care for people with COVID-19 that they have only recently encountered, but also those who have other life-threatening health problems.
The professionals in healthcare are working to keep people out of the hospital if they can, but they can safely provide care for those people who are not sick from Covid-19.
Masks and protective gear for healthcare workers and patients go a long way to ensure a safe environment.
Further, people with chronic conditions need to know that avoidance of needed care could ultimately be as big or bigger a threat as the virus.
“As we fight coronavirus, we need to combat perceptions that everyone else must stay away from the hospital. The pandemic toll will be much worse if it leads people to avoid care for life-threatening, yet treatable, conditions like heart attacks and strokes“, says Harlan Krumholz, MD, a professor of medicine at Yale and director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation.
Have a happy healthy Easter and Passover Weekend, stay home, Keep the Faith!