As an emergency department attending physician and a primary-care physician, we see the full spectrum of patients afraid to seek hospital care when they really could use it.
During a recent weekend at our primary-care practice, a patient called because he was having severe abdominal pain. So severe, in fact, that he could barely speak. Yet he refused our advice to get to the emergency department right away.
“I can’t go to the ED,” he muttered. “It’s full of COVID there — I’ll catch it, for sure. Can you just call in something for pain?”
We talked a bit more, and he finally agreed to go. It was a good decision; he had a large kidney stone that required surgical removal. Calling in a prescription for pain medicine would have delayed emergency care, and could have resulted in a dire situation and much worse outcome.
On a recent emergency department shift, a senior with diabetes came in at the repeated urging of his neighbor. The open sores on his feet had worsened despite his best efforts at home. An evaluation revealed that the area had become seriously infected, to the point he required intravenous antibiotics and admission to the hospital.
He tried his best to follow public health precautions to lessen the risk of COVID-19, yet he also avoided seeing his doctor and would not allow safe visits from friends with masks who otherwise would routinely check in on him. He needed to be assured that hospital staff adhere to strict safety precautions for everyone’s protection.
COVID-19 fear-induced avoidance of urgent or emergency care has been an issue throughout the pandemic. But it appears it may be getting worse as the current surge continues. A recently published survey study showed that “an estimated 41% of U.S. adults had delayed or avoided medical care including urgent or emergency care (12%) and routine care (32%).” And this avoidance seems to be more prevalent among “unpaid caregivers for adults, persons with underlying medical conditions, Black adults, Hispanic adults, young adults, and persons with disabilities.”
Earlier in the pandemic, when COVID-19 first began to fill hospitals and emergency rooms, facts were limited and fear pervasive, as much among clinicians as patients. But urgent medical conditions including diagnoses such as stroke, heart attack, overdoses, and trauma have continued unabated throughout our city; conditions that must be addressed quickly. EDs are the appropriate and safe place to go if you are concerned. This imperative is underscored by the results of a study from 39 U.S. emergency departments, which found that being located in the ED with COVID-19 infected patients was not associated with contracting COVID-19.
Although COVID-19 case numbers continue to climb, we have learned a great deal about this virus and how to keep our patients safe. Emergency departments require that everyone wear a face mask and health care professionals are required to wear personal protective equipment (PPE). Waiting room seating is arranged for social distancing. Everyone entering is screened for COVID-19 signs and symptoms, and those who have symptoms may be asked to wait in separate, designated areas of the ED away from those who do not. All ED rooms, restrooms, and surfaces are cleaned and disinfected in accordance with COVID-19 hospital cleaning protocols.
Emergencies remain predictably unpredictable. If you believe that you need urgent or emergency care, emergency departments are there to care for you safely, 24/7. Don’t let unwarranted COVID-19 fears keep you from getting the care you need.
Anish K. Agarwal is an assistant professor in the department of emergency medicine at the University of Pennsylvania’s Perelman School of Medicine. Jeffrey Millstein is a primary-care physician and regional medical director for New Jersey and Bucks County practices of Penn Primary Care.