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Canada ‘Behaviour changed’: Emergency hospital visits fell 50% in early days of pandemic

01:35  25 november  2020
01:35  25 november  2020 Source:   globalnews.ca

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This report describes that emergency department visits have declined 42% during the coronavirus disease 2019 pandemic according to the The proportion of infectious disease–related visits was four times higher during the early pandemic period. What are the implications for public health practice?

The COVID-19 pandemic has impacted hospitals around the world. Many hospitals have scaled back or postponed non- emergency care. This has medical consequences for the people served by the hospitals , and it has financial consequences for the hospitals .

a truck is parked in front of a store: Paramedics transport an elderly man to the hospitals emergency department during the COVID-19 pandemic in Mississauga, Ont., on Thursday, November 19, 2020. Ontario has entered the second wave of coronavirus infections. THE CANADIAN PRESS/Nathan Denette © Nathan Denette/THE CANADIAN PRESS Paramedics transport an elderly man to the hospitals emergency department during the COVID-19 pandemic in Mississauga, Ont., on Thursday, November 19, 2020. Ontario has entered the second wave of coronavirus infections. THE CANADIAN PRESS/Nathan Denette

As hospitals prepared for an influx of coronavirus patients, emergency departments across Canada saw a significant decline in people seeking medical attention in the first few months of the pandemic amid increased restrictions.

According to data from March to June, released last week by the Canadian Institute for Health Information (CIHI), there was a 50 per cent drop in emergency visits in April compared to the same time last year. Even when services resumed, visits remained lower than usual, the CIHI data showed.

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“Our analysis shows that fewer people sought care for significant concerns like cardiac events and trauma, as well as for common concerns like abdominal pain, colds and flu,” the CIHI noted.

Different provinces went into lockdown and announced service restrictions in mid-March to curb the spread of the coronavirus, leading to fewer visits.

A fear of exposure to COVID-19 coupled with a sense of social responsibility to stay home amid heightened public awareness during the first wave also contributed to the lower occupancy in emergency wards, health care workers say.

"There was a great deal of concern that if you went to a hospital, sitting in a waiting room, you could potentially put yourself at risk for picking up COVID-19," Dr. Ann Collins, president of the Canadian Medical Association (CMA), told Global News.

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"I think people spent a little more time reflecting on why they might have gone to the emergency room and just opted to stay away."

Tim Guest, president of the Canadian Nurses Association (CNA), said: "There were still a lot of unknowns around the virus and people were scared to go out unless it was an absolute emergency."

Triaging patients virtually or at the door and redirecting them to the relevant departments likely contributed to the decline, the CIHI said.

“People’s behaviour changed. They weren’t getting together in groups, they weren’t playing sports, they weren’t getting injured. That drove some of the decrease in volume,” Dr. Howard Ovens, an emergency physician at Sinai Health System, was quoted as saying by the CIHI.

Virtual medicine

During the first wave of the pandemic, many Canadians also turned to virtual medicine for help, instead of an in-person consultation.

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Some 50 to 100 million people died in the 1918 influenza pandemic – numbers that surpass the death toll of World War One, which was being fought at the same time. Early estimates of the economic damage from Covid-19 have already crossed the trillion-dollar mark.

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Provinces introduced temporary payment codes to their health system which allow doctors and physicians to be paid when offering telemedicine services to their patients.

Nearly 70 per cent of Canadians are in favour of continuing telemedicine even after the pandemic is over, according to an Ipsos poll earlier this month.

Guest said it was important for the government to ensure all Canadians have access to reliable and high-speed internet to facilitate online treatment.

"I think that is something that we need to continue to explore and see growth in our health system because I believe that the public want to have more virtual access to care, particularly those who live in rural and remote communities who are already challenged to be able to access specialty care, but also those who are challenged to be able to even get to an appointment because of transportation-related issues," he said.

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To free up beds, staff and equipment for COVID-19 patients, hospitals also cancelled planned surgeries, with a 47 per cent decline in the number of procedures performed. Life-saving surgeries, including bypass and for cancer, were the least affected in comparison to urgent and less-urgent conditions.

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The cancellations have created a massive backlog for hospitals, health-care workers say.

A Deloitte study commissioned by the CMA last month estimated that at least $1.3 billion is required in additional funding to return wait times for six types of procedures to pre-pandemic levels.

As the country grapples with a second wave of the pandemic, with record daily cases and hospitalization levels, there are concerns over the increased delays in routine screenings and elective procedures putting patients at risk and further straining the health-care system.

"Surgeries did increase through the summer months in certain parts of the country, but there still is a backlog that exists from the first wave of the pandemic," Collins said.

"So there certainly will be an additive effect and depending upon how long this second wave lasts, the impact could be greater as a result of the second wave."

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usr: 4
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