(Reuters) – A Texas man who waited until his brain tumor was the size of a softball; a baby who suffered an ear infection for six days; a cardiac patient who died: The resurgence of COVID-19 is creating another health crisis as hospitals fill up and patients fear or cannot receive non-emergency care.
A protective screen is seen at the entrance to a negative pressure ICU hospital room, where patients with COVID-19 are treated, at St John Regional Medical Center in Oxnard, California, USA, July 9, 2020. Photograph taken on July 9, 2020. REUTERS / Sandra Stojanovic
With US coronavirus infections reaching new heights, doctors and hospitals say they are also seeing a sharp decline in patients seeking medical care and routine screening, and an increase in those who have delayed Care for so long that they are much sicker than they would be.
“I had a lady who was five days behind with abdominal pain that was getting worse and worse,” said Dr. Diana Fite, who practices emergency medicine in Houston. “When she finally entered, she had a ruptured appendix.”
After the pandemic declared a national emergency in March, many states banned nonessential medical procedures, and the number of patients seeking care for other ailments plummeted. Hospitals and medical practices were severely affected financially.
Use of the emergency department decreased by 42% during the first 10 weeks of the pandemic despite an increase in patients with symptoms of the coronavirus, data from the US Centers for Disease Control and Prevention show. In the same period, patients seeking care for heart attacks decreased by 23% and care for strokes by 20%.
As the initial outbreak stabilized in the following weeks, health care experts planned to manage primary care differently in case infections increased again, ensuring that minor procedures such as screening tests were still allowed. cancer and assuring patients that hospitals and clinics were safe.
But the recent surge in cases has flooded hospitals in many states, including Texas, Arizona, Florida, and parts of California.
CANCER MORTALITY RATES
Texas has once again banned many non-emergency procedures, although cancer surgeries are still permitted, and a hospital in California’s San Joaquin Valley admitted only COVID-19 patients for several days.
Patients without COVID-19, either because of fear, confusion, or difficulties obtaining the care they need, stay home again.
The result is a budding health crisis, said Austin oncologist Dr. Debra Patt, who said she expects cancer death rates to soar in the years after the pandemic because patients have delayed their care.
“They are afraid to go to the hospital unless absolutely necessary,” said Patt. “And even when patients are willing, it is difficult to do things.”
Patt in the past few days treated a man who was waiting for headaches and dizziness to enter until he lost 35 pounds and had a softball ball-sized tumor to his head.
Fite, who is president of the Texas Medical Association, cared for a baby whose parents waited six days before bringing him with a serious ear infection.
Patt said screening mammograms are down 90% in Austin, where she specializes in breast cancer and serves as executive vice president of Texas Oncology. That means some tumors will be overlooked, and women who develop aggressive cancers may not know it until the disease is more advanced and more likely to be fatal.
“It is an impact that we will see on cancer survival in the coming years,” he said.
Dr. David Fleeger, a colorectal surgeon in Austin and former president of the Texas Medical Association, said he has had numerous patients who canceled colonoscopies in the past few days.
“The delays in colonoscopies that are occurring right now will ultimately lead to more cancers and more deaths,” he said.
‘IN A FIXING PATTERN’
Patt’s patient, Helen Knost, had to postpone breast cancer surgery in early spring because she was considered to be a non-emergency in Texas and was excluded at the time, and was instead treated with the drug Tamoxifen.
“It is very strange to know that you have cancer and that you are simply spending time with it, only in a retention pattern,” said Knost, who finally underwent successful surgery.
In California, doctors at the 150-bed Lodi Memorial Adventist Hospital in the San Joaquin Valley barn determined that a second increase in coronavirus cases would not bring a repeat of the first days of the pandemic, when visits to the emergencies were cut in half. Emergency medical technicians also reported a 45% increase in the number of cardiac patients who died before they could be taken to the hospital.
The hospital’s executive director, Daniel Wolcott, led a campaign to inform the community that the medical center was open and safe, including talking to people about it at the grocery store.
But with new cases of COVID-19 flooding the hospital, sickening nearly 30 staff members and forcing him to divert non-coronavirus cases to other facilities for several days, Wolcott fears that patients with heart conditions and other illnesses will again stay away.
“We will not know for years how many people lost their lives or lost good years for fear of the coronavirus,” he said.
Report by Sharon Bernstein in Sacramento, California; edited by Bill Tarrant and Cynthia Osterman
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