With coronavirus and social distancing now a major part of our lives, hospitals and medical organisations are increasingly concerned that people are failing to seek urgent treatment for fear of catching the virus.
Visits to Emergency departments have now halved since the pandemic started and figures released by the Office of National Statistics indicate that deaths from causes unrelated to Coronavirus have increased.
Whilst the reason for this is still being investigated, Nick Stripe, head of health analysis at ONS, has suggested it could be because people with other illnesses were avoiding going to hospital for treatment.
It seems likely that people are avoiding hospitals due to the risk of coronavirus, but in doing so they may be putting their lives at greater risk.
The president of the Royal College of Emergency Medicine, Dr Katherine Henderson, reported that while admissions have dropped significantly, hospitals are admitting the highest proportion of attendances on record. this is in part due to the acute condition of those presenting with coronavirus, but also suggestive of an increase in the severity of those being admitted with other conditions raising concerns that those with serious illness may be waiting longer before seeking the treatment they need.
There is also a concern that people may be staying away for fear that departments will be too busy – or they will be taking away resources from those who need them more. However, the decline in Emergency attendance suggests otherwise. This is supported by anecdotal evidence from hospital staff across the country indicating that whilst intensive care and related step down wards where recovering patients are treated are understandably stretched, other hospital services are reportedly quieter than usual. It is to be expected that the cancellation of elective procedures will have reduced demand on surgical and other non-urgent services, but doctors and nurses in specialisms including paediatrics, cardiology and gastro-enterology, are also noticing significantly fewer patients.
Specific concerns have been raised about the impact that delays in seeking medical care may have on children. The Royal College of Paediatrics have issued public statements urging parents to seek medical advice promptly if they have concerns about their children's health and not to be afraid to attend hospital with non-coronavirus related complaints. This is particularly is important for young children who may not be able to effectively communicate their symptoms and whose resilience can make it difficult to appreciate the severity of their condition until fairly late in the day.
Another area of major concern is the fall in heart attack attendances. The 29% reduction in Emergency attendances in March 2020 compared with March 2019 included a staggering the 50% drop in attendances related to heart attacks.
The British Heart Foundation state that as may as 5,000 people per month who would otherwise have gone to hospital because they were experiencing the symptoms of a heart attack are putting themselves at risk by staying at home. This is particular alarming as very short delays can significantly increase the long damage muscular damage to the heart increasing the risk of long term complications and death.
Professor Simon Ray, president of the British Cardiovascular Society, has pointed out that this significant drop in heart attack attendances has is mirrored in other countries – with evidence suggesting an international reduction in emergency attendances of around 40%. There have also been a significant reduction in referrals in serious conditions such as acute coronary syndrome. Some units have also reported an increase in unusual heart attack complications in patients who have attended hospital after a potential delay.
Unfortunately I have seen both personally and professionally how rapidly someone can deteriorate in these situations and the importance of prompt treatment in preventing long term complications. The message from the medical profession is clear, and one with which we can wholeheartedly agree. Don’t delay seeking treatment for yourself or a loved one out of fear or because you think hospitals might be too busy. There are systems in place to provide urgent care to those who need it and the price for not doing so could be devastating.
Catherine Bell is a Director in Freeths Oxford office specialising in clinical negligence.
Medical leaders are appealing for patients with serious conditions to continue using the NHS after the first official data since the lockdown began revealed a 29 per cent year-on-year drop in A&E use, including a 50 per cent drop in heart attack attendances.