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 With U.S. coronavirus infections reaching new heights, doctors and
hospitals say they are also seeing sharp declines in patients
seeking routine medical care and screenings - and a rise in those
who have delayed care for so long they are far sicker than they
otherwise would be.
"I had one lady who had delayed for five days coming in with
abdominal pain that was getting worse and worse," said Dr. Diana
Fite, who practices emergency medicine in Houston. "When she finally
came in, she had a ruptured appendix."
After the pandemic was declared a national emergency in March, many
states banned non-essential medical procedures, and the number of
patients seeking care for other ailments took a nosedive. Hospitals
and medical practices were hit hard financially.
Emergency department use dropped by 42% during the first 10 weeks of
the pandemic despite a rise in patients presenting with symptoms of
the coronavirus, data from the U.S. Centers for Disease Control and
Prevention show. In the same period, patients seeking care for heart
attacks dropped by 23% and stroke care by 20%.
As the initial outbreak leveled off in the weeks that followed,
healthcare experts planned to handle primary care differently should
infections rise again, making sure minor procedures like cancer
screenings were still allowed and assuring patients that hospitals
and clinics were safe.
But the recent surge in cases has swamped hospitals in many states,
including Texas, Arizona, Florida and parts of California.
CANCER MORTALITY RATES
Texas has again banned many non-emergency procedures, though cancer
surgeries are still allowed, and a hospital in California's San
Joaquin Valley for several days admitted only COVID-19 patients.
Patients without COVID-19 - either out of fear, confusion or because
of difficulty in obtaining the care they need - are again staying
home.
The result is a healthcare crisis in the making, said Austin
oncologist Dr. Debra Patt, who said she expects mortality rates from
cancer to skyrocket in the years after the pandemic because patients
have delayed their care.
"They're scared to go in the hospital unless they absolutely have
to," said Patt. "And even when the patients are willing, it's hard
to get things done."
Patt in recent days treated a man who waited to come in for
headaches and dizziness until he had lost 35 pounds and had a
softball-sized tumor in his head.
Fite, who is president of the Texas Medical Association, cared for a
baby whose parents waited six days before bringing him in with a
severe ear infection.
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Patt said screening mammograms are down by 90% in Austin, where she specializes
in breast cancer and serves as executive vice president of Texas Oncology. That
means some tumors will be missed, and women who develop aggressive cancers might
not know about it until the disease is more advanced and more likely to be
deadly.
"It's an impact we will see on cancer survival for years to come," she said.
Dr. David Fleeger, a colorectal surgeon in Austin and a past president of the
Texas Medical Association, said he has had numerous patients cancel
colonoscopies in recent days.
"The delays in colonoscopies that are occurring right now ultimately will lead
to more cancers and more deaths," he said.
'IN A HOLDING PATTERN'
Patt's patient Helen Knost had to put off surgery for breast cancer in early
spring because it was considered non-emergency in Texas and barred at the time,
and she was treated instead with the medication Tamoxifen.
"It's very strange to know you have cancer and you're just hanging out with it,
just in a holding pattern," said Knost, who did ultimately undergo successful
surgery.
In California, doctors at the 150-bed Adventist Lodi Memorial Hospital in the
San Joaquin Valley breadbasket were determined that a second surge in
coronavirus cases would not bring a repeat of the pandemic's early days, when
emergency room visits dropped in half. Emergency medical technicians also
reported a 45% rise in the number of heart patients who died before they could
be brought to the hospital.
Hospital CEO Daniel Wolcott led a campaign to inform the community that the
medical center was open and safe, even speaking to people about it in the
grocery store.
But with new COVID-19 cases swamping the hospital, sickening nearly 30 staff
members and forcing it to divert non-coronavirus cases to other facilities for
several days, Wolcott fears that again patients with heart conditions and other
illnesses will stay away.
"We won't know for years how many people lost their lives or lost good years of
their lives for fear of coronavirus," he said.
(Reporting by Sharon Bernstein in Sacramento, California; editing by Bill
Tarrant and Cynthia Osterman)
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