Hospital admissions for almost everything came to almost a complete halt this year because of the pandemic. In March and April 2020, people stopped coming in with heart attacks (which remain the world’s top killer), according to reliable reports from France, the UK and New Zealand. Yes that’s right, even in New Zealand, which had low rates of COVID-19.

Hospitalizations by week in New Zealand. Chan et al. The Lancet Regional Health – Western Pacific 2020 DOI: 10.1016/j.lanwpc.2020.100056

 

A marker of the impact of the reduction in admissions is the rise in what people call “excess deaths” (a term that sounds a tad too dismissive of death but actually refers to the deaths that wouldn’t have happened if it weren’t for the pandemic). Another marker of negative impact is the rise in poor outcomes from out-of-hospital cardiac arrests. Again, this was seen even in regions with low COVID-19 rates. This suggests we are seeing the effects of the pandemic in its fullest sense, not the direct effect of the virus on the body, but the effects of consequences of the pandemic like lockdowns, fear and confusion.

We did not manage to get the message across to the public that coming to hospital isn’t more dangerous than delaying treatment for a heart attack. The public hear and see things like:

    1. Friends and family dying in hospital from COVID-19 having gone in with something else.
    2. Constant statistics about death rates.
    3. Emergency construction of hospitals to increase bed capacity.
    4. Lockdown, restrictions, closures etc.

Right or wrong as these things may be, naturally these observations make people perceive that:

    1. You can catch COVID-19 in hospitals
    2. COVID-19 is a killer
    3. So many people are sick that we need more beds and the system is about to collapse
    4. They must avoid COVID-19 at all costs

No wonder people won’t come to hospital! How can we change this perception? Can we change it? Of course, we are making hospitals as resistant as possible to transmission but even when this is battle is won, the perception war will wage on. Here are some counter-arguments to the misperceptions:

    1. Yes COVID-19 can be caught in the hospital but all the things that were life-threatening before the pandemic (like heart attacks), did not become any less life-threatening. Emergencies are still emergencies. Treatment can save your life and prevent complications further down the line. Also, we are taking precautions in hospitals – I promise!
    2. Yes, many many people die from COVID-19 and getting COVID-19 is more likely to harm you than getting flu, but the majority of people do recover. And yes, long-COVID is a worry but so is your immediate emergency!
    3. In terms of bed capacity we are much better equipped for the second wave than we were for the first. If you go to hospital with your emergency and you don’t need to be there, the healthcare professionals will support you to get the care you need later/elsewhere.
    4. This isn’t black and white like, ok there’s COVID-19 now so I’ll just stay at home no matter what. Many things outweigh the risk of getting COVID-19 (and the risk isn’t as high as you might think when you and hospital staff take appropriate precautions). Get cancer tests done. Seek help for chest pain.

Anyone have any better ideas? I’d love to hear them.

 

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