When To Go to the ER During the COVID-19 Pandemic

During the COVID-19 pandemic, many patients have had fears about visiting hospitals and emergency departments (ED) out of concern for a higher risk of contracting the virus. These fears led to a decline in emergency department visits, particularly in the early months of the pandemic.

According to data from researchers from the U.S. Centers for Disease Control and Prevention, between March 29 and April 25, 2020, visits to emergency departments dropped 42%. In addition, between December 2020 and January 2021, the CDC noted that ED visits were still 25% lower than during the same months the year before. And an August 2020 poll from the American College of Emergency Physicians (ACEP) found that nearly a third of people delayed getting care out of concern around COVID-19.

The reasons cited in the ACEP poll that patients offered about avoiding visits to the ED included concerns about contracting COVID-19 from another patient or visitor and worries about overstressing the health care system and overcrowding hospitals.

As hospitals across the United States continue to care for patients with COVID-19, you may feel uncomfortable visiting the hospital for other conditions. However, stalling needed immediate medical attention or avoiding the hospital at all costs to prevent exposure to the virus is a dangerous decision.

Russell Rodriguez, MD, medical director at John Muir Health's Concord and Walnut Creek Medical Centers' emergency departments, told Health that his emergency departments witnessed many patients waiting several days to seek treatment after having a stroke during the pandemic. "By that point, there is no immediate treatment that can be provided," said Dr. Rodriguez. Patients have also opted to stay at home, even while suffering from crushing chest pain. "When these patients finally decide to seek care, they have been diagnosed with a heart attack, often resulting in outcomes like permanent cardiac damage."

"People still have heart attacks, car accidents, strokes, and [severe] abdominal pain, which all need to be treated acutely," Shannon Sovdnal, MD, told Health. Dr. Sovdal is the author of Fragile, a board-certified doctor in both emergency medicine and emergency medical services, who serves as a physician and medical director for multiple EMS agencies and fire departments.

Symptoms That Need Emergency Attention

The American College of Emergency Physicians urges anyone who thinks they have a medical emergency to seek immediate emergency care. Avoiding or delaying medical treatment can have life or death implications.

According to the American College of Emergency Physicians, if you think you or someone else may be having a medical emergency, call 911 or seek immediate medical care. Though these do not represent every kind of sign or symptom that might occur, below is the ACEP's list of adult medical emergency symptoms that require immediate medical attention:

• Difficulty breathing, shortness of breath
• Chest or upper abdominal pain or pressure lasting two minutes or more
• Fainting, sudden dizziness, weakness
• Changes in vision
• Choking
• Head or spine injury
• Injury due to a serious motor vehicle accident, burns or smoke inhalation, near drowning, deep or large wound, or other serious injuries
• Ingestion of a poisonous substance
• Difficulty speaking
• Confusion or changes in mental status, unusual behavior, difficulty waking
• Any sudden or severe pain
• Uncontrolled bleeding
• Severe or persistent vomiting or diarrhea
• Coughing or vomiting blood
• Suicidal or homicidal feelings
• Unusual abdominal pain

Concerning COVID-19 symptoms, the CDC underlines the importance of seeking emergency medical care for severe COVID-19 symptoms, urging people to go to the ER if they experience trouble breathing, persistent pain or pressure, new confusion, inability to arouse, or bluish lips, nail beds or face.

Precautions Taken by EDs for COVID-19

The good news: "Even with COVID-19, hospitals are prepared to treat people who need care," said Dr. Sovdnal. "Hospital systems all over the US are putting additional measures in place to ensure proper handling and care of COVID-19 and non-COVID-19 patients," said Dr. Rodriguez.

"It's most important for everyone to understand the risk of suffering significant pain, short- or long-term disability, or death from an untreated medical or surgical condition is likely much higher than possible exposure to COVID-19. Patients should be reassured they can be safe seeking needed medical care," said Dr. Rodriguez.

The American College of Emergency Physicians (ACEP) asserts that emergency departments across the country have been taking key steps to keep everyone as safe as possible during the pandemic. Some of these precautions include:

• Screening patients on arrival for COVID-19 symptoms
• Limiting the number of people in the emergency department
• Creating separate entrances and external waiting rooms for patients with known symptoms
• Keeping individuals who test positive for COVID-19 separate from non-COVID-19 patients
• Training for emergency physicians and nurses to prevent the spread of highly contagious illnesses
• Separate entrances for staff, checking staff temperatures and symptoms before every shift, wearing more protective equipment
• Intensified cleaning and disinfecting efforts
• Enhanced treatments to decontaminate the air and prevent the spread of the virus

In addition, emergency departments around the country are continually adapting their procedures as we learn more about the virus and how to treat it. You should feel free to check with your local hospital or emergency department to see how they're adapting to COVID-19.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.