Why are fewer patients going to hospitals during the COVID-19 pandemic?

As health professionals grapple with the coronavirus pandemic and hospitals across the nation prepare for a rise in COVID-19 patients, they are also witnessing a noticeable drop in the number of patients coming in for the slew of other medical conditions that typically fill their emergency departments and clinics.

But why? After all, those other health issues have not disappeared just because there’s a pandemic.

Scott Wieters, MD, FACEP, associate dean of the Texas A&M College of Medicine’s Temple Campus and an emergency medicine physician at Baylor Scott & White in Temple, Texas, says it’s less about the number of emergencies and medical conditions occurring and more about how people are utilizing health care services.

“Like anything, there’s a lot of factors going into this,” Wieters said. “I am sensing in our local community a sense of selfless service to others for limited health care resources. The patients that I am seeing are sincerely apologetic. Their perception seems to be that there are people dying left and right of COVID-19, and they feel like they are using up valuable resources that could be better used for others.”

Another contributing factor is fear of coming into contact with the coronavirus in a hospital or clinic.

“Certainly, a hospital is not a place people desire to go if they’re at risk for obtaining an infection because there are other infected people there. I think that’s a very real concern as well,” Wieters said.

Of course, fewer visits to clinics and doctor’s offices can be also be attributed to postponed elective procedures and a move to telehealth. However, physicians caution against staying home during a true medical emergency.

“We might see that people were delayed in their presentation, and they might have had subtle strokes and gone on to have major strokes. They might have had minor heart attacks and might have congestive heart failure in the future. They might have been dehydrated or they might have had other medical problems go out of control, and the outcomes of that might not be witnessed until many months and years down the road,” Wieters said. “We might see that, and it’s hard to say right now, but I think that is something a lot of experts are suspecting.”

Quickly implementing digital medical resources is one way the health care system is combating these potential downsides of delaying care while also freeing up hospital beds for COVID-19 patients. By screening people through telehealth, online messaging systems or telephone, physicians and advance practice professionals can provide guidance to patients on whether or not their condition warrants a visit to the emergency room.

“I would encourage patients to find out about the myriad resources available to them,” Wieters said. “I’ve seen an exponential growth in the numbers of patients embracing these new technologies. I think that people are more comfortable receiving that health care advice through other platforms than just driving to the hospital or calling an ambulance and seeing what happens.”

Wieters, who is part of the leadership team at the College of Medicine, says telemedicine is also allowing medical students to safely continue some clinical activities during the pandemic. The Association of American Medical Colleges has recommended medical schools suspend students’ involvement in activities involving direct patient contact. However, students can still take patient histories, perform physical examinations and practice communication skills through telehealth resources.

“Our medical students and residents have welcomed this, and they’ve been excited about being on the curve of this steep growth in the technology,” Wieters said.

Telehealth does have limitations, of course. Students cannot conduct a physical examination by feeling the abdomen, for example, and procedures must still be done in person. But the health care system, medical schools and patients are all showing “incredible resiliency” during this unprecedented time, Wieters says.