Sunday, July 19, 2020

Covid 19 Scares Poor from Getting Emergency Care

Another Hidden Tragedy Behind the Pandemic
File Photo


By Mario J. Garcia, MD, July 16, 2020

We are all aware of the excess deaths caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19), which has been widely covered by the media and has disproportionally affected the socially disadvantaged communities of the Bronx. 

On the other hand, we are just beginning to discover the indirect impact of this pandemic on other areas of healthcare. 
Among them, is the increase in deaths caused by heart attacks, which was initially noted by researches in Northern Italy and more recently brought to our attention in an article published on June 1st by Denise Lu in The New York Times. In her article, Ms. Lu reported an increase in non-COVID deaths from March 15 to May 2, 2020 compared to the same period in 2019. Accordingly, there were 6,000 deaths in New York and New Jersey alone attributed to heart disease above the number reported during the same period in the previous year. 

More recently, investigators from the FDNY, Montefiore Health System and Albert Einstein College of Medicine reported in the scientific journal, JAMA Cardiology, that in the first two months of the COVID-19 pandemic in NYC, there were three times more cases of cardiac arrest compared to the same period in 2019. In this study, which was approved by the institutional review board of Montefiore and Einstein, the authors also reported a significantly lower number of patients who survived after first responders attempted CPR (below 10%); we believe this lower survival rate could be attributed to a delay in seeking emergency medical care. 


At the height of the pandemic, Montefiore, the largest healthcare network in the Bronx, reached a peak number of nearly 1,200 hospitalized patients with COVID-19 in a single day. Since then, the number has been steadily declining and for the last several weeks has remained below 50 patients hospitalized with COVID-19.

In the meantime, patients with other conditions, even potentially life-threatening ones, have been reluctant to seek medical care in inpatient or outpatient areas. This is understandable, after having witnessed numerous images depicting illness and death in the hospitals. But the truth is that the risk of contagion today is very low. In fact, as pointed out by Governor Cuomo in one of his many inspiring addresses, healthcare workers have a much lower risk of becoming infected than the rest of the population in New York, by the fact that personal protective equipment, proper hygiene and disinfection protocols are followed more strictly inside healthcare facilities than in most other locations. Our healthcare workers are following these strict guidelines so that our patients can safely seek care at our facilities. 

Montefiore continues to lead in our efforts to provide a safe environments for people who require a range of services including, being admitted to the hospital, outpatient medical care or more advanced care requiring a clinical consultation. Patients now have many safe options, from remote consultations via telehealth in their own home, to in-person visits, testing and treatments in COVID-19-safe environments (details provided at the COVID-SAFE website: https://covidsafecare.montefiore.org/covid-safe and at the 24/7 hotline: 844-444-2819).

Like in many other advanced healthcare facilities, Montefiore is performing rigorous screenings and practicing physical distancing and proper disinfection to minimize the risk of spreading this virus so that our patients can receive attention to their healthcare issues.

The COVID-19 pandemic has been devastating to many families in the Bronx. But let’s remember that even though over 135,000 men and women have died in the U.S. since March 1st, over the same period of time, the number of deaths normally expected to be caused by heart disease was about 215,000. That number could get to be much higher if we do not pay adequate attention to our healthcare needs now, leading to be another, even larger, “hidden tragedy.”

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