By Jill Drachenberg, Editor, Relias Media

As the United States slowly begins to resume some activities during the COVID-19 pandemic, Americans are proceeding with caution — including with needed healthcare. Emergency department (ED) visits nationwide are down more than 30%, according to the American College of Emergency Physicians. Heart attack admissions also are down 60%. Physicians are concerned that people may not be seeking necessary emergency care due to fears of contracting COVID-19.

According to a survey from the Society for Cardiovascular Angiography and Intervention (SCAI), 36% of respondents view going to the hospital to be one of the riskiest behaviors — even more than going to a hair salon or to a beach. Fifty percent fear COVID-19 more than heart attack or stroke, and 61% believe they are somewhat or very likely to contract COVID-19 in a hospital.

“The data that we are seeing from this survey is not just disturbing, it is a clear sign that Americans may be in for a dangerous third wave of complications, and even fatalities, from delaying cardiac care during the time of this pandemic,” said SCAI President Cindy Grines, MD, MSCAI, in a statement. “While there is still much we don’t know about COVID-19, we do know that when it comes to heart attacks or strokes, getting to the hospital quickly and receiving immediate care is the only safe course of action. Time to treatment helps ensure the best possible patient outcomes.”

EDs and physician’s offices across the United States have taken steps to ensure the safety of patients and staff, as well as to calm anxiety in emergency patients.

Smaller EDs, such as Adventist Health Lodi Memorial Hospital in Lodi, CA, set up vital sign and symptom screening in the parking lot. Patients’ vitals are taken while in their cars, and they can remain in their cars for treatment if they are stable and low-acuity. Those who need more care are sent to a tent equipped with a portable X-ray machine and some lab work. (For more information, see the story in the June issue of ED Management.)

Like many hospitals and medical centers, Vanderbilt Medical Center uses a nurse hotline to triage patients and connect them to telehealth, if appropriate. The ED also is triaging patients into separate areas: one for respiratory and COVID-19 symptoms, another for non-COVID-19 symptoms, such as heart attack, stroke, or injuries. Staff are screened daily for symptoms, and high-touch areas are regularly cleaned.

“Communicating all these measures to patients has helped relieve anxiety,” Jessica Van Meter, DNP, MSN, RN, APN-BC, CCRN, A-EMT, an emergency and Life Flight nurse with Vanderbilt University Medical Center, told Hospital Case Management. Van Meter also explained that Vanderbilt’s media messages emphasized the importance of seeking timely medical care to avoid the possibility of worse outcomes.