Risk of catching COVID-19 in the emergency room is likely low, study shows

By Amelia Templeton (OPB)
Nov. 24, 2020 2 p.m. Updated: Nov. 24, 2020 5:06 p.m.

If you’re having a medical emergency, get care immediately — and don’t worry too much about the possibility of catching COVID-19 in the emergency room.


That’s the upshot of a recent study, which found no evidence that people who were admitted to emergency departments in 39 hospitals across the western U.S. had contracted COVID-19 while they were there.

Since the novel coronavirus pandemic began, emergency rooms across the country have reported a decline in people coming in for other life-threatening conditions like heart attacks, strokes and uncontrolled high blood sugar.

The study’s authors suspected that people were avoiding medical care because they feared contracting COVID-19 in the emergency department.

“The question was, is the fear of picking up COVID in the ED a real one?” said Ari Robicsek, doctor and chief medical analytics officer for Providence St. Joseph Health.

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To try to answer that question, Robicsek and his coauthor used a case-control study: A retrospective approach epidemiologists often use to look back and understand whether a specific exposure was responsible for making a group of people sick.

The study used data from dozens of Providence hospital emergency departments in Oregon and Washington, including Swedish Medical Center in Seattle and Providence St. Vincent Medical Center in Portland.

The researchers identified 102 cases: People who plausibly could have been exposed to COVID-19 in the emergency department.

The cases were patients who visited an emergency department between March and July 2020 without any symptoms of COVID-19, and who tested positive for COVID-19 one to three weeks later.


Each case was matched with two members of a control group. The people in the control group had similar demographic profiles to the cases, had visited the same emergency department on the same week, and had also gotten tested for COVID-19 one to three weeks later. The difference between the groups was that the control group tested negative.

Using the timestamps in the patients’ electronic medical records, the researchers looked back and counted how many minutes each person had been in the emergency department at the same time as someone with COVID-19, or shortly after someone after COVID-19 had been there.

They found no link between being in the emergency room at the same time as someone with COVID-19 and testing positive for it later.

“EDs are actually safe, and people shouldn’t be delaying getting the care that they need,” Robicsek said.

The ventilation systems in most emergency rooms, combined with strong infection control practices like identifying and isolating possible COVID-19 patients may help prevent transmission.

“In a typical emergency department, unlike in a setting like a school, the personnel who work there are really, really good at managing contagious diseases,” Robicsek said.

Other medical experts say the study, while small, adds to a growing body of work showing patients are relatively unlikely to acquire COVID-19 in hospitals.

“The conclusions that the authors reach based upon their study are reasonable,” said John Swartzberg, an epidemiologist at UC Berkley’s School of Public Health. “It’s reassuring that the ERs are not particularly dangerous places to go.”

For health care workers, however, the risk of acquiring COVID-19 in the hospital setting is significantly higher than it is for patients.

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Doctors, nurses and nurses assistants spend much more time in close contact with people who are infected.

“The amount of exposure to people with COVID for health care workers is far greater than for any patient in the hospital,” Swartzberg said.

Both Swartzberg and Robicsek noted that people who fear the emergency room during a pandemic should consider the upside, as well as the risk. For a person having a heart attack, getting there without delay can mean the difference between life and death.

“If you do need to go to the emergency room, for God sakes, don’t hesitate,” Swartzberg said.


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