A group of researchers from Oregon and Washington found that people who went to the hospital with non-COVID-19-related illness died at a higher rate during the pandemic.
Dr. Ty Gluckman, a cardiologist at the Providence Heart Institute who serves as medical director of the Center for Cardiovascular Analytics Research and Data Science, was one of the authors in the study who theorized these patients were dying because of a delay in seeking medical care.
“While there may be a number of drivers that contributed to this,” Dr. Gluckman said, “one of the big concerns was hesitancy by patients, caregivers and loved ones to seek medical attention in urgent care facilities, emergency departments and hospitals because of a fear of potentially getting infected and developing COVID-19.”
Gluckman and the other authors in the study were interested in finding out what impact the pandemic had on the rates of urgent and emergency hospitalizations among people not infected with the virus. They looked at 51 hospitals across six states and at a broad mix of conditions.
Journal of Hospital Medicine: Excess Mortality Among Patients Hospitalized During the COVID-19 Pandemic
The hospitals in the study are all part of the Providence Health network. Gluckman said that during the initial outbreak of COVID-19, in spring 2020, conversation about the lack of beds and ventilators at hospitals was dominating the narrative.
“I think over time we recognized that there was a potential impact for patients who may be delaying care or maybe more resistant to seek medical attention,” Gluckman said.
Looking at patients who were not being treated for COVID-19-related illness, the number going to the hospital for emergency care dropped significantly.
“In the spring surge, compared to pre-pandemic, the rates of hospitalization were down by nearly 50%,” Gluckman said. “The numbers came back up to baseline, and then in the fall surge we saw a drop by about 25%.”
Not only were hospitalization rates dropping; mortality rates were going up among these non-COVID-19 patients.
“During the periods of time when we saw a decrease in hospitalization rates, we saw an increase in hospital death rates across a broad range of conditions,” Gluckman said. “We saw that, during both the spring and fall surge, death rates had risen in relative terms by as much as 20%.”
The mortality rate was increasing among a broad range of conditions, from gastrointestinal bleeding, to stroke, to heart attack, to infections like pneumonia. Gluckman said early treatment for these life-threatening conditions is crucial to survival. While social distancing guidelines were in place at the beginning of the pandemic – he says that should have never deterred people from getting emergency medical care.
“I want to just emphatically reinforce — and I think this is a consistent message nationwide as amongst health care providers, physicians and health systems — do not hesitate to seek medical attention in the outpatient setting, in emergency departments and in hospitals,” Gluckmand said. “They are safe places to receive care. "
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“One of our co-authors was involved in another publication involving patients with our health system that showed that the ability to contract or develop COVID-19 in emergency departments was not greater at all,” Gluckman said.
He says there’s a lesson to be learned, particularly surrounding how hospitals share information with the public.
“The next time something like this occurs, I think with the rising cases related to the delta variant in terms of case rates and hospitalizations, this is an opportunity to not revisit what we saw during the spring surge and the fall surge in 2020,” Gluckman said. “But reinforce emphatically that all individuals who have acute illness, who are concerned about their health and well-being, should seek out any and every opportunity to connect with the medical system.”
The study analyzed hospitalizations through 2020. Gluckman said there is potential to expand the analysis into 2021 to see if rates go back to normal.