Some Canadian hospitals are half-empty – and that’s a mixed blessing


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13 comments

  1. Catharine Whiteside

    At a meeting of diabetes-related NGOs and Diabetes Action Canada yesterday, it was reported that a Canadian with Type 1 diabetes had died in diabetic ketoacidosis after failing to seek emergency care. Drs. Verma and Razak are correct that persons with chronic conditions who suffer acute illness are particularly vulnerable at this time and must receive necessary urgent care without fear of overloading the system or contracting COVID-19. Messaging within the healthcare community should include assurance that hospitals including their emergency departments are looking after those without COVID-19 symptoms.

    • Amol Verma

      Thank you for sharing. This message is so important and is somewhat counterintuitive to the ‘social distancing’ messages that are predominating but it’s important they not be seen as conflicting. They are not.

      • Phyllis

        Thank you for sharing. I work with both Drs Amol and Razak on internal medicine at UHT and both are superb doctors. I will say that the messaging of fear around Corona virus has been expressed profoundly by our leaders. Dont get me wrong, it’s a very deadly virus however, I beleive there are lots of people home that are getting more sicker and sicker and not getting early or the appropriate treatment. As mentioned in the article, for example infections (diateties and pressure ulcers), cellulitis, UTI’s etc because of the fear of getting the virus. I beleive that after Corona virus, emergency department will be filled with people that are more sicker, therefore more interventions and longer stay and recovery.

        • Amol Verma

          Thanks Phyllis – you’re so right and it is our pleasure that we get to work with colleagues like you!

    • phyllis Nugent

      I totally agree with you Catherine that messaging by our leaders should also include assurance that they are important and healthcare professionals are available to look after them before it gets worse. I bet there are people home now with abnormal electrolytes and other lab values.

  2. james waddell

    Hi,
    Very interesting analysis but you have apparently overlooked a significant reason for decreased hospital admissions – the suspension/cancellation of all elective surgical procedures. What percentage of hospital admissions prior to the current situation were related to elective interventions such as joint replacement?

    • Amol Verma

      Thanks James. We are talking about medical admissions, which are down much lower than you would expect, even if you consider potential admissions related to procedures or post-procedural complications.

  3. rick

    Your mother died from the covid ‘situation’ – not from covid, not even with covid, just how we managed things overall.
    Nice, real nice for modern healthcare in 2020

  4. cindy gough

    I can speak to direct experience with this. My elderly neighbor fell and hit her head. She reported temporarily blacking out, along with suffering a serious laceration. I told her I would call an ambulance as she was in clear need of emergency care. She became panicked and utterly refused citing fear of contracting Covid-19. I called her family and shockingly, they agreed with her and declined to take her to hospital OR even a walk-in clinic. MORE alarming is they expressed concern that I risked exposing her to the virus by coming to assist as she lay crumpled and bleeding on her front walk. The fear narrative around this has escalated to hysterical proportions. I am not remotely surprised our ERs have seen troubling decreases due to patients so afraid that they would rather risk death/serious complications rather than be exposed to the threat of contagion

  5. Carolyn Thomas (@HeartSisters)

    Thank you Drs. Verma and Razak for helping to raise awareness of this alarming (yet predictable) development. I quoted you and this article in my Heart Sisters blog post this week (“Empty Beds: When Heart Patients Are Afraid To Seek Help” – https://myheartsisters.org/2020/04/12/covid19-heart-patients-afraid-to-seek-help/ Cardiologists in several countries are now reporting a dramatic drop (as high as 40 per cent) in cath lab activations for STEMI even in high-volume heart hospitals, for example, suggesting as you say that people are so worried about the corona virus that they’re making the dangerous decision to stay away from the hospital.

    This morning, one of my readers commented in response to this new post about her own experience years ago (which mirrors my own) of being misdiagnosed in mid-heart attack and sent home from the Emergency Department (in her case, remaining “persistent” and ultimately appropriately admitted to hospital for triple bypass surgery).

    Do you know yet how many of those included in this drop in non-COVID19 admissions to hospitals may be occurring in those who DID seek help, but have been turned away from Emergency?

    • Amol Verma

      I don’t have concrete data about that but I can tell you anecdotally that volumes in the Emergency Department are lower as well. And I can also say that COVID is making it more challenging for clinicians to make diagnoses of other conditions because of all the precautions that need to be taken.

      • Abhi Mukherjee

        Thank you Dr. Verma and Dr. Razak for raising the red flag on such a vital issue. My prediction is that it will take us quite a while to combat and conquer Covid 19. By the time we have dealt with this pandemic, our healthcare workforce (and the entire system along with long-term care) will likely be exhausted – both physically and mentally.
        Due to the shutdown, we may regress to an economic recession or at a minimum, a slow down in GDP growth. The effect of all the financial packages and subsidies may result in us having huge budgetary deficits both at the provincial as well as federal levels. To deal with these deficits the respective governments will be forced to cut back on governmental expenditures and that may lead to cuts in healthcare spending. This post Covid 19 period will coincide with the “bounce back” in patient volumes, both in the emergency as well as medical admissions. Exacerbating this volume explosion would be the pent-up demand for all the elective procedures that are currently on hold.

        Unless we have the vision to think of the long-term consequences of Covid 19, and plan ahead to build capacity in our healthcare system to deal with the challenges above, I am concerned that we will fail the nation and healthcare in Canada will fall significantly behind.

  6. Casey

    “Even if COVID-19 is as challenging as expected, it is unlikely to come close to cancer and heart disease as a major cause of death in our country.”
    Bingo.

    Can we discuss the major discrepancies in expected COVID-19 hospitalizations from epidemiological models versus actual data? Perhaps we can get an update on your article.

    Is there any effort to minimize cost in vacant hospitals to reduce to looming tax burden to come?

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