A University Medical Center employee walks toward the entrance to the emergency room on May 25, 2020. (Corrie Boudreaux/El Paso Matters)

A dramatic decline in visits to emergency rooms has health officials worried that El Pasoans are not seeking the care they need for fear of contracting COVID-19. Delaying care could have dire consequences.

Officials at University Medical Center said there has been a 40 percent reduction in typical emergency room visits since the pandemic reached El Paso in March.

Eric Johansen, assistant administrator of emergency services at UMC, said the decline may be partly attributed to the traumatic images from emergency rooms across the country and globe of the effects of the pandemic in cities like New York and Italy.

“The things we saw on the news really started becoming overwhelming for our country, not just El Paso, but for the country. When you saw those messages to stay home and be safe, limit yourself, that really hit the population. People stayed home,” Johansen said.

But avoiding the hospital for emergency care has resulted in patients arriving with exacerbated symptoms that should have been treated sooner, Johansen said.

Dangers of delay in care

Dr. Edward Michelson, professor and chairman of the department of emergency medicine at Texas Tech University Health Sciences Center El Paso and chief of emergency medicine at UMC, said stroke patients, for example, are arriving at the hospital outside of the timeframe for which life-altering treatments can be administered.

Michelson said prior to COVID-19 hitting the area, about 15 to 17 percent of stroke patients arrived outside of the window for crucial treatment. He said in April the percentage jumped to 25 percent arriving late.

University Medical Center has erected tents outside of the emergency room to hold patients who arrive with symptoms of COVID-19, (Corrie Boudreaux/El Paso Matters)

“I think the reason for that is because people were afraid to come in and as a result the outcomes will not be as good when a higher percent of people delay coming in,” Michelson said.

Dr. Kenneth Berumen, emergency medicine specialist and network director for emergency medicine with The Hospitals of Providence, said his network has seen a 60 to 70 percent drop in typical emergency room visits.

Berumen said the decrease includes visits from patients suffering from strokes, heart attacks and abdominal pain.

“We are really concerned about how many people are out there that have had this and are still sitting at home not coming in and not getting treated by primary care physicians or emergency room physicians,” Berumen said. “All of us are worried about delay in care.”

Berumen said the hospital has seen instances where issues like appendicitis, ear infections and tonsillitis should have been treated sooner.

“Even an ear infection, it can be a ruptured eardrum and they are going to have to have fallout for that,” Berumen said.

Emergency rooms are safe

Dr. Ogechika Alozie, chief medical officer at Del Sol Medical Center, said they have also seen a drastic drop in typical emergency room visits since COVID-19 reached El Paso.

“I think everybody in the city, everybody across health care in America has seen decline,” Alozie said. “The rates range from anywhere from 20 to 80 percent (drop) depending on the service line.”

Alozie said it’s too early to tell what the long-term health effects will be from people delaying medical care because of the pandemic. He emphasized that it is safe to go to El Paso emergency rooms.

At Del Sol, everyone that enters the emergency room is treated as if they have COVID-19 until proven otherwise for safety reasons, Alozie said. All patients are tested and given masks. Staff uses the necessary personal protective equipment to keep themselves and patients safe, he said.

“There is no separation because we don’t know who has COVID,” Alozie said.

The emergency room entrance at Del Sol Medical Center in East El Paso. (Corrie Boudreaux/El Paso Matters)

Providence officials said they take the same approach.

“We are extremely safe,” Berumen said. “We worry about where the patients go, we worry about cross contamination, we’re just as worried about getting infected as protecting our patients.”

Officials at UMC said all patients who enter the emergency room are immediately screened and any suspected COVID-19 cases are treated in a separate area.

“We make sure that we created a workplace to separate potential COVID (patients) from other health care issues and manage them separately,” Johansen said. “We also put that level of personal protective equipment in place to protect them as well as other patients that are coming into the hospital.”

If you’re having an emergency, go to the hospital

Health officials urge anyone having a health emergency to go to the hospital if they think they need immediate care.

Heart attack/cardiac arrest

Advice from the American Heart Association:

For men:

Don’t wait to get help if you experience any of these heart attack warning signs. Some heart attacks are sudden and intense. But most start slowly, with mild pain or discomfort. Pay attention to your body and call 911 if you experience:

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes – or it may go away and then return. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath. This can occur with or without chest discomfort.
  • Other signs. Other possible signs include breaking out in a cold sweat, nausea or lightheadedness.

For women:

If you have any of these signs, call 911 and get to a hospital right away.

  • Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
  • Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
  • As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.
Stroke signs and how you should respond

Stroke warning signs and treatment recommendations from the Centers for Disease Control and Prevention.

  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance, or lack of coordination
  • Sudden severe headache with no known cause

Call 911 right away if you or someone else has any of these symptoms.

Acting F.A.S.T. can help stroke patients get the treatments they desperately need. The stroke treatments that work best are available only if the stroke is recognized and diagnosed within three hours of the first symptoms. Stroke patients may not be eligible for these if they don’t arrive at the hospital in time.

If you think someone may be having a stroke, act F.A.S.T. and do the following simple test:

F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

T—Time: If you see any of these signs, call 9-1-1 right away.

Note the time when any symptoms first appear. This information helps health care providers determine the best treatment for each person. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room.

Cover photo: A University Medical Center employee walks toward the entrance to the emergency room on May 25. (Corrie Boudreaux/El Paso Matters)

Correction: An earlier version of this story incorrectly spelled Dr. Ogechika Alozie’s first name.

Elida S. Perez is a senior reporter for El Paso Matters. Her experience includes work as city government watchdog reporter for the El Paso Times, investigative reporter for El Paso Newspaper Tree and communities...

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