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Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

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Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#91

Post by rconti »

umvi wrote: post #24

Are just the ERs empty? Or the whole hospital as well? If hospitals are empty, it's time to stop sheltering in place, because it means it's working too well . What's the endgame? We can't just keep the country shut down indefinitely. Life must move on. Even though there's still a lot of fear, I think reopening the country is the best option (while still maintaining social distancing, etc).

The hospitals largely shut down elective surgeries, tried to get rehab patients to other facilities to free up surge capacity, etc.

So, generally, they're less busy than normal.

The problem with opening back up is, we've already seen the growth curve, and that was 2 months ago.

What happens when you multiple that same growth rate against a much higher baseline number of infected people?

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#92

Post by calibas »

guscost wrote: post #5

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19: https://www.washingtonpost.com/health/patients-with-heart-at... > The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to c…

Where's the source of "excess mortality is way up"? I didn't see it in the article, though it does suggest there may be fewer heart attacks and strokes because of "a decrease in air pollution and fewer high-fat restaurant meals".

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#93

Post by ajmurmann »

newacct583 wrote: post #37
sacks2k wrote: post #31

People are staying home and dying. This is one of the major trade offs no government official is talking about regarding re-opening the economy.

How is that related to the lockdown? Hospitals are open. People are staying home because they're scared of getting sick, that's not something that can be fixed by public policy.

My anecdata confirms your view exactly. My wife was concerned a few weeks ago that she might have a heart attack (she did not). I suggested to go to urgent care, but she was more concerned about COVID and wanted to just take Aspirin and monitor the situation. She also is in a group vulnerable to COVID, so this might be skewed.

Government closure had nothing to do with this decision. In fact I've zero trust in US government recommendation around this and don't factor their recommendation into any of my personnel decision making around this topic.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#94

Post by 34679 »

"Air pollution, of which whose small particulate matter are the most toxic, contributes to about one-third of the global burden of stroke."

https://www.sciencedirect.com/science/article/pii/S003537871...

"In 2004, the American Heart Association issued a scientific statement concluding that exposure to air pollution contributes to cardiovascular illness and mortality. A 2010 update elaborated on those risks.

Short-term exposure can increase the risk of heart attack, stroke, arrhythmias and heart failure in susceptible people, such as the elderly or those with pre-existing medical conditions, according to the statement."

https://www.heart.org/en/health-topics/consumer-healthcare/w...

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#95

Post by wafn »

guscost wrote: post #74
indecisive_user wrote: post #67

Earlier quoted context omitted.

Crime is down, while domestic violence is up. That's evidence people are staying inside more. https://www.bbc.com/news/world-us-canada-52416330 As a counter anecdote, I know many people that only leave their house a few times per week, including for walks. They are definitely more sedentary now.

And you'd think deaths from auto accidents would be way down, but apparently not in Boston: https://boston.cbslocal.com/2020/05/04/coronavirus-covid-19-...

Anecdotally, around my town the lower number of drivers on the road seems to be causing those who remain to feel like traffic laws don't matter. I can't even count how many times I have seen blatant "it's red but there's no traffic so I'll just go" behaviors, along with ridiculous speeding and lane changing. Doesn't help that the police essentially announced that they won't be looking for crime anymore.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#96

Post by downerending »

guscost wrote: post #5

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19: https://www.washingtonpost.com/health/patients-with-heart-at... > The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to c…

Plus in other countries, they expect a massive uptick in polio, tuberculosis, etc., due to lack of vaccination and treatment.

Some of this is inevitable. Some of this is due to economic lockdown, which will simply crush third-world economies.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#97

Post by guscost »

calibas wrote: post #92
guscost wrote: post #5

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19: https://www.washingtonpost.com/health/patients-with-heart-at... > The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to c…

Where's the source of "excess mortality is way up"? I didn't see it in the article, though it does suggest there may be fewer heart attacks and strokes because of "a decrease in air pollution and fewer high-fat restaurant meals".

https://www.nytimes.com/interactive/2020/04/21/world/coronav...

http://euromomo.eu

There's nothing for the USA as a whole, it will be compiled from states' records and estimates eventually. But it already seems obvious to me that the excess deaths in the next few years from secondary effects (avoiding hospitals, drug overdoses, suicides, stress/panic attacks, less traffic/police on roads, etc) will far outnumber the deaths where COVID-19 took away more than one year of life. I'm probably still in the minority with that belief.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#98

Post by macintux »

JJMcJ wrote: post #40
SkyPuncher wrote: post #23

Earlier quoted context omitted.

My wife is a doctor. Not an ER doc, but had to do rotations through the ER and frequently interacts with the ER in other rotations. The amount of non-emergencies the ER department sees is astounding.

24 hour urgent care would reduce the load on ERs.

We used to have 24 hour urgent care facilities in Indianapolis, but I don’t believe any are still open (or open 24 hours, anyway).

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#99

Post by wafn »

downerending wrote: post #80
treeman79 wrote: post #72

Earlier quoted context omitted.

Had a dozen visits to the ER. I was Constantly sent away because nothing serious. Tests generally clean. Told it was mental. Problems persisted. Kept avoiding ER, I felt bad wasting time. Plus money. Finally went in and they ran an extra test and found the issue. Probably had seen 30 doctors during all of this. Some of the doctors were amazed I hadn’t dropped dead yet.

The realization that the median doctor is probably about as good at their job as the median techie makes me shudder at the thought of going to the ER. Yeah, I'll do it if I have to.

The old joke applies: what do you call the graduating student with the lowest grade? Doctor.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#100

Post by Guest42 »

guscost wrote: post #5

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19: https://www.washingtonpost.com/health/patients-with-heart-at... > The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to c…

Perhaps unemployment being up leads to people not wanting ER bills even more than usual.
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