6 minute read
pandemic plans across hospitals in canada have helped hospitals prepare for a surge that, mostly, has been manageable. as the number of cases of covid-19 begins to stabilize, however, the next wave of illness may not come from the novel coronavirus itself, but from non-covid patients not receiving the treatment they need.
in ontario, a study in april found at least 35 patients have died waiting for heart procedures since mid-march. ontario health minister christine elliott said this was tragic, but the decision was made by medical personnel.
angiograms, angioplasties, cardiac surgeries, biopsies, and any life-saving procedures with no possibility to delay are still occurring, but any others that can be delayed are deferred based on recommendations from the canadian cardiovascular society .
“at this point, it is safer to delay a procedure than to bring the patient into the hospital and expose them to an infection,” says dr. diego delgado , a heart failure and transplant cardiologist at the university health network (uhn). “in general, that’s the principle: patient safety first. based on that we determine if the patient needs to be seen or not.”
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in a press conference last week, ontario premier doug ford says the decision to delay procedures “weighed heavily on all of us.” cardiac and cancer patients may have to wait several more weeks until outbreaks in long-term care homes and other congregate living settings stabilize, as its demand continues to be unpredictable.
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dr. victor tseng is an atlanta-based pulmonologist and critical care physician who first shared a prediction of the four waves of the pandemic online. the ‘second wave’ is predicted to include resource restriction for urgent non-covid-19 patients. in a sombre echo of delgado’s concern, more emergency departments are seeing patients stay home out of fear of covid-19.
there are already emerging stories of the pandemic’s effect on people without covid-19 . tseng describes seeing a patient who had a “very clear exacerbation” of his congestive heart failure recently who waited at home for a long time before coming to the hospital.
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in the u.s., where one’s health insurance is intimately tied with their employment status and 20.5 million americans have lost their jobs , it’s no wonder many people hesitate to treat their symptoms if a visit to the hospital can quickly add up to the hundreds or thousands. but canadians are also waiting too late to treat their symptoms.
new research from the heart & stroke and canadian cardiovascular society shows ontario cardiac centres have seen almost a 30 per cent reduction in emergency department visits between march 16 to april 12, compared to the same month last year. vancouver coastal health has also seen approximately a 40 per cent drop in stemi patients during this time period.
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austria has seen a significant decline in coronary syndrome admissions and warns of a “possible cardiac collateral damage caused by covid-19.” studies have shown spain has also seen a 40 per cent reduction in patients for stemi and the us has seen a 38 per cent drop. and earlier this year, researchers in china and hong kong found covid-19 caused patients with major heart attacks to delay seeking care . this all has detrimental effects in the long term.
