In the chaos surrounding the COVID-19 pandemic, many people in Florida with medical issues decided that it would be better to stay at home than go to the hospital. In fact, recent reports from Broward Health and Fort Lauderdale Fire Rescue showed an alarming trend of patients choosing self-.jpg)
care at home rather than dialing 911—with often tragic results.
“Emergency medical services (EMS) in Fort Lauderdale have seen a tremendous uptick in ‘dead on arrivals’ (DOAs) when they get to homes,” said Joshua Lenchus, D.O., chief medical officer, Broward Health Medical Center. “At Broward Health, we’ve seen a dramatic decrease in stroke and heart attack patients coming into the hospital.
“These people are electing to forego emergency medical care for fear of getting the coronavirus if they come to the hospital; they don’t think that they will be protected,” he continued. “Sadly, this supposition—which is incorrect—can kill them.”
While people were trying to do the right thing during the COVID crisis by staying out of public facilities and avoiding crowded places, Dr. Lenchus said that the shelter-in-place instructions were never meant to discourage people from going to the hospital for acute care. He adds that this trend is not unique to Florida; many facilities across the country are also seeing an increase in DOAs while seeing a decrease in emergency patients.
Clarifying the Message
According to Dr. Lenchus, this confusion can be credited to several factors.
“In the run up to prepare for the potential surge of cases, hospitals across the nation were following an incident command structure, which requires them to free up resources so that they can be brought to bear when needed,” he explained. “Before it hit in Florida, our system tried to get patients out of the hospital who did not require acute hospitalization. They were encouraged to convalesce at home and were provided with what they needed, such as additional appointments and medication, to expedite their safe departure from the hospital so that we would have enough beds and personnel in case of a surge.”
At the time, it wasn’t known whether Florida would follow the Italian model or the California or New York models. “You have to work with the data on the ground at the time, and try to make needed resources available as safely as possible,” said Dr. Lenchus.
While people understood the concepts of social distancing and shelter-in-place instructions, not every message was as clear.
“In hindsight, what was lost in the message is that if you need emergency medical attention, you should seek it,” said Dr. Lenchus. “Unfortunately, for a number of reasons, people chose to forego the care they needed.”
Broward Health’s four hospitals in Fort Lauderdale saw a 30 percent drop in patients arriving with stroke symptoms, and a 50 percent drop in patients arriving with heart attacks. “When you look at the commensurate increase in deaths at home that EMS personnel recorded, it stands to reason that these people were not coming in for care,” said Dr. Lenchus.
Hospitals Ready to Serve
While the COVID crisis continues, Broward Health and the rest of the healthcare community want to make sure that patients understand that they should not avoid going to hospitals—especially since it could save their lives.
“Being healthy starts here—we are in the business of caring for patients and if they need medical attention, they can be confident that we can protect them as well as our healthcare workers,” said Dr. Lenchus.
Patients at Broward Health are asked screening questions when they come in, and given a mask if they are not wearing one. Everyone’s temperature is checked, and patients who are admitted or who are having procedures are first tested for the virus.
“We have specific areas for patients who test positive with the virus, as well as dedicated resources for their care,” said Dr. Lenchus, adding that healthcare workers are fully supplied with personal protective equipment (PPE).
Broward Health opened back up for elective surgeries, and is seeing an influx of patients who have been waiting since the crisis started. ”Some people being contacted to reschedule appointments are still reluctant to come in and remain that way, while others reschedule once we’ve explained all of the protective measures we have in place,” said Dr. Lenchus. “Others have been waiting in line, so to speak, and are eager to have their surgeries performed.”
What’s most important, however, is that individuals use the hospital when they need it.
“We’re encouraging people to re-engage with the healthcare system,” said Dr. Lenchus. “We never close—not even during a pandemic. Talk to your medical professional about having your procedure scheduled—and understand that there is no reason not to seek emergency medical attention.”
