Aussies avoiding emergency departments 

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29 September 2020

ED presentations declined substantially in Australian hospitals in 2020 during the early months of the pandemic, reports The Medical Journal of Australia.

The findings have fuelled fears Australians are delaying seeking medical attention during the coronavirus pandemic.

“The numbers of presentations with infectious enteric disease, pneumonia, wrist or hand fractures, stroke or intracerebral haemorrhage, and chest pain not resulting in another diagnosis were lower in 2020 than in 2019”, the research finds. “The numbers of presentations with acute coronary syndrome were similar.’’

On the flipside, and “equally concerning”, The University of Sydney study also reported a surge in the number of people presenting for mental health reasons.

The researchers studied presentations through the Western Sydney Local Health District, a metropolitan network of four hospitals with a total capacity of 1,925 beds, serving a catchment of 950,000 people.

The March 29 to May 31 findings revealed an almost 25 per cent drop in ED presentations for the same time last year (26,617 to 35,268).

However, mental health-related admissions were higher in 2020 (averaging 8.4 daily) than in 2019 (6.9).

Overall, the number of people admitted to hospital was also lower in 2020 (8,047 patients compared to 11,838 in 2019).

“South Australia experienced a similar trend during the early part of the pandemic with a significant decline in ED presentations as hospitals braced for an anticipated surge in COVID-related cases,’’ said ANMF (SA Branch) CEO/Secretary Adj Associate Professor Elizabeth Dabars AM.

“Following the Government’s direction for elective surgery to cease, hospital activity dropped dramatically, with many nurses going from steady shifts to no work at all.

“Thankfully the COVID-19 surge never eventuated and as the risk began to dissipate we saw a resumption of ED presentations at normal levels and beyond.’’

In attempting to explain the reduced presentations, the University of Sydney researchers said “social distancing may have reduced the spread of infectious enteric diseases and community‐acquired pneumonia, and home isolation may have led to fewer fractures.

“However, lower numbers of presentations with chest pain or stroke (also reported overseas) may reflect factors other than lower incidence, such as suspension of outpatient clinics and elective procedures, social distancing measures, and public anxiety.

“COVID‐19 has profoundly affected health care delivery,’’ the researchers said.

“We found concerning reductions in ED presentation numbers that may indicate delayed seeking of appropriate medical attention.

“Public health messages should encourage timely presentation of people with time‐sensitive, potentially life‐threatening conditions, even during pandemics.

“Equally concerning is the higher number (of) mental health‐related presentations, which may reflect anxiety about COVID‐19, loss of job security, or prolonged isolation.

“Studies of patients presenting to health care services as they re‐open are required to fully appreciate the health implications of the COVID‐19 epidemic.’’