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Hospitals report increases in amputations, ruptured appendixes as patients put off seeking medical care due to coronavirus fears

COVID-19 Update: April 23, 2020

As he has done for several days now, Gov. Baker used part of his daily press conference today to urge people with non-Covid-19 health issues to call their doctors or 911. But this time, he was joined by executives at three hospitals, who reported many people are trying to wait out symptoms at home, which means they eventually come into the hospital far sicker - and sometimes beyond help.

"We've seen children coming to the hospital after having several days of abdominal pain, coming with a ruptured appendix," Dr. Michael Apkon, CEO of Tufts Medical Center, said. "We've seen patients with symptoms of stroke staying at home long beyond the point at which medications that would markedly improve their outcome could safely be delivered." And Tufts has had patients with kidney disease stay at home so long that by the time they finally show up at the hospital, it's too late to save them, he said.

Six Boston hospitals have produced PSAs that will begin airing on local TV stations that urge people with non-Covid health issues - chest pain, symptoms of stroke and prolonged abdominal pain - as well as victims of physical trauma and domestic abuse to call their doctors or 911, that hospitals have plenty of beds for them and that, as Apkon said, "we are keeping you safe at the hospital."

Officials said hospitals are doing everything they can to keep the virus from spreading - patients with the virus are placed in separate units, all healthcare workers wear masks and other protective gear, surfaces and gear are constantly sanitized, patients in waiting rooms are made to sit at least six feet apart.

Baker, as he now does every day, emphasized that part of the planning by state and hospital officials to expand hospital capacity over the past couple of months was to ensure that people with non-coronavirus health issues could continue to get care. He said that more than half of the roughly 18,000 hospital beds now available in Massachusetts are empty, and that that shows both that the planning worked, that even as Covid-19 bed use has increased - statewide, there were 3,977 people hospitalized for Covid-19 symptoms yesterday, up 100 from the day before - there is plenty of room for patients with other issues.

"We don't want people getting sicker or exacerbating an injury," Baker, a former HMO CEO, said.

Dr. Gregg Meyer, the chief clinical officer at Partners Healthcare and the interim president at Newton-Wellesley Hospital, said emergency-room visits at the hospital have dropped from 5,400 in January to 2,800 over the past 31 days - with half of those being Covid-19 patients. While some of the decrease is due to fewer car crashes as people drive less, many are people simply staying home. He said the hospital's stroke census has dropped from an average of 20 a month to just 7 so far this month. He said that within the whole Patients system - which includes Mass. General and Brigham and Women's - visits for heart attacks have dropped 37%; visits for appendicitis 14%.

But one thing that's up, he continued, is leg amputations - patients with leg ulcers and vascular problems are waiting too long to seek medical attention and by the time they do show up, their conditions have become so advanced the only way to save their lives is to amputate their leg.

Like Baker and Meyer, he urged people to call their doctors before things get too bad.

"Massachusetts hospitals are open for business," he said. "We have the beds, we have physicians, we have the nurses, we have the specialists, we have the resources to treat you."

Nancy Shendell-Falik, president of Baystate Medical Center in Springfield, said her hospital has seen similar decreases in patient numbers. She said one particular problem has been that parents of children with diabetes are waiting too long to seek medical care when their children develop new symptoms, in some case so long that when they finally do get to the hospital, their children have developed new permanent problems.

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Comments

I wonder how many people wait because they have lost their health coverage and haven't been able to navigate the system?

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Unless you can prove otherwise, I'll say none.

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Why should your unreasonable assumption be the standard that needs to be disproven? I mean, I know why, but you should spell it out why you've assumed 0 (zero) people have done this

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Given that a majority of people get their health insurance via their employers and something like 20-25% of people are now unemployed, it would stand to reason a good chunk of people have lost their insurance.

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90+% of the restaurant industry, and 20+% of the population at large, have lost their jobs and thus their health care, but I'm sure your make-believe libertarian paradise fan-fiction has figured out a way for them to go to the ER before their ruptured appendix turns septic. Make sure to tell the rest of us how it works, will you?

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Didn't you know, we're supposed to shop around first...

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Most people's health insurance is tied to employment.
Lose employment, lose insurance.
Many people are now unemployed.
Fill in the conclusion: __________________

Unless you're disputing any of these premises, the conclusion ought to be obvious here.

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My wife and I have Harvard Vanguard (Atrius Health) for our primary care doctors and other specialists. They have pretty much made it clear to us that they do not want to see us and that they have no services to offer us until this crisis is over. Entire clinic buildings have been closed, appointments have been cancelled and not rescheduled, and doctors in various specialties are no longer working at the clinic -- not sure if they've been fired, furloughed, or what, but we've definitely been left in the lurch. I was supposed to have some follow up blood tests in April but I have nowhere I can go to get them, and I'm not sure who (if anyone) would review the results if I had them.

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Doctors will respond via Zoom (presume you have a computer?). I placed a call to to my BID PCP yesterday morning and he examined me via Zoom at 3PM for a tick bite that had gotten infected. He prescribed tetracycline which was available at my CVS by 5PM last night. Suggest you find a computer and try again.

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Atrius Health is my doctor as well and they have said no such thing. I took the following from their website (I also got something from them that stated something similar).

"Change of Practice Operations - Updated April 10, 2020

During the COVID-19 crisis, we have temporarily suspended some of our practice operations and relocated some services to other practices in order to protect the health of our patients and staff and to best utilize staff and equipment which are in short supply. We have also changed hours of operations for many of our practices. We are reaching out to our patients to re-schedule appointments affected by these changes with in-person visits for urgent needs at one of our other practice locations, with phone or video visits, or for a later date. We are committed to supporting our patients through this challenging time. Should you need care, please continue to call your doctor’s office. Calls to relocated services are being re-routed so that staff will direct you as appropriate for medical advice and care."

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Atrius Health is open in ways that help to keep patients safer during this crisis. Please call Patient Relations at (617) 559-8440 for assistance.

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As the Boston Globe reports this morning, deaths at home are up substantially, likely meaning some COVID-19 deaths aren't reported and that some percentage of people are delaying treatment because of COVID-19 fears.

https://www.bostonglobe.com/2020/04/22/nation/official-toll-massachusett...

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I read that story. OK, deaths are up 11%, fine. It was a long story that all boiled down to, "Deaths are up. It may be just COVID or maybe something more. We don't really know."

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"But one thing that's up, he continued, is leg amputations - patients with leg ulcers and vascular problems are waiting too long to seek medical attention and by the time they do show up, their conditions have become so advanced the only way to save their lives is to amputate their leg."

Guess what..."A mysterious blood-clotting complication is killing coronavirus patients"

https://www.boston.com/news/coronavirus/2020/04/23/blood-clotting-corona...

My guess...the 'asymptomatic' patients are having other problems. They assume life is 'normal' then shit gets bad in a hurry.

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Or...they know something's wrong, but they don't have the money to go to the doctor for anything that's not immediately life-threatening, so they don't. I guess that is pretty normal for Americans, but it's also pretty sad.

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