Preparing for the surge of non-COVID patients

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COVID-19 has lead to dramatic changes in how we live our life. Could you imagine me telling you last year that you would be purchasing multiple facemasks to match different clothing and different styles? How about the idea that most cities in the United States will have been under quarantine for months? Ok, I know this one is hyperlocal, but how about the fact that the Toronto Blue Jays (Major League Baseball - MLB) will not be playing any home games this year in Toronto due to COVID-19, but will be playing them in Pittsburgh instead. Conversely, the Pittsburgh Penguins (National Hockey League - NHL) will not be playing any home games in Pittsburgh due to COVID-19 but will be playing those home games in Toronto.

I remember being in a pre-operative waiting room with a family member who was waiting to have elective surgery when this coronavirus first started to spread. While sitting there, I received a news alert on my phone that the hospital I was in had confirmed it's first three patients that day. Who would have guessed that the fundamental way hospitals would operate would be changing so much?

During the initial wave of COVID-19, hospitals across the world diverted resources from routine care to stand and fight this pandemic. Personnel was diverted from various departments for drive-thru testing and ICU units to care for the victims of this illness. There are stories of medical staff around the globe working around the clock to comfort, treat, and provide solace to their patients. But what happened to all of the other, Non-COVID patients?

First, because of statewide quarantines, fewer people were venturing from their homes, reducing the number of accidents on the roads. Next, people re-evaluated their need to visit an emergency room. More and more people sought out their care through telemedicine and urgent care centers or did not seek medical attention. Some estimates report that emergency departments saw a 40% or more decline in non-COVID related patients. Most disturbingly, the postponement of needed emergency and preventative medical care could lead to a sharp rise in more severe diagnosis and lengthened treatments later.

The combination of many governors ordering stay-at-home orders and the fear of the general public to venture near healthcare facilities has caused many people to not keep appointments with their physicians. This decrease in preventative care, such as mammograms and cancer screenings, will have long-term consequences in the near future. "Even with coronavirus, we still have healthy people who get an illness and need to go to the emergency room," Dr. Christopher Freer, director of emergency medicine at RWJBarnabas Health said. "Heart attacks don't stop."* Further, many would-be patients are seeking out palliative care at pharmacies, Eastern Medicine storefronts, or their local supplement shop.

The reality is that this unprecedented pause in non-COVID related healthcare is going to lead to a substantial burden on the medical infrastructure at a time that many experts are predicting "the next wave" of COVID infections.

So how can a healthcare facility prepare?

First, hospitals across the countries must continue the public relations campaign to show that their hospitals are safe. By following CDC guidelines to prevent the spread of the virus and the strict enforcement of these guidelines amongst their staff, vendors, and patients, hospitals can take the first step to regain public confidence.

While the media focus has been on COVID patients, healthcare facilities need to have adequate resources to diagnose, stabilize, and treat non-COVID patients properly. An Emergency Department that releases a non-COVID asthma patient complaining of shortness of breath after stabilizing their breathing with a nebulizer treatment, but not thoroughly examining their heart could lead to a massive heart attack.

Lastly, healthcare facilities need to prepared for the inevitable surge in non-COVID. Hospitals need to prepare for an increase in cardiac cases stemming from unchecked or undiagnosed hypertension caused by the decrease in preventative care visits. Additionally, experts are predicting a wave of cases relating to strokes, cancer, and diabetes.

Let's all hope next year I am not writing about purchasing multiple Tyvek suits for formal occasions.

• *Feuer, Will. "Doctors Worry The Coronavirus Is Keeping Patients Away From US Hospitals As ER Visits Drop: 'Heart Attacks Don't Stop'". CNBC, 2020, https://www.cnbc.com/2020/04/14/doctors-worry-the-coronavirus-is-keeping-patients-away-from-us-hospitals-as-er-visits-drop-heart-attacks-dont-stop.html. Accessed 22 July 2020.