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Emergency departments see some stay away during pandemic

Why some ERs look empty

The sound of Nicole Odermatt's son gasping for air woke her just after midnight.

The Cambridge, Ont., mom immediately recognized an attack of croup, which the six-year-old had faced several times before. But even as his lips turned blue, she admits to hesitating before she ultimately called an ambulance.

"I didn't want to be one of those people filling up the beds at the ER unnecessarily," Odermatt said days later, with Max no longer feverish and on the mend.

"I don't know what the situation's like in the emergency room. I don't want to take him there and expose him to something unnecessarily and I don't want to be taking up a bed that somebody else may need more."

She initially thought, "Can this wait until morning?" But her son was in distress.

"No, he couldn't have waited."

Odermatt's medical scare has a happy ending, but an era of public health directives to social-distance and conserve precious health-care resources for COVID-19 has many people grappling with when it's OK to go to the ER.

Contrary to what one might think, several emergency room doctors report relatively quiet ERs these days — likely due to the fact people have curtailed routine visits that can be addressed by virtual or in-person consults with their family doctor, and the fact widespread isolation has cut opportunities for sports injuries, traffic accidents and other common ER traumas.

Of course many emergencies — heart attacks, anaphylaxis, burns — can occur regardless of whether a person is housebound or not.

While some hospitals are under increased strain from COVID-19 patients, emergency physicians said people should not hesitate going to hospital if they are in medical distress.

Dr. Carolyn Snider, chief of emergency medicine at St. Michael's Hospital, described careful isolation measures that separate COVID-19 patients from others, and pointed to many weeks of planning to ensure adequate care is available for whoever — and whatever — may come.

"You never use the 'Q' word in the emerge because we're all pretty superstitious," said Snider, instead describing a "calm before a storm."

"We just know we have to be ready, and that the more time we have to be more ready is what we're thankful for."

Over at another Toronto hospital, emergency physician and health services researcher Dr. Jennifer Hulme said she fears some overly cautious patients will suffer at home and even die from lack of care.

She described one recent patient who required intubation for a severe respiratory ailment that he later admitted began two weeks before he was rushed to hospital.

"It was incredibly sad to see this guy so, so sick, who didn't feel that he could access services because he was afraid of COVID-19," said Hulme.

"We could have had more time to figure out what was going on and to potentially treat his underlying condition before it got that bad."



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