Where Have All the Hospital Patients Gone?

Pauline Chen in The New York Times:

Weathered, wiry and in his early 60s, the man stumbled into clinic, trailing cigarette smoke and clutching his chest. Over the previous week, he had had fleeting episodes of chest pressure but stayed away from the hospital. “I didn’t want to get the coronavirus,” he gasped as the nurses unbuttoned his shirt to get an EKG. Only when his pain had become relentless did he feel he had no choice but to come in. In pre-pandemic times, patients like him were routine at my Boston-area hospital; we saw them almost every day. But for much of the spring and summer, the halls and parking lots were eerily empty. I wondered if people were staying home and getting sicker, and I imagined that in a few months’ time these patients, once they became too ill to manage on their own, might flood the emergency rooms, wards and I.C.U.s, in a non-Covid wave. But more than seven months into the pandemic, there are still no lines of patients in the halls. While my colleagues and I are busier than we were in March, there has been no pent-up overflow of people with crushing chest pain, debilitating shortness of breath or fevers and wet, rattling coughs. But surprisingly, even months later, as coronavirus infection rates began falling and hospitals were again offering elective surgery and in-person visits to doctor’s offices, hospital admissions remained almost 20 percent lower than normal.

…Some experts have pointed to patients’ overwhelming fear of contagion as a reason for the drop in the numbers seeking hospital care. But the patients in the study who had the greatest persistent drop in hospitalization were those with acutely worsening asthma or emphysema, pneumonias, sepsis, strokes and even heart attacks, all illnesses where hospitalization is generally not optional.

More here.