Atlanta, GA—Pharmacists and other healthcare professionals are being asked to help communicate the importance of emergency care for acute health conditions. The CDC says that national syndromic surveillance data suggest a decline in emergency department (ED) visits during the COVID-19 pandemic.

An article in the CDC’s Morbidity & Mortality Weekly Report points out, “In the 10 weeks following declaration of the COVID-19 national emergency, ED visits declined 23% for heart attack, 20% for stroke, and 10% for hyperglycemic crisis.”

Public health officials are asking pharmacists and other healthcare professionals to advise immediate emergency care for people experiencing chest pain, loss of motor function, altered mental status, or other life-threatening issues, regardless of the pandemic. They also should reassure the public that EDs are implementing infection prevention and control guidelines to ensure the safety of patients and healthcare personnel.

Following the declaration of COVID-19 as a national emergency on March 13, 2020, the National Syndromic Surveillance Program identified significant reductions in numbers of ED visits by males and females in all age groups for three potentially life-threatening conditions: 
• Myocardial infarction (MI) (23% decrease), 
• Stroke (20%), and 
• Hyperglycemic crisis (10%) 

“These estimates are consistent with, but smaller in relative magnitude than, the 42% overall decline in ED visits observed during the early pandemic period,” the authors note, adding that the largest absolute differences were observed in adults 65 and older for MI and stroke, and adults aged 18–44 years and youths 18 and under for hyperglycemic crisis. 

“The substantial reduction in ED visits for these life-threatening conditions might be explained by many pandemic-related factors including fear of exposure to COVID-19, unintended consequences of public health recommendations to minimize nonurgent health care, stay-at-home orders, or other reasons,” according to the authors. “A short-term decline of this magnitude in the incidence of these conditions is biologically implausible for MI and stroke, especially for older adults, and unlikely for hyperglycemic crisis, and the finding suggests that patients with these conditions either could not access care or were delaying or avoiding seeking care during the early pandemic period.”

Citing reports of excess mortality during the COVID-19 pandemic where deaths not associated with confirmed or probable COVID-19 might have been directly or indirectly attributed to the pandemic, public health officials suggest, “The striking decline in ED visits for acute life-threatening conditions might partially explain observed excess mortality not associated with COVID-19.”
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