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National media has reported on a concerning trend that people are delaying or foregoing healthcare during the COVID-19 pandemic, and the delay is sometimes having major consequences.

Here locally, both EIRMC and Idaho Falls Fire Department (IFFD) share similar concerns. The numbers tell the story: both ER volumes and in-home EMS calls are down substantially in April, but simultaneously reflect a higher number of sicker patients.

When compared to March, the EIRMC ER has experienced a 42% reduction in patient volume. Yet, the number of inpatient admissions resulting from an ER visit has increased 20%. In fact, the number of inpatient admissions resulting from an ER visit has increased 41% since this time last year. Simply put, people seeking care in the ER are sicker than usual, and ill enough to require inpatient hospitalization.

The increase in inpatient hospitalizations is not due to COVID-19. Instead, they are due to injury and illness that may not have needed inpatient hospitalization if medical care had been sought sooner.

EIRMC is currently treating two COVID-19 positive patients, and has only treated a total of eight.

Dr. Kenneth Krell, Intensive Care physician, explains further. “Delayed care can have life-threatening consequences in some circumstances. Seeking immediate care during ‘time sensitive emergencies’ such as heart attacks and stroke is vital. But many other ailments, such as severe abdominal pain, can signal a life-threatening condition. Delaying care for some conditions can mean that patients are sicker by the time they arrive at the ER. This can limit treatment options to address conditions, and result in a higher level of care needed, such as emergency surgery or an inpatient hospitalization. EIRMC has done, and will continue to do more than any other healthcare institution in the region to protect patients and staff. There should be no fear about exposure, or worry about burdening our healthcare workers.”

IFFD is experiencing a similar trend. IFFD responded to 840 in-home calls in April 2019, and 507 calls in April 2020. Calls for heart-related issues are down 44%, and calls for stroke care are down 53%.

IFFD’s EMS Division Chief Eric Day says, “Our emergency crews are responding to increased numbers of emergencies where the patients have put off going to the hospital until they are critically ill. Often by the time they call, their condition requires hospital admission and longer stays in order to recover. If you feel unwell, or have a chronic condition that is changing, do not ignore your symptoms. Contact your physician or seek evaluation in the emergency room before you are too sick to recover. Our providers have the training and protective equipment to safely get patients to the care that they need.”

Is it safe to receive care at EIRMC?

It has always been safe, and remains safe, to receive care at EIRMC. To date, we have experienced zero patient or staff exposures. EIRMC adheres to CDC protocols for infection control and ensures that staff are using appropriate Personal Protective Equipment (PPE). The small number of COVID-19 patients that have been treated at EIRMC have been deliberately placed only in specific areas of the facility and separated from the general patient population.

How is the ER specifically keeping patients safe?

As soon as a person enters the foyer of the ER and before they enter the waiting room, they are asked about possible COVID-19 symptoms. If the person indicates they have a fever, cough, or shortness of breath, they are masked and triaged to an isolated “respiratory hallway.” During their ER care, they are isolated and placed on droplet precautions.

If a person without respiratory symptoms is seeking ER care, they are masked and placed in our waiting room until triage.

All ER personnel are wearing CDC-recommended PPE.

What has EIRMC instituted throughout the hospital to keep patients, physicians and staff safe?

Many weeks ago, EIRMC implemented multiple measures to limit the potential for exposure.

• Temperature checks/ symptom screenings: Required of all people before allowed entry into facility.

• “No visitor” policy, with some exceptions: Has significantly limited the number of people in the building.

• Universal masking precautions: Required for everyone in the building while in patient care areas.

• Isolation areas: people confirmed or suspected of COVID-19 are in isolation under droplet precautions. Their caregivers are in full Personal Protective Equipment (PPE) that is donned and doffed per CDC guidelines.

• High level disinfection protocols for all patient care areas.

• ER patients: They are immediately triaged before entry into the waiting room, and those people with respiratory illness are segregated from other ER patients.