Where Did All The Non-Coronavirus Patients Go? Hospitals Worry About Silent Sub-Epidemic Of People Not Seeking Care

"Everybody is frightened to come to the ER," doctors say. But that means people who do need care aren't getting it. In other public health news: the increased risk for patients who are diabetic or obese; an uptick in hospitalizations among children; the fraying safety net for disabled Americans; and more.

The Washington Post: People Who Need Care Are Not Going To Hospitals Because Of Coronavirus, Doctors SaySoon after he repurposed his 60-bed cardiac unit to accommodate COVID-19 patients, Mount Sinai cardiovascular surgeon John Puskas was stumped: With nearly all the beds now occupied by victims of the novel coronavirus, where had all the heart patients gone? Even those left almost speechless by crushing chest pain weren’t coming through the ER. Variations on that question have puzzled clinicians not only in New York, the epicenter of the coronavirus outbreak but across the country and in Spain, the United Kingdom, and China. (Bernstein and Sellers, 4/19)

West Virginia Gazette-Mail: 'Chronic Health Problems Have Not Gone Away:' How Rural Health Centers Are Navigating A New World Of Patient CareHealth care for Kanawha County’s rural residents looks nothing like before the coronavirus pandemic. Almost all care is virtual. Patients who want rashes examined, for example, send pictures through a secure email. Newborns are immunized in their homes. The last 30 days have been a whirlwind, said Dr. Jessica McColley, lead clinician at Riverside Health Center in Belle. (Severino, 4/18)

Modern Healthcare: Diabetics At Four Times Greater Risk Of Death From COVID-19Diabetic and hyperglycemic patients who contract COVID-19 are more than four times as likely to have complications that result in either death or longer hospital stays than their peers without those co-morbidities, according to a new study. An analysis of more than 1,100 COVID-19 patients hospitalized in 88 facilities from March 1 to April 6 found 39% had either diabetes or uncontrolled hyperglycemia. (Johnson, 4/17)

WBUR: Who's Hit Hardest By COVID-19? Why Obesity, Stress, And Race All Matter As data emerges on the spectrum of symptoms caused by COVID-19, it's clear that people with chronic health conditions are being hit harder. While many people experience mild illness, 89% of people with COVID-19 who were sick enough to be hospitalized had at least one chronic condition. About half had high blood pressure and obesity, according to data from the Centers for Disease Control and Prevention. And about a third had diabetes and a third had cardiovascular disease. So, what explains this? (Aubrey, 4/18)

The Wall Street Journal: Coronavirus Strains Safety Net For People With Disabilities Damian Gregory worries about the things that have quickly become normal to worry about in the coronavirus era: Is there Clorox at the grocery store this week? When will social distancing end? Will he and his family stay healthy until a vaccine is found? But the 46-year-old consultant and advocate, who has cerebral palsy, says he carries an extra layer of fear. He has to worry if he will be able to navigate in his wheelchair at the store or arrange for services to transport him. (Koh, 4/19)

Boston Globe: In Rare But Growing Number Of Cases, Children Hospitalized With Coronavirus In Massachusetts Last week, when the state first released data on coronavirus cases by hospital, the numbers seemed almost predictable. Many large hospitals had well above 100 patients; smaller community ones had dozens. But one number was striking: Boston Children’s Hospital had seven patients admitted with confirmed or suspected cases of coronavirus, including three in the intensive care unit. The number of COVID-19-positive admissions has since climbed to 13, with three in the ICU as of Sunday. (Ostriker, 4/19)

CIDRAP: US Flu Activity Now Low, CDC SaysLaboratory-confirmed influenza activity in the United States is now low, and influenza-like illness (ILI) activity is lower but still elevated, the Centers for Disease Control and Prevention (CDC) said today in its latest FluView report. The percentage of respiratory specimens testing positive for flu dropped from 0.9% to 0.4% the week ending Apr 11, the CDC said, while visits to healthcare providers for ILI decreased from 3.9% to 2.9%, which is still above the national baseline of 2.4%. Five of 10 US regions remain at or above their baselines. The number of jurisdictions experiencing high or very high ILI activity decreased from 21 to 12, and the number of jurisdictions reporting regional or widespread influenza activity fell from 31 to 17. (4/17)

The Wall Street Journal: Why Hypertension Is More Deadly Than It Has To BeHere’s a new reason to have your blood pressure checked: Data from the coronavirus outbreak suggests that high blood pressure can make patients more susceptible to COVID-19, more likely to develop severe symptoms no matter what their age, and more likely to die if they are older. Researchers are also studying whether some blood-pressure medications might help or hurt with regard to the coronavirus. (Landro, 4/19)

The New York Times: Is The Virus On My Clothes? My Shoes? My Hair? My Newspaper? When we asked readers to send their questions about coronavirus, a common theme emerged: Many people are fearful about tracking the virus into their homes on their clothes, their shoes, the mail, and even the newspaper. We reached out to infectious disease experts, aerosol scientists and microbiologists to answer reader questions about the risks of coming into contact with the virus during essential trips outside and from deliveries. While we still need to take precautions, their answers were reassuring. (Parker-Pope, 4/17)

CNN: Experts Say It May Be Time For Grocery Stores To Ban Customers From Coming Inside Because Of COVID-19Dozens of grocery store workers have died from the coronavirus, despite masks, temperature checks and capacity restrictions to keep them safe. So far, supermarkets have resisted the most draconian policy: banning customers from coming inside. However, some worker experts, union leaders, and small grocery owners believe it has become too dangerous to let customers browse aisles, coming into close range with workers. (Meyersohn, 4/19)

Stateline: Speeders Take Over Empty Roads — With Fatal Consequences, Daily vehicle traffic dropped by two-thirds nationally from March 1 through April 10, according to StreetLight Data, a San Francisco-based traffic analytics company. And while many states, such as California and Ohio, have seen a reduction in overall crashes during the pandemic compared with last year, some are reporting a jump in traffic fatalities that they say is linked to speeding or reckless driving. (Bergal, 4/20)

The Associated Press: Amid Virus Gloom, Glimpses Of Human Decency And Good WorksThe idea formed on a day when all the news headlines were dire. The coronavirus was surging worldwide; Nashville had lost lives in a devastating tornado and children had their lives upended as they separated from beloved classmates to shelter at home. But only bad news is never the whole story. Days later, The Associated Press started its daily series “One Good Thing” to reflect the unheralded sacrifices made to benefit others that normally wouldn’t make a story, but maybe always deserved one. (Stapleton, 4/20)

CNN: How To Have A Safe Home Birth During A PandemicFor pregnant women considering a home birth, the American Academy of Pediatrics has updated its guidelines with everything that should be in place to ensure the safety and well-being of both mother and baby. The AAP generally doesn't recommend planned home births, citing an increased risk for complications and infant mortality. However, the organization says, it is up to the parent to decide -- and for those who know they'd prefer a home birth, the AAP says it's best for women who have no preexisting or maternal disease and who can plan to have two medical providers present with the necessary skills and equipment. (Rogers, 4/20)

NBC News: The Coronavirus Will Change How We Travel. That Will Probably Be Good For Us. As millions of travel and tourism workers now find themselves out of jobs, furloughed or, as in the case of some cruise ship employees, stuck indefinitely at sea, the industries involved seem to be gearing up for some future "recovery", insinuating a return to the baseline of pre-coronavirus. That simply cannot happen because the pre-coronavirus travel and tourist industries will not function in a post-coronavirus world. (Evans, 4/19)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

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