Covid-19 causes risky fear of hospital, say doctors

Trauma and emergency units have reported a dramatic drop in casualties caused by road accidents and drunken violence over the past five weeks of lockdown.

But some doctors believe the fear of contracting Covid-19, coupled with economic hardship, could also be behind the startling decrease in admissions — and the delayed arrival of seriously ill patients in emergency rooms.

Paediatric pulmonologist professor Heather Zar, head of child health at the University of Cape Town and Red Cross War Memorial Children’s Hospital, said a significant number of children with severe non-coronavirus respiratory conditions, especially pneumonia, were arriving at the hospital in an advanced stage of infection.

“The overall sense is that children are presenting late with more severe illness from all causes, partly due to delays in coming to hospital,” said Zar.

“This may be due to a combination of factors such as lack of transport, lack of means to get to hospital given the impact on poverty of the lockdown ... and fear of coming to hospital due to Covid-19.”

Dr Heloise Buys, who heads the hospital’s emergency unit, said the workload dropped by half at the start of the lockdown, but then children with severe asthma and serious dehydration due to diarrhoea started arriving.

Buys warned against delays in seeking treatment, saying this often resulted in life-threatening situations. “We do not want any children who are having convulsions to experience delays in treatment ... because this could affect the brain quite badly,” she said.

“The sooner children who have bloodstream infections, for instance, receive antibiotics and other life-saving measures, the better their chances of surviving.”

Dr Stefan Smuts, chief clinical officer at the Mediclinic group, said emergency cases had halved, and, “anecdotally, fears of Covid-19 do pose a threat to those seeking medical attention and attendance of a hospital”.

Smuts advised patients to seek help early in the event of a trauma or medical emergency. “Delaying presentation to hospital ... can have long-term effects on an individual’s health and wellbeing. In the instance of a medical emergency such as a stroke or heart attack, this impact will be more immediate,” he said.

Dr Charl van Loggerenberg, emergency medicine specialist at Life Healthcare, said a sigsignificantmber of patients were using telemedicine instead of going in person to emergency rooms.

Mande Toubkin, Netcare’s general manager in emergency, trauma and transplants, said there had been a “huge” drop in patient numbers.

“This could be ascribed to precautionary measures to not allow persons presenting with flu and respiratory symptoms into the emergency department except in real emergency cases,” she said. “Another reason could be concern about visiting a hospital during the Covid-19 outbreak.”

Professor Sebastian van As, head of trauma at the Red Cross Children’s Hospital, reported a 70% drop in road accident injuries but said the number of burn victims had risen notably — “as more children are at home during lockdown”.