While hospitals across the country are busy preparing for a potential COVID-19 surge, they are also noticing a shocking new trend. Emergency room visits for things like heart attack and stroke are down nearly 50% in New York City hospitals, causing doctors to wonder if patients are choosing to dismiss serious symptoms out of fear of potentially catching the coronavirus.

And while it is too early to validate these anecdotal reports, the American Heart Association/American Stroke Association has started studying the trend.

What you need to know: Even in a pandemic, hospitals are safe for all patients and it’s important to react quickly to symptoms of serious illness like signs of stroke or heart attack, injury or mental health concerns.


News coverage of overwhelmed hospitals in New York has also distorted the public’s perceptions. At Novant Health hospitals, in most cases, the vast majority of patients are not there for COVID-19.

Still open for business

Amber Mabe RN at triage station
Amber Mabe, RN, checks patients in at triage.

Heather Norman, director of nursing at Novant Health Forsyth Medical Center in Winston-Salem, has also noticed a decrease in patients in the emergency room. The normal visit volume hovers around 250 patients a day, but over the last six weeks that number has dropped to an average of 130.

“It’s not too surprising in light of the recent stay-at-home orders,” she said. “But we want people to know that our No. 1 priority is to keep our patients safe and to make sure they get the care that they need in a timely manner.”

David Martin, nurse manager of the emergency room at Forsyth Medical Center, added that patients who put off treatment are at risk of causing additional injury or harm.

“We are seeing some examples of that now,” he said. “Some patients that should have come in earlier are a lot sicker when they get here. Our message is: Don’t hesitate to get help.”  

To help patients do that safely, the hospital recently implemented new visitor restrictions and a new triage process for patients.

What to expect

Jasmine Ward RN Michaela Evans RN Liz Myers CNA Ashley Carter CNA Whitney Dixon RN Jessika Serber RN Kaley White RN
Nurses give a reassuring thumbs up outside of the emergency department.

Even before entering the emergency department the patient and any accompanying family members will be greeted by a special triage, or pivot, team.  

“They will ask questions at the door to better assess the patient’s situation,” Norman said. “And to ensure the safety of visitors, family members will be asked to either wait in their car or at home and updates will be provided over the phone.”

The emergency room has been divided into sections called pods to better protect patients and team members. If a patient does have COVID-19 symptoms, they will be transported to that pod which is isolated from the rest of the hospital and well-stocked to care for those patients.

If patients enter the emergency room with symptoms such as stroke or heart attack, they will be immediately transported to another area of the hospital for treatment and or surgery.

“The bottom line is that we are prepared to continue to care for the needs of our community,” said Norman. “Our team members are well-trained, we have enough personal protective equipment (PPE), and we have enough capacity (space in the hospital) to care for those patients that really need us.”

Don’t ignore mental health

Dr. Michael Clark
Dr. Michael Clark

Dealing with stress correctly is important for your health during times of crisis, said Dr. Michael Clark, of Novant Health Psychiatric Associates in Huntersville.

Clark said anxiety can present itself in different ways, and that people should be mindful if they notice a change in their sleep, concentration or become more irritable.

“If you find yourself dwelling on it (COVID-19), and not being able to disengage from it, that’s a sign,” he said. “Some people find themselves turning to different substances more, such as alcohol.”

He warns that any kind of abrupt change of behavior can be a red flag and that it is important to keep an eye on your kids as well.

“As parents, we need to set the tone,” he said. “If we come across as worried, scared or panicked, it doesn’t matter what you tell the child, they’re going to read your body language and emotions and take their cue from that.”

Clark suggests that parents keep updates simple and on a level that their child can understand. But to also remember to ask for help if you need it.

North Carolina residents who are in emotional distress – or would like guidance on helping someone they know who is struggling – can call a free 24-hour helpline at 800-718-3550 to speak with a counselor. The service, provided by Novant Health, connects callers with a master’s level therapist who can offer immediate guidance and help determine possible next steps, which could include a further assessment or connection to community resources for those in need. Translation services are also available.

Top photo: Left to right - Heather Campbell, RN, and Jessica Johnson, RN. 

Group photo in front of the emergency room: Left to right - Jasmine Ward, RN; Michaela Evans, RN; Liz Myers, CNA; Ashley Carter, CNA; Whitney Dixon, RN; Jessika Serber, RN; Kaley White, RN. 

Note: Cliff Mehrtens contributed to this article.

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