She just couldn’t stop vomiting.
It had been about 30 years since the last time ABG Gellert retched, but earlier this month the 44-year-old Crested Butte woman found herself unable to keep down food or fluids. She called the local hospital for help, but because of the risk of being exposed to the new coronavirus they told her to stay away.
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Gellert was fearful, too, of catching COVID-19, the disease caused by the coronavirus. She has asthma and watched from afar in recent weeks as friends in New York City went into health care facilities only to never leave.
On top of that, she didn’t want to take a hospital bed away from someone in need.
“I was determined to tough it out on my own,” she said. “But it just wouldn’t stop.”
Hospitals across the country, including Colorado, say patients are avoiding emergency rooms because they are fearful of seeking care, worrying they will actually put themselves at greater risk because of the coronavirus. And that has had dire consequences, especially for people having heart attacks and strokes. For them, every minute they delay going to a hospital could mean more severe long-term effects.
“People end up with permanent damage where they could have been treated and completely healed,” said Dr. Stephen Cobb, who is the chief medical officer of Centura Health’s Denver metro group. “We’re still hospitals. We can still take care of you.”
The situation has become so serious that Gov. Jared Polis even used his broad platform to encourage the public to go to the hospital when they need it.
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“If you think you need hospitalization because of a non-COVID symptom, please call 911. Do what you normally would do. Don’t be afraid to seek medical treatment,” he said at a recent briefing with reporters.
Some in the medical field are worried that the public is confused by messaging that people should stay away from emergency rooms unless they absolutely need medical care. But heart attacks and strokes — and the symptoms that alert people to the fact they are in distress — fall into that category of absolutely needing care.
“I think early on, when we were worried about what this pandemic was going to be like, I think people got the message, ‘Oh my gosh, I can’t go to the hospital for everything,’” Cobb said. “In fact, what we were saying is if you have respiratory symptoms that feel like the flu or a cold, stay home. If you have symptoms where you are more severely ill, come to the hospital. We’re here for you. I think what people began to hear is ‘Don’t come to the hospital.’ Man, if you have a life-threatening illness, get to our hospitals.”
Yes, hospitals are treating coronavirus patients. But they have taken steps to ensure that people infected with the virus, or with symptoms, are cordoned off from everyone else who needs care.
“We are being very safe, very clean,” said Dr. Jean Kutner, chief medical officer of UCHealth’s University of Colorado Hospital in Aurora. “We have all the personal protective equipment so that we are not transmitting between patients. I think people can feel safe coming to the hospital and not contracting coronavirus here.”
The use of telehealth has grown dramatically since the coronavirus crisis hit Colorado, and experts say that can be a good way of determining whether or not you need to urgently visit a hospital.
Kutner says her own patients at her UCHealth clinic in east Denver are worried about coming in to be seen. “These are patients that have chronic health problems,” she said. “Diabetes, heart diseases, hypertension, etcetera. I worry about them pushing it out.”
One patient had an accident while out walking the dog and didn’t want to visit a hospital because he feared he would be taking resources away from someone who needed it more. His severe leg injury, however, required “pretty urgent” surgery. Eventually he capitulated.
Kutner says emergency room doctors she’s spoken with have seen people with diabetic complications waiting to get care until significant damage has been done. Patients with appendicitis have waited so long that they have had significant infections requiring either a complex operation or several days in the hospital.
Cobb said one of Centura’s hospitals recently saw a 55-year-old man who had risk factors for heart disease and was having pretty intense chest pain. But he thought he would be fine and reasoned that going to a hospital would expose him to coronavirus.
Three days later, the man became so short of breath that he sought care thinking that he may have become infected by COVID-19.
He didn’t have coronavirus, but he had experienced a heart attack. And waiting cost him dearly.
“The whole anterior wall of his heart was affected, and he is in congestive heart failure,” Cobb said. “Fluid backs up into your lungs and legs and other parts of your body. Once you have congestive heart failure, it’s often progressive and you can die from it, for sure.”
Heart attack and stroke patients are the ones Centura’s doctors are most often seeing delay care. For those ailments, waiting is the worst option.
“Early care is really important,” Cobb said. “Every minute that the brain is deprived of oxygen, increases the chance the brain won’t recover. Every minute that we don’t reprofuse the coronary arteries to the heart, you lose heart muscle.”
Gellert, luckily, was able to get care before it was too late. She reached a doctor through UChealth’s telemedicine program and eventually traveled to University of Colorado Hospital in Aurora for care.
Doctors still aren’t sure what caused her vomiting, which has subsided But they did find something potentially more troubling while examining her.
“We separately have had what you call an incidental finding on a CT scan where they found a tumor between my bladder and kidney that I’m having removed tomorrow,” she said Tuesday. “So all kinds of things were going on.”
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