Denton County residents may be dying preventable deaths as medical professionals report the COVID-19 pandemic has made people afraid to go to the hospital.
Experts in emergency care nationwide and in Denton County are documenting disturbing trends. In Denton, for example, the number of 911 calls is down, but paramedics are finding more patients dead on arrival compared with the same time last year.
A few days ago, Dr. Nik Mendrygal, an emergency room physician and director of emergency services at Medical City Denton, did something that he’s never had to do in his 15 years practicing emergency medicine.
Paramedics had arrived at a woman’s home after she was found on the floor. The 911 caller managed to get the woman in a chair before the medics arrived. She was clear-headed enough to know what was happening, yet she wouldn’t agree to go to the hospital. Mendrygal told the medics to put him on the phone to persuade her to come in.
“She was in really bad condition and probably wouldn’t have made it through the night,” Mendrygal said.
Even after she got to the emergency room, she was reluctant to be admitted into the hospital because of her fear of getting the coronavirus, he said.
In that way, her case was not exceptional. The emergency room staff have noticed big changes over the past seven weeks. Before the pandemic, patients arrived in respiratory distress or cardiac arrest once a week or every other week. Now, it’s almost a daily occurrence, Mendrygal said.
“I cannot remember the last shift without a CPR,” Mendrygal said.
In a conference call Thursday, he learned that the hospital has seen a 30% increase in Level 1 acuity cases, the most urgent cases that require immediate care and resources.
“That’s completely unheard of,” he added.
Some patients never come to the hospital at all, according to reports from paramedics.
“They are going to so many calls where the patient’s already dead,” Mendrygal said.
He said he has also learned of patients who suffered with chest pains for several days before finally seeking help.
Denton is noting the same pattern in 911 calls, Denton Fire Chief Kenneth Hedges said. In April 2019, Denton paramedics responded to about five times more calls for chest pains not caused by a heart attack than for actual heart attacks. While 911 calls for heart attacks remains about the same, the department saw a 52% drop in calls for chest pains this year.
“That’s the number that concerns me,” Hedges said.
MedStar, which serves the southern portion of Denton County, reported a 54% increase in heart attack patients they were not able to resuscitate in March and April.
Those 911 calls that exhausted departments in other cities hard hit by the pandemic haven’t hit Denton. In fact, 911 call volume decreased after stay-at-home orders began, Hedges said.
However, reports he received about each day’s dispatches showed that when a report came in, “it was a true emergency,” Hedges said.
Hospital staff may have fewer options for patients who come in after suffering chest pains for days, or even a week or more, Mendrygal said.
The sooner people come in with symptoms of a possible heart attack, stroke or kidney failure, “the better we can turn that ship around,” Mendrygal added.
It may be a while before hospitals and public health officials get a fuller picture of how virus fears are keeping sick people away. Early in the pandemic, the public and the medical community were ordered to defer elective care. Hospitals shut down visits. In addition, some areas had shortages of protective gear for doctors, nurses and other hospital staff, triggering worries nationwide and in Texas that medical workers were vulnerable.
At Medical City Denton, the hospital screens every patient, and those showing symptoms of the virus are quarantined on designated floors with designated staff until tests are complete, Mendrygal said. If the individual doesn’t have the virus, that person is moved out of that designated part of the hospital to reduce the risk of exposure.
No one working in the emergency room at Medical City Denton has contracted the virus, Mendrygal said.
“That’s key,” Mendrygal said. “We’re getting exposed every single day. You’re going to be safe.”
And paramedics have always been scrupulous about cleaning vehicles and equipment after runs, Hedges said.
On Thursday, the hospital relaxed some restrictions on visitors, spokeswoman Dana Long said.
Patients are now allowed one visitor. Long and Mendrygal called the change a big win for patients.
“For some patients, that’s a huge concern,” Mendrygal said.
Older patients are particularly reluctant to be admitted when they can’t have a family member at their side, he added.