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Excess Deaths: People Who Are Dying Because of COVID-19 — but Not from It

  • Experts are becoming concerned about the number of “excess deaths” being reported during the COVID-19 pandemic.
  • Many of these non-COVID-related deaths may be happening because people are delaying or avoiding healthcare appointments due to fears of contracting the virus.
  • Experts say it’s still important for people to go in for checkups and other appointments when and where they can.
  • They note that many medical facilities outside of COVID-19 hot spots are less busy than usual.

Nearly a third of people in the United States are apparently not going in for routine healthcare during the COVID-19 pandemic.

A recent poll from the American College of Emergency Physicians (ACEP) reported that 29 percent of Americans are avoiding or delaying medical care due to fear of contracting the new coronavirus, SARS-CoV-2.

Experts say that trend could lead to an increase in the number of people who die due to the pandemic but not directly from the virus itself.

“There are large proportions of Americans and people worldwide just afraid of coming to see the doctor, and it’s a huge concern because unfortunately routine medical illnesses don’t take a break because of coronavirus,” Dr. John N. Mafi, MPH, an assistant professor of medicine in the division of general internal medicine and health services research at the University of California Los Angeles, told Healthline.

In the early weeks of COVID-19, the United States recorded 15,000 “excess deaths.” That’s a term used to describe the number of deaths beyond what would typically be expected for that time of year.

Yale researchers found that from March 1 to April 4, there were 8,128 COVID-related deaths reported. Excess deaths accounted for nearly two times that amount for the same period.

The researchers say the number of excess deaths isn’t necessarily attributable directly to COVID-19, but it could include people who were too frightened to seek treatment for unrelated illnesses due to the pandemic.

Overcoming the fear

In the survey, 73 percent of respondents said they were worried about overstressing the healthcare system during the pandemic and 59 percent said they were concerned a physician wouldn’t be able to treat them if they needed care.

“I definitely see where these concerns are coming from, but I want to reassure people that health systems across the country have adapted to this pandemic in really remarkable ways,” said Dr. Shoshana J. Herzig, MPH, director of Hospital Medicine Research at Beth Israel Deaconess Medical Center in Massachusetts and an associate professor of medicine at Harvard Medical School in Massachusetts.

“Many health systems are now doing outpatient visits virtually, via telemedicine,” Herzig told Healthline. “Your physician would then help you make a decision about whether or not you need in-person care, for COVID or non-COVID-related symptoms/conditions.”

“For acute conditions, like chest pain, stroke symptoms, severe abdominal pain… I would note that emergency departments and hospitals are still fully functional, and people with sudden onset of these symptoms should seek medical care immediately,” Herzig said.

Dr. Gary L. LeRoy, FAAFP, the president of the American Academy of Family Physicians, said that although many nonurgent care visits are being postponed, people should still take advantage of virtual or telehealth visits, and, when necessary, can still see a doctor in person.

“These virtual visits are an excellent way for family physicians and patients to work together to manage many chronic conditions, refill prescriptions or adjust medications, and to check in on other health items, including their mental health,” LeRoy told Healthline.

“Early intervention is key for addressing many health issues, which is why patients are encouraged to contact their family physician and meet with them virtually, or in person, to address those concerns,” he added.

“Timing is critical so patients are always encouraged to seek immediate medical care if they are experiencing an emergency issue,” LeRoy said.

Medical facilities available

There have been concerns surrounding access to care in COVID-19 hot spots such as New York City, but in many parts of the country experts say hospitals are operating at normal or even at a lower capacity than usual.

Dr. Jaime Friedman is a pediatrician in a part of San Diego County in California that has recorded fewer COVID-19 cases than other areas.

She says many doctors’ offices and clinics are much slower than normal.

“Most doctors’ offices and hospitals have actually seen a huge decrease in volume… so currently, if you do not live in a hot spot, it is very likely you will have excellent access to medical care,” she told Healthline.

“Most urgent cares, doctors’ offices, and clinics are very slow as people are avoiding going in public and assume these places are overrun with COVID patients,” Friedman noted. “If you have a medical concern that you think can’t wait and you are not in a hot spot like New York, it is likely safe to seek urgent care.”

However,” she said, “if you are not experiencing a life-threatening emergency and have time to make a call, go ahead and call your doctor or local urgent care first to find out about safe access to care.”

Routine healthcare still important

Friedman said that anything that was an emergency before the COVID-19 pandemic should still be considered an emergency now.

This includes symptoms of heart attack, stroke, respiratory distress, trauma, or appendicitis.

Mafi argues that in the wake of COVID-19, there’s likely to be a surge in diagnoses for people who were either hesitant or unable to receive medical care during the pandemic.

“I do think there’s going to be a sort of second wave. If you look at the history of crises, you see evidence over and over in history that crises harm health,” he said. “Health suffers during pandemics and because patients are unable to come in, or they’re afraid to come in, there will be pent-up demand, there’s going to be a backlog of symptoms, there’s going to be some delays unfortunately in cancer diagnoses.”

“There’s going to be a lot of procedures that need to be caught up with: colonoscopies, endoscopies, surgeries to remove certain things,” he added. “It’s going to be busy once we start getting back into becoming fully functional.”

Experts say if people don’t go to doctors for care during the pandemic, there’s also likely to be an increase in deaths from non-COVID-19 related illness.

“Based on data suggesting that patients are not presenting for care as consistently, we are almost certain to see an increase in deaths from non-COVID-related causes now and in the near future. If people don’t seek medical attention when they have symptoms of heart attacks, strokes, or other imminently dangerous conditions, there are bound to be instances of morbidity and mortality,” Herzig said.

“The longer people go without preventive checkups and chronic disease management, the more we will see the downstream morbidity associated with even more indolent or preventable conditions,” she added.

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