When the novel coronavirus struck Louisiana last year, doctors and emergency medical workers noticed a peculiar and worrisome trend: they were seeing far fewer people suffering from heart attacks, strokes and other serious problems.
It didn’t take long for them to realize that an untold number of people were likely suffering from various emergency medical problems silently, and at home, because so many of them were leery of stepping foot in a hospital or ambulance amid a broadening pandemic.
Months later, doctors say they’re starting to see the beginning of those consequences as some hospitals have seen upticks in patients who opted to forgo treatment for heart problems in past months.
“With the long-term effects of this pandemic, we’re just beginning to break the ice on that,” said Dr. Johnny Jones, who heads emergency medicine at Baton Rouge General Hospital.
The hospital saw some 65 patients with congestive heart failure in January, a 50% rise from past years. A number of those patients acknowledged they put off going in until their symptoms were too serious to ignore, Jones said.
Congestive heart failure is a condition when the heart muscle weakens to the point that it cannot pump as much blood as it should. It can be managed and treated but is often permanent.
In a study conducted last summer among 15 Louisiana hospitals, nearly a dozen facilities reported admissions decreases in stroke centers by as much as 20% to 60% of their regular volume.
Also, roughly one-quarter of patients refused an ambulance ride to a hospital at times last spring and summer from Acadian Ambulance Service, even after emergency workers told them they had likely suffered a heart attack or stroke that can only be treated at a hospital, according to the ambulance service.
Doctors have voiced worries about the serious and potentially long-term health impacts of untreated heart problems, saying that it can lead to more complicated, higher-risk procedures and irreparable damage in some cases.
Though Ochsner in Baton Rouge hasn’t experienced the same influx of patients as Baton Rouge General recently, the facility saw a similar decline in the number of heart attack and stroke patients who came in last spring.
During the first quarter of 2020, the hospital only saw three heart attack patients compared to about 30 patients who came in to be tested for potential heart problems, which is significantly lower than usual.
“I think what makes sense is a lot of the patients were starting to notice the effect of COVID,” said Dr. Bahij Khuri, who heads Ochsner's catheterization lab in Baton Rouge. "A lot of the people were afraid to get exposed, and a lot of them went by the wayside."
Reassuring a nervous public that hospitals and ambulances were safe vexed medical workers for months, even after they took considerable steps to isolate COVID patients and create designated areas for emergency care.
Heart disease is among the top killers in Louisiana, second only to cancer, according to the U.S. Centers for Disease Control and Prevention. And since a large share of the state’s population is overweight or obese, many more people are at risk of underlying illnesses that make heart problems more likely.
In recent months, emergency medical providers haven’t seen the same number of people refusing to go to the hospital as they encountered last spring and summer, even when hospitals across the Baton Rouge region saw the highest influx of COVID-19 patients than any other time.
“Unfortunately, we have a high population of congestive heart failure in this area anyway because of all of the other comorbidities we live with in this part of the country,” Jones said. “When you throw in ignored symptoms on top of that, it exponentially speeds things up.”
Had it not been for an increase in the use of virtual visits and checkups, Khuri said the trend of people forgoing treatment could have been much worse.
Secondary effects from the coronavirus itself could also be a factor in more patients having heart problems since an unknown number of people may have contracted it but never got sick.
Health experts had initially believed COVID-19 to largely impact the lungs, but a growing body of evidence suggests the illness can impact the heart, kidneys and other vital organs.
The full impacts of the virus and the illness it causes may not be known for some time, doctors say.
For people who may have put off seeking treatment for a potential heart attack or even skipped a regular check-up, Jones said they should schedule an appointment as soon as possible.
“If you get ahead of it, even with congestive heart failure, it’s kind of ‘damage done,’ but if you don't manage that appropriately, it’s more damage down the line,” Jones said. “It’s better to get ahead of it.”