Suddenly-Vacant Hospital Emergency Rooms

"Some days are busier than others. Sometimes you get lots of patients. Some days you get none."
"Our volumes are way, way, way, way down. And when we speak with people across the province, everybody is seeing the same thing."
"We are seeing way lower volumes than we normally would be for both sexual assault and domestic violence."
"I think [victims] are staying at home and suffering, unfortunately. I can't imagine that the pressures of an abusive relationship are gone because we're sheltering in place."
"It's really important for people to know that we're available. We are that port in the storm for everyone."
"For patients who are running out of a dangerous situation right now -- and that happens at any time of the day -- we're always open. The lights are always on."
Dr.Kari Sampsel, medical director, sexual assault and partner abuse care, ER, Ottawa Hospital

Ottawa Hospital - Civic Campus (File Photo/CTV Ottawa)

"I usually go through an ER shift where I'm seeing ten people with chest pain to rule out a heart attack."
"[Now] I'm not seeing anyone. The issue is, where the f--- are all these patients?"
"The ones with symptoms: You need to get  our ass [to the ER]. Because you can't delay the rule-out heart attack, the rule-out stroke, the severe abdominal pain."
"You can't use wishful thinking. That is not a valued therapeutic."
"Patients are screened, people are isolated, physicians and nurses are wearing the appropriate equipment [to ensure no COVID transmission takes place in hospital]."
"We're basically seeing catastrophic illness and then COVID. But the question is where is everyone else?"
Dr.David Carr, emergency medicine, Toronto

“Our volumes are way, way, way, way down,” says one Ottawa ER doctor. The story is the same across the country. Getty Images

This is anything but normal when emergency room doctors find themselves puzzling over the sudden non-appearance of people suffering all-too-dangerous, potentially health-catastrophic illnesses requiring immediate medical attention. Add to the symptoms of stroke, heart attack or appendicitis, women desperate to escape partner violence or to report in with sexual assault, now absent from hospital emergency rooms across the country.

According to doctors working in hospitals in a number of provinces, fewer trauma patients are reporting to hospital emergency rooms, consequently fewer stitches are being done, fewer and fewer minor sicknesses that tend to overwhelm ERs in their once-predictable numbers are showing up for treatment. On the one hand that can be a positive, since it means doctors will have more time and resources to devote to remaining safe while fighting COVID-19.

On the other hand, medical professionals are concerned that patients who do require urgent care now delay or entirely set aside treatment for concern over contracting COVID-19 in a hospital setting where other patients have entered who have been infected with the insidious, threatening novel coronavirus that is so terrifyingly infectious. The major concern is that heart patients are placing themselves in great danger by opting to stay clear of ERs.

Overall, however volumes in Ontario are seen to be down between 20 and 50 percent. Leaving doctors seeing fewer stroke patients, fewer patients with appendicitis. Dr.Daniel Kalla, head of emergency at St.Paul's Hospital in Vancouver now sees fewer opioid overdose patients, a worrying trend, despite that the number of overdose deaths continues to rise. It is absurd to think fewer heart attacks are occurring, or that social isolation doesn't allow for appendicitis attacks.

Two months earlier, people who wasted little time entering ERs with chest pain now wait, eventually arriving with permanent heart damage. Under normal circumstances, opioid users would get their highs in the company of friends, but during this time of social isolation overdosing may be accelerating. "That's a definite fear of mine", stated Dr. Kalla. Yet, for drug users, the mentally ill, the homeless, even under normal conditions ERs are viewed as a last-resort haven.

Dr. Kari Sampsel at The Ottawa Hospital

As well, points out Dr.Sampsel, victims of intimate-partner violence, generally first surface within the medical system, but at the present time that isn't occurring. One of the worries is that the tools and systems in place to connect victims with critical support to enable them to get a place to stay, to reach out to the police or even get medical care through the emergency room, is not making that vital connection with victims too fearful to approach ERs.