Just 6.7% of hospital emergency room visits in 2020 involved any mention of COVID-19, according to federal statistics released Tuesday that raise new questions about the public health response.
Among 131 million ER visits during the first year of the pandemic, only 1.8% involved a confirmed coronavirus case, the Centers for Disease Control and Prevention reported.
Another 0.3% mentioned suspected COVID-19 cases, 3.3% involved testing or screening and 1.8% shared “other mentions” of the virus, according to a data brief from the CDC’s National Center for Health Statistics.
The numbers cover “the very early stages of the pandemic” before medical professionals created and implemented a new international diagnosis code for COVID-19, the CDC said.
With more than 20 million coronavirus infections overwhelming the U.S. health care system during the pandemic’s first year, the percentages are lower than expected — suggesting hospitals failed to accurately track cases.
Data gathering from emergency departments and short-stay hospitals was delayed in 2020 as collectors switched to remote methods, according to CDC researchers.
“Because of this and lack of widespread testing in 2020, the estimates in this report may be undercounted,” said Christopher Cairns, lead author of the CDC study.
Michael Adamse, a clinical psychologist in Boca Raton, Florida, contacted by The Washington Times for comment, said the stigma of infection may also have scared some COVID-19 sufferers into avoiding hospitals.
“Psychologically, the level of fear associated with a visit to the [emergency department], being found positive for COVID, and concern that an admission may be the result, could have dissuaded individuals from seeking help,” Mr. Adamse said. “A major lesson to be learned is the importance of educating the public on health issues without overcommunicating fearful messages.”
The overall rate of emergency department visits in 2020 was 40 for every 100 people, the CDC said. Rates were highest among infants, the elderly and non-Hispanic Blacks.
Doctors say even the low share of COVID-19-positive patients was enough to overwhelm many urban emergency rooms, which lacked the beds and personal protective equipment to absorb pandemic surges.
“It does not have to be 100% of the cases, but just enough to undo a fragile health system overall,” said Dr. Panagis Galiatsatos, a professor at the Johns Hopkins School of Medicine. “Introduce a new disease that is incredibly resource-draining and we will be unable to handle it.”
Hospitals “run like hotels” with incentives to operate near capacity and had “little excess bed capacity even pre-pandemic,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
“When hospitals want to expand capacity, they have to go through a bureaucratic process with state regulators. And even competitors, in some states, have the ability to object to added beds,” the infectious disease specialist said.
It is impossible to say how many people may have walked into emergency rooms with unreported COVID-19 symptoms in 2020, according to the experts.
“During the early days and months of the pandemic, it was unclear what was going on,” said Thomas Plante, a member of the American Psychological Association and professor at Santa Clara University. “It took a long while for emergency room personnel to get their sea legs in order to effectively diagnose and then treat COVID.”
For more information, visit The Washington Times COVID-19 resource page.
• Sean Salai can be reached at ssalai@washingtontimes.com.
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