Good Medicine in the time of Covid-19
My initial plans for this blog post have taken a turn. I initially wanted to comment about how people who need to see their doctor, or even worse, need to be seen immediately in a hospital emergency department, were not being seen or treated because our healthcare system was overwhelmed with Covid-19 patients. Why? Because they had a reasonable fear of contracting Covid-19 from other patients or even their healthcare providers if they sought care at their family doctor’s office, the ever present “doc in a box,” or the local emergency department.
A recent article in the Wall Street Journal (“The Hidden Toll of Untreated Illness”) focused on this very issue. The article reported how at Detroit Medical Center the number of heart attacks being treated dropped from 15 to 20 a week to one or two. The article discussed how the case volumes for appendicitis, gallbladder infections, and obstetric emergencies had all dropped in frequency. The article concluded that based upon prior epidemics from around the world (Ebola, HIV/AIDS, and malaria) the United States may well see “non-coronavirus” deaths increase in large numbers. I intended to conclude this blog by encouraging Virginians to avoid going to the doctor for routine issues like blood pressure or diabetes management…save those trips for chest pain, stroke symptoms, serious and unrelenting abdominal pain, etc. In short, seek medical care for important and serious medical issues, regardless of the current pandemic.
And then I read an article in today’s Roanoke Times written by Luanne Rife, “Care Hard to Find for Virus Sufferer.” The article was about Becky Helgeson who went to her local emergency department at Carilion Franklin Memorial Hospital with two weeks of worsening Covid-19 symptoms, at the direction of her family doctor, and was turned away from the emergency department by a nurse! That’s right, her symptoms had been present for two weeks and had worsened to the point she could not breathe. Her family doctor wanted her to get a chest x-ray and possibly IV antibiotics…but she was turned away from the emergency department by a nurse.
After being turned away from Carilion Franklin Memorial Hospital, two additional weeks of worsening symptoms resulted in a friend calling her treating doctor (a pulmonologist) who called the emergency department of a hospital located in a nearby city. She was seen at that hospital the next day, received a nebulizer treatment and steroid shot within one hour, an EKG, chest x-ray and blood was drawn. She was diagnosed with continuing Covid-19 symptoms and acute bronchitis. She is now recovering from her illness.
My Question: How can this happen? How can an Emergency Department turn away a patient with Covid-19 symptoms lasting two weeks who presents at the hospital emergency department upon the direction of her doctor? We need a better answer from Carilion Clinic than…we are “disappointed to read” about what happened. Someone should lose their job because someone could have lost their life.