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May 6, 2020

Patients Need to Come Back

South Carolina hospitals have faced a paradoxical dilemma over the past month.

On the one hand, facilities around the state have been working overtime to ensure that they have enough bed capacity, ventilators and PPE to care for all South Carolinians even in the worst-case scenario.

Meanwhile, they have also seen reduced traffic flows in their facilities, leading to cash flow problems that have resulted in the reduction of work hours and staff furloughs that are troubling but necessary as they manage this crisis. These lower patient numbers are in part due to curtailing elective procedures and the tertiary effects of stay-at-home orders and a slackening economy, but also due to sick would-be patient’s unfounded fears of hospitals as places rife with COVID-19.

“I’d say we’re about 50 to 60 percent of where we typically are during this time of year,” says Dr. Christine Carr, Professor of Emergency Medicine and Public Health Sciences at the Medical University of South Carolina in Charleston. “And that’s very significant. We are a level one trauma center, a comprehensive stroke center, we do a lot of oncology [work] and transplants in a very sick patient population. So where are all these patients?”

Dr. Carr believes that is in part the success of the “stay home” communications that has perversely led many patients to not seek care at the hospital even when it’s necessary.

“We’ve had patients come in after they’ve completed their [heart attack] or stroke, and there’s really nothing that can be done. But they were afraid to come in because we did such a good job of messaging.”

Meanwhile, much of MUSC’s emergency room sits vacant, with one of the three pods typically running now entirely shut down.

“It’s basically empty,” she reports. “One or two hours during the day the [emergency] beds might get a little fuller, but there’s nobody in the waiting room.”

And even if the emergency room was its more typically crowded self, Dr. Carr notes that MUSC and other hospitals are taking extensive precautions to separate out COVID-19 and non-COVID-19 suspected patients. All patients are pre-screened at one of the tents sent up outside specifically for that purpose before entering the hospital at MUSC Charleston, for instance, and patients who test positive have a separate entrance and section of the emergency room and ICU to ensure adequate protection.

“We are currently cohorting all of our COVID patients to a certain section of the ER,” she confirms. “Because none of [the hospitals] have overwhelming volumes in the entire state, we are easily able to do this.”

South Carolina hospitals are still working through the challenges regarding COVID-19, but they still want to take care of all the other health problems and ailments South Carolinians face as well.

“We are very concerned that patients that need to be in the ED are not coming and having bad outcomes as a result,” Dr. Carr concludes.