Visits to hospital emergency rooms fell off sharply in March when the COVID-19 pandemic started keeping people at home -- and a new study reports they never returned to normal.
"This is a case where public messaging appears to have worked too well," said researcher Dr. Edward Melnick, associate professor of emergency medicine at Yale University in New Haven, Conn. "We said, 'stay home,' and what people heard was: 'Stay home at all costs to avoid COVID-19.'"
His team analyzed data from 24 emergency departments in five health care systems in the United States between January and April 2020. The departments varied widely, serving small rural populations as well as large urban ones, with an annual emergency department volume ranging from 12,500 to 115,000 patients per year. The researchers focused on daily ER visits and hospital admissions.
As the number of COVID-19 cases rose, emergency department visits dropped in all five states studied.
The decline in emergency department visits started the week of March 11. The biggest drop was in New York (64%), followed by Massachusetts (57%), Connecticut (49%), North Carolina (47%) and Colorado (42%).
During the same period, hospital admissions from the emergency department spiked, along with state-level increases in COVID-19. The surge ranged from 22% in North Carolina to 149% in New York, the researchers found.
After April 8, emergency department visits began to increase, but never returned to normal, Melnick said in a university news release.
He said public health officials need to give a more nuanced message so people realize that, even during a pandemic, it's essential to go to the emergency department for serious injuries and illnesses.
"Our new rallying cry is that hospitals are safe," Melnick said. "Few hospitals outside of New York approached going over capacity during March and April 2020. That means a lot of people suffering from non-COVID illnesses and injuries may have stayed home and unnecessarily suffered or even died because they were too scared to come in."
The report was published online Aug. 3 in JAMA Internal Medicine.
Learn more about COVID-19 from the U.S. Centers for Disease Control and Prevention.