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Focus on COVID-19 keeping people from seeking medical attention for strokes

Photo Credit: Peshkova/iStock Photo

It’s either a miracle, that the number of people experiencing strokes has magically declined the past two months, coinciding with the COVID-19 lockdowns, or … people experiencing strokes aren’t seeking medical attention.

A study published in the New England Journal of Medicine earlier this month notes that the number of people seeking stroke treatment has dropped 39 percent compared to pre-COIVD-19 lockdown levels.

Augusta Health has experienced similar decreases in people seeking stroke treatment in the Emergency Department.

“In March of 2019, we had 46 stroke alerts in our Emergency Department. In March of 2020, we had only 22 Stroke Alerts in our ED,” says Amy Markham, MSN, RN, SCRN and Quality Coordinator for Neurology, Sepsis and Emergency Medicine at Augusta Health.

In April, the numbers were a greater concern: 43 stroke alerts in 2019 and only 14 stroke alerts in 2020.

“It is unlikely that there were fewer strokes in the area. It is likely that those experiencing a stroke are avoiding to seek treatment in the Emergency Department because they are concerned about exposure to COVID-19,” Markham said.

Wonder why that might be. You’ve had the media bombarding the airwaves and interwebs with the message that stepping outside will result in COVID-19 exposure and imminent death, which even the CDC is conceding now was a bit overblown, with the Wednesday release of planning scenarios that estimate all-age fatality rates at .2 to .4 percent, much lower than had been projected two months ago.

Now we’re seeing the focus slowly – too slowly, in the view of some – shift to the collateral damage. Suicides and drug and alcohol abuse issues could end up killing as many Americans as COVID. There are concerns with people who have had their cancer treatments delayed.

Heart disease. Stroke.

“While COVID-19 is a concern, the fact is that heart disease is the leading cause of death in our area and stroke is the leading cause of disability. Unfortunately, these emergencies, among others, have not gotten the message about a pandemic and continue to afflict patients,” says Adam Rochman, MD, Medical Director of the Emergency Department and member of Augusta Health’s interdisciplinary Stroke Team.

“Many of these emergencies are dependent on rapid treatment to ensure the best results, and therefore it is critical that everyone understand that if you are having signs or symptoms of a heart attack, stroke, or other emergency that you call 911 and go to the Emergency Room. You need to be examined and treated as quickly as possible,” Rochman said.

The signs and symptoms of a stroke are often reduced to acronyms such as BE FAST—which stands for Balance, Eyes, Face, Arms, Speech and Time.

There is a wider range of symptoms that are all could indicate a stroke – confusion, difficulty understanding, dizziness, loss of balance, numbness, severe headache, trouble speaking, trouble walking, vision change, weakness.

Sudden onset of any of these symptoms is cause for concern and a reason to seek care as quickly as possible.

Uzo Ugochukwu, MD, Augusta Health neurologist from the Stroke Team, urges anyone experiencing any of these symptoms to seek immediate care at the Emergency Department.

“When it comes to stroke, time is brain,” Ugochukwu says. “The treatment options to reduce the risk of permanent damage to the brain are very time sensitive. We are here 24/7 to give our patients the best chance of recovery from a stroke, and Augusta Health is taking all necessary precautions in this pandemic crisis.”

Dr. Rochman agrees.

“One of the very concerning trends we are experiencing in the Augusta Health Emergency Department is what we call ‘late presentation’. It means someone has delayed the decision to come to the ED, so they are arriving later than they should to have the best chance of recovery. We’ve seen this with patients who are having strokes,” Rochman says.

Another Augusta Health neurologist and Stroke Team Medical Director, Renzo Figari, MD, adds, “Having a stroke is a very dangerous situation. We have good treatments, but they are effective when begun during the first several hours after the stroke starts. The Augusta Health Stroke Team is always ready with the appropriate protective equipment to keep both patient and caregiver safe. We are prepared to treat you and help you recover—do not have a fear of coming to the hospital.”

“We’ve learned a lot about the best practices for containing the spread of COVID-19 while continuing to treat non-COVID-19 patients,” says Dr. Rochman. “So honestly, I can say that right now, your risk of death or harm from delaying coming to the ED for treatment of a stroke or other emergency condition is greater than your risk of contracting COVID-19 in the ED. Please, pay attention to what your symptoms are telling you and seek care as early as possible.”

Story by Chris Graham