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Now frightening numbers from New York City's overwhelmed emergency medical system may provide part of the answer: hundreds of people a day have been dying of cardiac arrest in their homes, an eight-fold increase over the same period last year. "We're in battlefield wartime triage," Mike Greco, Paramedic and Vice President of Local 2507, told Angioplasty.Org. He compared the situation to Baghdad. "We are stretched thin, and the call volume is so high. That's how overwhelmed these ERs are right now in NYC.” Greco's Union represents EMTs, paramedics, and fire inspectors of the Fire Department of NYC. The Department’s most recent figures of cardiac arrests occurring at home are striking: for the week from March 30-April 5, 2020, there were 1,990 cardiac arrest calls, four times as many as the same period a year earlier; and of those, 1,429 could not be revived, an eight-fold increase over 2019. The arrests were greater in number than normal, and far more lethal. Many of the people whose hearts stopped at home are thought to have died from cardiac arrest brought on by untreated COVID-19 infection. Since the Office of the Chief Medical Examiner is similarly overwhelmed, autopsies and COVID tests are not being carried out in most cases. So we may never know how many were caused directly by COVID. But it's very possible that some of these people have died from blockages due to coronary artery disease, blockages that at any other time could have been treated promptly, opened via angioplasty in a catheterization lab, saving those lives. It seems logical that these cases may be some of the "missing" heart attacks noted by hospitals. Regardless of the direct cause, most of these hundreds of cardiac arrest deaths at home can be attributed to the pandemic, because even those who didn’t have the COVID-19 virus in their bodies died because COVID-19 is in "the system." The virus has flooded hospitals, emergency services and the hearts and minds of everyone. Greco observed that "the fear is worse than anything. I attribute this to the fear of COVID and patients not reporting their symptoms, and don't want to go to the hospital to get it checked out, the fear of catching this disease...."
"In this uncertain time we need to be sure our patients are certain that rapid responses to heart attack symptoms still matter – and that the hospitals are prepared to keep people safe and treat them rapidly – and we will lose lives needlessly if people stay home with their heart attacks," Dr. Krumholz told Angioplasty.Org. Despite ambulance wait times, despite over-burdened emergency rooms, despite the dangers of COVID-19, cardiologists are urgently advising patients to call doctors and 911 if they have chest pain and/or related heart attack symptoms. The personnel, equipment and procedures are ready and waiting in catheterization labs to save the lives of heart attack sufferers.
Dr. Robert A. Harrington, Chair, Department of Medicine, Stanford University and President of the American Heart Association, told Angioplasty.Org: "We know that patients with chronic cardiovascular disease have an increased risk of bad outcomes [from COVID-19], so patients are understandably concerned or even scared about seeking emergency care even if cardiac symptoms are acutely worse. From an American Heart Association perspective, we would want our patients to seek care with their cardiologist, most/many of us are doing video visits at a markedly increased rate. Or, through the emergency medical system." Reported by Burt Cohen and Deborah Shaw, April 8, 2020 |
