COVID-19: How do emergency departments fare after normalisation steps?

ABSTRACT

OBJECTIVE: Restrictions imposed for the COVID-19 pandemic and the people's fear of getting infected have caused a significant drop in the number of emergency service admissions. Herein, we aimed to investigate the reflections of our otherwise crowded emergency services' quietness in the period of normalisation. METHODOLOGY: Our study retrospectively investigated three groups of patients the patients who were admitted to the emergency service in the 'Period of Restrictions' when the restrictions were imposed to limit the spread of the COVID-19 infection; the patients who were admitted to the emergency service in the 'Period of Normalisation' when normalisation attempts were made and the restrictions were lifted; and the patients who were admitted to the emergency service in the 'Period of Pre-pandemic Normal' exactly 1 year before the normalisation period, which would reflect the normal functioning of the emergency service at that time. The three groups were compared with respect to the demographic characteristics and patient outcomes (death/hospitalisation/discharge). RESULTS: A total of 69 474 patients were admitted to the emergency service in the 'Period of Pre-pandemic Normal' whereas 21 278 patients were admitted in the 'Period of Restrictions'. The number of emergency service admissions in the 'Period of Restrictions' was significantly lower (P < .01). A total of 72 843 patients were admitted to the emergency service in the 'Period of Normalisation'. There was no statistically significant difference between the 'Period of Pre-pandemic Normal' and the 'Period of Normalisation' in terms of the number of emergency service admissions (P = .127). A total of 9421 (13.5%) patients were hospitalised in the 'Period of Pre-pandemic Normal' and the corresponding figure for the 'Period of Normalisation' was 19 876 (27.2%). A total of 24 (0.03%) patients died in the 'Period of Pre-pandemic Normal', whereas 172 (0.23%) patients died in the 'Period of Normalisation'. The number of patients who were hospitalised and lost in the 'Period of Normalisation' was significantly higher than that of patients who were hospitalised and lost in the 'Period of Pre-pandemic Normal' (P < .01). CONCLUSION: In the period of COVID-19 pandemic, fear of getting infected and the restrictions imposed to limit the spread of the disease have kept people out of hospitals. We believe that while the restrictions imposed on various activities have prevented the virus from spreading, they also caused the course of non-COVID-19 diseases to worsen and mortality rates to rise. Therefore, we are of the opinion that the public should be informed about the importance of uninterrupted treatment/follow-up and 'Life-threatening Urgent Conditions' that should necessarily prompt hospital visits in possible pandemics.