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

Area of Science:

• Emergency Medicine
• Public Health
• Epidemiology

Background:

• COVID-19 pandemic restrictions and public fear significantly decreased emergency service admissions.
• This study examines the impact of these changes on emergency services during the subsequent normalization period.

Purpose of the Study:

• To investigate the changes in emergency service admissions and patient outcomes before, during, and after COVID-19 restrictions.
• To compare patient demographics and outcomes across different periods: pre-pandemic, restrictions, and normalization.

Main Methods:

• Retrospective analysis of three patient groups admitted to emergency services.
• Comparison of demographic characteristics and outcomes (death, hospitalization, discharge) between 'Period of Restrictions', 'Period of Normalisation', and 'Period of Pre-pandemic Normal'.

Main Results:

• Emergency admissions dropped significantly during the 'Period of Restrictions' (21,278) compared to 'Period of Pre-pandemic Normal' (69,474).
• Admissions during 'Period of Normalisation' (72,843) were similar to pre-pandemic levels (P = .127).
• Hospitalization rates rose from 13.5% (pre-pandemic) to 27.2% (normalization), and mortality increased from 0.03% to 0.23% (P < .01).

Conclusions:

• Pandemic-related fear and restrictions led to delayed or foregone treatment for non-COVID-19 conditions.
• The normalization period saw significantly higher hospitalization and mortality rates, suggesting delayed care worsened disease progression.
• Public awareness campaigns are crucial to emphasize seeking timely medical attention for urgent conditions during future pandemics.