How has Covid-19 pandemic affected crowded emergency services?

We aimed to investigate the demographic shifts in emergency service admissions, possible measures and room for improvement in emergency services during the Covid-19 pandemic.

Our study retrospectively analysed the demographic features and clinical admission types of patients admitted to Batman District State Hospital Emergency Service at two different time periods, one between 28 March 2019 and 28 April 2019 (prior to the Covid-19 pandemic) and the other between 28 March 2020 and 28 April 2020 (during the Covid-19 pandemic). The results were compared between the two periods designated as the pandemic period and the pre-pandemic period.

The number of patients admitted to emergency service was 47,681 in the pre-pandemic period and 9455 in the pandemic period (P < .01). The number of patients examined in green zone (non-urgent cases) was 27,701 (58%) in the pre-pandemic period and 3668 (38.7%) in the pandemic period (P < .01). The number of patients admitted for trauma was 1247 (2.61%) in the pre-pandemic period and 59 (0.62%) in the pandemic period (P < .01). The number of patients hospitalised to cardiology department or coronary care unit for acute coronary syndrome was 602 (1.26%) in the pre-pandemic period and 29 (0.3%) in the pandemic period (P < .01). The number of patients hospitalised to neurological intensive care unit for acute cerebrovascular disease was 542 (1.13%) in the pre-pandemic period and 22 (0.2%) in the pandemic period (P < .01). The number of patients hospitalised to pulmonary diseases department or intensive care unit for dyspnea was 622 (1.21%) in the pre-pandemic period and 515 (5.4%) in the pandemic period (P < .01).

Measures taken to prevent the spread of Covid-19 infection have caused a significant drop in emergency service admissions. We are of the opinion that this will lead to an increase in deaths occurring at home, and we will soon encounter patients with worse prognosis and overcrowded emergency services. We are in opinion that the public awareness about emergency conditions requiring emergency service admission should be heightened alongside of the "stay home" calls. As: "In order to reduce morbidity and mortality from non-covid-19 conditions, we call for heightened public awareness on other emergency and urgent symptoms, which should prompt urgent attendance to medical services."