By Mary O’KEEFE

Hospitals across Southern California are reporting that their Emergency Departments have seen a reduced number of patients since the onset of COVID-19, which makes doctors wonder who is not coming for needed treatment.

Children’s Hospital Los Angeles [CHLA] recently shared a story of a couple that was concerned about bringing in their child to CHLA.

Jenn and Mike Dupke were nervous about taking their 4-year-old son Rhett into the CHLA Emergency Department. Their son has been battling cancer for over a year and his immune system is compromised. They were concerned about exposing him to the hospital environment during COVID-19.

“We were worried,” Jenn said. “But Children’s Hospital has been taking every single precaution. They’re constantly cleaning. They have a mask for you the minute you walk in. They’re limiting the number of people, so you’re not walking into a crowd. Even the Child Life Program doesn’t loan out toys anymore – they gave Rhett a brand new toy to take home.”

The initial concern of the Dupke family appears to be shared by others who are hesitant about going to the ER out of fear of COVID-19.

CHLA normally sees about 300 patients a day in their Emergency Department. The visits now are at about 60% of that, said Rhonda Foster, RN chief nursing officer at CHLA.

She added that she has spoken with her counterparts in other areas and found they are experiencing the same thing.

“When [parents or guardians] finally do come in the children are pretty sick,” she said.

Medical staff is seeing everything from earaches that have been active for more than two days to traumas. They are not seeing the little things that may have previously brought children to the ER, which is a concern because catching early the little issues can make a big difference.

The CHLA has seen Kawasaki disease [see separate story on this page] but not all children have the same symptoms.

“It shows up differently depending on the child. They could be good one day, and sicker than a dog the next day,” Foster said.

Some children may only have a rash; others may have more severe symptoms like vomiting and diarrhea.

Parents or guardians will bring in their child, who has a temperature over 101 degrees, and doctors then find out the child has had this temperature for over three days, Foster said.

“We are seeing that families are fearful to come in,” she added. “This is not a fear they need to have here.”

CHLA has taken several COVID-19 safety precautions like limiting visitors to only one guardian or parent per child. The other parent can wait in the lobby and will be able to follow the examination’s progress remotely. The child and parents/guardians are screened for COVID-19. The staff at CHLA is also screened.

“Everyone in the hospital gets screened every single day no matter what their job is and, if there are any questions, they get a secondary screening,” Foster said.

Despite “safer-at-home” guidelines, kids are still riding scooters and still being kids, which can lead to a trip to the ER with injury or illness; yet it seems they are waiting to come in.

“The American Academy of Pediatrics, the U.S. Surgeon General and the Centers for Medicare and Medicaid Services have all stated that it is important to address in a timely manner health care that was previously postponed,” said Paul S. Viviano, president and CEO of CHLA.

He added that families should know their child’s health is essential and not to unnecessarily delay care.

Children are not the only patients not going to the ER; adults are also waiting to go to the hospital out of COVID-19 concerns.

Six of Los Angeles County’s largest nonprofit health systems with hospitals, clinics and care facilities across the region have come together, united in a mission to encourage community members to put health first and access care when needed. 

Keck Medicine of USC, Providence, UCLA Health, Kaiser Permanente, Dignity Health and Cedars-Sinai have launched public service announcements called BetterTogether.Health. The PSAs have themes that include “Life may be on pause. Your health isn’t,” “Thanks LA for doing your part,” and “Get care when you need it.”

According to a release from USC Verdugo, “Among issues the educational campaign is addressing are the growing concerns by health professionals that many people are not seeking needed medical advice and assistance when critical to do so. Health care providers remain committed and available to serving the community’s health care needs – including emergency, primary, specialty and urgent care. Rather than each health system individually addressing what medical professionals increasingly call a “silent sub-epidemic” of those requiring [care] but instead avoiding timely medical services, they came together to tackle head on what could become, if not curbed immediately, the next public health crisis, resulting in serious and avoidable health consequences. Today the six health systems are joined for this purpose, believing it is their duty to reach out and let people know they are open and committed to maintaining the health of the communities they serve – and saving lives.”

The BetterTogether.Health public service effort will include messages in multiple languages. The hospitals’ staffs stress that getting to the hospital quickly following a heart attack and/or stroke will save lives.

“There is concern that patients with serious conditions are putting off critical treatments,” said Tom Jackiewicz, CEO, Keck Medicine of USC. “We  know that seeking immediate care for heart attacks and strokes can be life-saving and may minimize long-term effects. Our hospitals and health care providers are ready and open to serve your needs.”

  Mary Okeefe