State urges people not to delay care after 62% hike in out-of-hospital deaths amid pandemic

Lansing — Chief Medical Executive Dr. Joneigh Khaldun is urging Michigan residents to go to the hospital for medical emergencies as recent figures show an alarming increase in out-of-hospital deaths at the height of the COVID-19 pandemic. 

From March 15 to May 23, out-of-hospital deaths soared 62% from the same time period in 2019 and out-of-hospital cardiac arrests increased 43.3%, according to data from Michigan EMS agencies.

The percentage increases represent a surge in out-of-hospital deaths from 1,579 in 2019 to 2,824 for that same two-month period this year, according to the Michigan Department of Health and Human Services. The number of out-of-hospital cardiac arrests for that March 15-May 23 period increased from 3,033 in 2019 to 4,346 in 2020. 

Michigan EMS transports during that same time period decreased 17%, heart attack transports declined 10% and stroke transports fell 12.1%. 

EMS transports decreased from 224,175 in that time period in 2019 to 187,363 this year, according to the Department of Health and Human Services.  

“It is incredibly important that people not delay care, especially if they are having concerning symptoms like chest pain, difficulty breathing or dizziness,” Khaldun said in Thursday statement. 

Out-of-hospital deaths are defined as those where EMS personnel have answered a call and found an individual dead at the scene and did not transport the deceased to a hospital. Out-of-hospital cardiac arrests are defined as those occurring before or after EMS arrived. 

Despite an uptick in coronavirus cases in recent weeks, Michigan’s hospitalization rate for COVID-19 fell again this week, with 325 infect patients as of Wednesday, including 193 in critical care and 103 on ventilators.

That’s compared with 346 patients a week ago, including 195 in critical care and 115 on ventilators. 

At the peak of the virus in Michigan, some larger hospital systems, particularly those in Metro Detroit, were reporting hundreds of patients with COVID-19 on any given day. The Henry Ford Health System reported on April 7 having 752 coronavirus patients admitted, but that number eventually declined and, as of Monday, the hospital system reported 16 COVID-19 patients admitted. 

Experts have speculated the number of people willing to go to the hospital for serious conditions have decreased out of fear of contracting COVID-19 in emergency care. 

In addition, clinics and hospitals were barred for several weeks by Gov. Gretchen Whitmer’s executive order from performing non-essential procedures during the COVID-19 pandemic, though physicians were given broad discretion regarding what constituted a medical emergency that would bypass the order. 

Whitmer’s order led to a federal lawsuit in mid-May by three Michigan medical centers and a patient that challenged her ban on non-essential procedures. The Michigan Supreme Court agreed this week to review the constitutionality of the governor’s emergency powers at the request of a Grand Rapids federal judge.

“The curve has been flattened,” said Dr. Randal Baker, president of Grand Health Partners, a plaintiff in the case. “There will likely be spikes of cases in the future, but we can’t shut down non-COVID health care every time. We need to reassess the best practices to save the most lives, particularly where COVID-19 cases are low.”

Nationally, emergency department visits plunged 42% in the 10 weeks following President Donald Trump’s declaration of a national emergency related to the pandemic, according to the U.S. Centers for Disease Control and Prevention. 

“Every minute counts in a medical emergency and we hope this alarming trend of people avoiding care and dying needlessly doesn’t continue,” said Jack Fisher, executive director and president of the Michigan Association of Ambulance Services. 

Melissa Nann Burke contributed.

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