Large jump in Michigan deaths outside hospitals as coronavirus raged

EMS responders reported deaths outside of hospitals jumped 62 percent during the pandemic, according to data released by the state — suggesting Michiganders were hesitant to seek medical care at the height of the COVID-19 pandemic. (Shutterstock image)

Deaths recorded by emergency personnel outside Michigan hospitals jumped 62 percent this spring as the coronavirus first raged through the state, according to the state health department.

The stark increase lends support to the notion that residents, including many with cardiac issues, decided to ride out chest pains or other serious symptoms at home rather than seek treatment in hospitals that were filling up with patients with suspected COVID-19. 

The 62 percent rise in “out-of-hospital” deaths was recorded between March 15 and May 23, when compared to the same period in 2019, according to the Michigan Department of Health and Human Services, which reviewed data from the state’s emergency medical services agencies.

Over that same period, out-of-hospital cardiac arrests climbed 43 percent, according to MDHHS. EMS transports of heart attack patients decreased nearly 10 percent, while transports of stroke patients fell 12.1 percent.

Rick Dupon said he witnessed residents’ reluctance firsthand. 

 

Dupon, chief of Denton Township’s EMS near Houghton Lake in north central Michigan, said monthly calls dropped about 25 percent between mid-March and the end of May, as metro Detroit was considered a national hotspot for new coronavirus cases. (The state recorded a 17 percent drop in ambulance calls over roughly this same period.) 

When EMS crews were called, the person in crisis often refused to leave their home, Dupon said.

“They’ve heard ‘Stay home, Stay Safe,’ and so they’d say, ‘Can you just take my vital signs?’” He said the person would be told that a hospital is safer than a grocery story, and they would respond, “I’m not going there, either.” 

“It was worse than we thought,” agreed Ron Slagell, president and CEO of Emergent Health Partners/Huron Valley Ambulance, which operates in several counties in southeast Michigan. 

The drop in ambulance calls may have reflected more than residents who were reluctant to visit the hospital. During the state economic shutdown, there were far fewer automobile accidents as well. 

Still, Slagell said, the rising number of deaths was startling. 

“Anecdotally,” Slagell told Bridge, “we had this gut feeling that things weren’t right. It was a surprise to see the magnitude of people’s reaction to” the virus. 

As COVID-19 filled hospitals — especially in southeast Michigan — in March and April, hospitals reported precipitous declines in emergency room visits. While hospital visits for elective or otherwise non-emergency care were soon prohibited during the outbreak, public health and hospital officials urged people with serious health issues to continue to seek care, with limited success. 

The slump in non-COVID emergency room visits remains, hospital officials have told Bridge, a trend that is not unique to Michigan.

Hospital emergency department visits across the country declined by 42 percent during the early months of the pandemic — a “striking decline,” according to a report this month by the U.S. Centers for Disease Control and Prevention.

Dr. Chadi Alraies, a cardiologist at Detroit Medical Center, was concerned enough that he asked fellow heart doctors on Twitter in April whether they had noticed the same sheer drop-off in cardiac patient visits.

Cardiac visits, he learned in 524 Twitter responses, had been reduced by half at the nation’s hospitals and cath labs.

At St. Joseph Mercy Hospital in Ann Arbor, cardiac surgeon Dr. Manak Sood, said he’s also not surprised by the data supplied by the state. 

“Clearly there was a reticence (for patients) in coming into an environment where they felt they would be exposed to COVID,” he said.

The St. Joseph hospital in Ann Arbor usually performs two or three repairs each month on aortic dissections — a deadly tearing of the aorta. Since COVID-19 arrived in Michigan, he said, “we haven't had one.” 

It’s likely those people died, Sood said. Nearly one in 10 patients with aortic tears of this kind die without surgery, he said.

“This isn’t a maybe-I’ll-go-tomorrow kind of situation,” Sood said.

Complicating estimates is mounting evidence that the new coronavirus itself can make people more susceptible to cardiac events — weakening heart muscles, triggering inflammation, or causing blood clots, even as people are less likely to pick up the phone.

“It’s a double jeopardy,” said DMC’s Alraies.

But while the pandemic may have made some reluctant to dial 911, there may be other reasons behind the decline in patients seeking care, he theorizes.

Seniors isolated during the pandemic didn’t have as much contact with loved ones, for example, who might rush them to the hospital, Alraies hypothesizes. One patient, he said, endured chest pains for days before her son found out and rushed her to DMC. She was fortunate to have survived, he said.

As coronavirus cases begin to inch up in Michigan and public health officials across the country predict a second wave of cases, hospitals and other health providers say they must convince patients it’s safe to seek medical care. Hospitals and doctors offices are focusing on virus screening and sanitizing methods, separating COVID patients from others, and the availability of personal protective equipment.

In Denton Township, Dupon said EMS workers use high-pressure aerosolizing sprayer to send disinfectant throughout ambulances after each run. Patients are immediately masked. Staff wear masks, gowns and face shields. 

“This is as clean and safe an atmosphere as you can get,” he said.

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Comments

duane
Thu, 07/02/2020 - 10:15am

Should we be surprised, the message we heard was all hospital functions [non essential treatments, elective surgeries, diagnostics, etc.] not for the treatment of Covid 19 were put on hold in other words stopped?
There was much about if you had low level of Covid 19 symptoms you shouldn't go to the hospital, shouldn't go to the doctors' offices, all to avoid contaminating those facilities with Covid 19 virus so what places should we have expected people to avoid?
I wonder if anyone who made the decisions on the actions and messaging have had conversations to capture the lessons learned from this pandemic and created an organizational memory [operating protocols] so people across the spectrum of organizations in the future can learn the lessons people have so personally invested in developing.

middle of the mit
Thu, 07/02/2020 - 11:14pm

This is why masks should have been mandatory from the beginning. America and it's "Freedom lovers" are the only thing that is making it worse and keeping the economy from opening up.

Most of the rest of the world is moving on, and not accepting us as visitors. I wonder why?

Matt
Sat, 07/04/2020 - 8:06am

Would it not make more sense to offer quarantine options to folks with underlying conditions (there's plenty of empty hotels!) or recommend for them higher level protections and let the virus move through the self-assessed more healthy populations or is too much personal agency for you? Given the nature of viruses this may likely be what you'll get anyway!

Jefferson
Sat, 07/04/2020 - 9:56am

Mit,

It is a proven fact that the masks people are wearing will not stop the coronavirus from passing through, and furthermore, increase their risk of infection - In the case of cloth masks, the CDC found an infection rate 13x higher.

Yet people are still forcing this mask issue as if it belongs anywhere other than inside a hospital where they wear costly surgical masks which are used in a sterile manner (the opposite of how we use them out in public in the non-sterile environment).

You can put a mask on my dead body - Based on what I see in all of the many cities I have visited during this "shutdown", it would appear that at least half of the state agrees with me.

middle of the mit
Sun, 07/05/2020 - 2:27am

Yeah....I get it. I am a stoopid dummy that doesn't know anything at all. What is the infection rate in Japan? Where face masks are worn without ANY vitriol?

Surgical masks are what I can purchase TODAY at less than $0.50/pc! Why can't you?

Because at first the professionals were asking you to not over compensate and purchase allllllll of the masks that were worthy of being COVID-19 resistant so that those could be saved for those in the hospitals?

https://www.nationalreview.com/2020/03/coronavirus-pandemic-japan-shows-...

Why are prominent Republicans now promoting wearing face masks?

I have given up. If you get it? You deserve it. At this point in time, if you can't see what you are dealing with, It is no longer my problem......

And YOU conservatives NO LONGER can blame Governor Gretchen.

This is ALL ON YOU!

GET READY!!!!

And I will make sure YOU OWN IT!

I am doing it with the dam and I will do it with this! Some one HAS TO SPEAK UP for lack of looking out for the least of us.

And take it from me............................you don't care about them., I don't care how many signs on your doorstep you have claiming your love for God.

If you did........YOU would step uP!

The LORD tells us one thing. In the end times , the love of man will wax cold.

Prepare yourselves, it is here!

And I am still looking out for you while you are beating on me!

Wait until they take you over!!

YOU might not like it.........others will..........who are they and why do WE listen to what they have to say? In the end, there has to be a bad person. And that is the devil. And in the end.................everyone who listens to the devil is disappointed in who the Devil really is.

Yet, who really wants the Devil to take over anything?

The least suspecting amongst us?

Do you really think that is me?

I don't know. I am just me. I am just telling you what IS happening! And I am tired of it!

Anonymous
Tue, 07/07/2020 - 9:21pm

Thank you, Middle, for your answer. You are much more patient than I am.

Gary Lea
Sun, 07/05/2020 - 9:11am

The CDC website contains quite a few pages related to cloth face covers:
Cloth Face Covers - "Use of Cloth Face Coverings to Help Slow the Spread of COVID-19," updated June 28, 2020
About Cloth Face Coverings
How to Wear Cloth Face Coverings
Washing Cloth Face Coverings
Making Cloth Face Coverings
Considerations for Wearing Cloth Face Coverings

Bones
Tue, 07/07/2020 - 2:05pm

Hey Bridge? Could you please start censoring obvious misinformation like this?

DL
Sun, 07/05/2020 - 7:51am

Sadly, these statistics are not surprising. My parents (70’s) are still not leaving the house. With all the media coverage on the recent ‘spikes,’ they plan to remain at home indefinitely. I am sure there will continue to be unnecessary deaths because of the fear of hospitals. I am afraid that my parents won’t ever come out. And that is not only sad for their mental health but quite possibly their physical health as well. They are not internet or social media people. They get all of their information from mainstream media and sadly, their pants have been scared off of them. The consequences of this lockdown are so multifaceted, we have only just begun to see the effects.

All Good
Tue, 07/07/2020 - 9:20pm

My Dad, 93, had a heart attack and was rushed to the hospital twice during the pandemic. He's was treated and after a couple of one-week stints is doing great. Guess it depends on the person/family. Trust doctors and science. Yes, doctors are only human and make mistakes, but generally speaking they are vert smart kind compassionate people who studied copious amounts of materials. They are worthy of our trust.

Fact
Fri, 07/10/2020 - 6:37pm

This article should not be considered credible. Chadi Alraies is not an attending physician. He is a cardiology fellow. I don’t understand how he could even speak on behalf of DMC.