Where have all the heart attacks gone?
Medical providers are worried about a new trend in health care: People who are afraid of COVID-19 are staying home instead of going to hospital emergency rooms when they are having heart attacks, strokes and other life-threatening conditions. The reality is that the emergency room is the best – and safest – place you can be. Emergency departments have the medical care and highly trained staff you need – and have taken necessary precautions to prevent the spread of infection.
Statistics indicate that the number of patients visiting emergency rooms nationwide has dropped by 40 - 50 percent since March. It's not surprising that people are reluctant to go to the ER, given news stories of hospitals overwhelmed with coronavirus cases. However, delays in treatment can cause complications, long-term health problems and even death.
Older adults are especially at risk because they are more likely to have cardiovascular disease, diabetes or other chronic medical conditions that make putting off emergency care especially risky.
Heart Attack Symptoms
Basmah Safdar, MD, director of the Yale New Haven Hospital Chest Pain Center, is concerned that people are staying home even if they’re suffering from a heart attack. “We are worried about these patients because without immediate treatment they may die or suffer lifelong disability. Heart attacks are still the number-one cause of death in the United States,” she said.
The most common symptoms of a heart attack include discomfort in the chest, shortness of breath and cold sweats. Those at higher risk for heart attack also include smokers and people with kidney disease, diabetes, high blood pressure or cholesterol, or existing heart disease.
“If somebody feels that they’re having a heart attack, call 911, come to the emergency department, and let us check you out,” Dr. Safdar said. “If you’re having symptoms that have been ongoing for a while, or you’re having it with fever and cough and you don’t think it’s a heart attack, at least call your doctor to understand what’s happening to make sure that it’s something that’s not dangerous or worrisome.”
Warning Signs of Stroke
According to Joseph Schindler, MD, clinical director of the Yale New Haven Health Stroke Center, the hospital has seen a decrease in stroke patients over the last two months. He said people who have minor signs of stroke may be reluctant to go to the emergency department because they’re afraid of being exposed to COVID-19. But even minor symptoms need attention.
“Stroke is a neurological emergency and there are time sensitive treatments for strokes so it’s especially important that when someone has symptoms of a stroke, that they call 911 and get to the emergency room immediately,” Dr. Schindler said.
Common signs of stroke include:
- Sudden onset of a severe headache
- Weakness or numbness in the face, arm or leg – especially on one side of the body
- Sudden confusion, trouble speaking or understanding speech
- Sudden vision problems in one or both eyes
- Sudden difficulty walking or dizziness, loss of balance or lack of coordination
An additional concern is that some people who are at high risk of stroke may be isolated due to social distancing during COVID-19. They don’t have their friends and family around as frequently to notice the signs of stroke. Dr. Schindler says that social networks are important in recognizing stroke and recommends staying in regular contact with loved ones, while practicing proper social distancing.
“Please know that if you do come to the emergency department at Yale New Haven Hospital, that we’ll evaluate you in a safe way to protect you and the practitioners that treat you,” Dr. Schindler said.
We’ll keep you safe when you need care
COVID-19 has changed the way we do things. Be assured that YNHH has a number of procedures in place to reduce any risks of infection and ensure that you are safe.
Do not delay seeking medical attention if you are experiencing life-threatening symptoms such as chest pains, slurred speech or a seizure. Call 9-1-1 immediately or go directly to the emergency department. Yale New Haven Hospital’s Emergency Departments at both the York Street and Saint Raphael campuses are fully staffed and ready to take care of you.
Our emergency department teams are well trained and equipped to protect you and themselves. They have an array of personal protective equipment (PPE) to keep you and others safe, including gloves, masks, face shields and gowns.
We use an advanced cleaning and disinfection process on all medical equipment, highly touched surfaces and frequently trafficked areas. We also keep patients who may have COVID-19 away from those with other health problems. Upon arrival at the ED, we ask people about their exposure risk and symptoms, and take their temperature to screen for fever. Anyone who has tested positive for the disease, or who is suspected of having it, is cared for in a separate area of the emergency room.
Have a new health concern? Require a check-up or follow-up visit? If you need to see a doctor for a non-medical emergency, in many cases you can schedule a telephone or video appointment with your healthcare provider instead of going to the office.
Nearly all of Yale New Haven Health’s Northeast Medical Group and Yale Medicine sites are continuing to provide “virtual visits” by telephone or real-time video. These visits are easy to set up on your phone and computer and will connect you directly with you physician. Call your doctor’s office using the same office number you would typically use to schedule a visit. The office staff can help you prepare for a visit by video or phone.
Video or telephone visits are available with pediatricians, primary care clinicians and many specialists across the Yale New Haven Health System.
Have questions about video visits and how to get started? Check out our video visit Frequently Asked Questions.
Is it allergies, or is it COVID-19?
Spring has sprung, and so have seasonal allergies. But this allergy season isn’t like previous ones. As the nation continues to tackle the spread of coronavirus cases, many people may now find themselves wondering if their sneezes and coughs are symptoms of the virus – or just seasonal allergies.
It’s true that there are some similarities between the symptoms associated with COVID-19 and allergies. People suffering from COVID-19 or allergies may experience dry coughs and difficulty breathing. However, there are several key differences.
According to the Centers for Disease Control and Prevention, the list of possible symptoms for COVID-19 include fever, chills and muscle aches — which may be commonly associated with the flu, but not with allergies.
Those suffering from allergies likely experience itchy and watering eyes, nasal congestion, and throat clearing, which are not typical COVID-19 symptoms, said F. Ida Hsu, MD, a YNHH-affiliated allergist and immunologist with offices in New Haven and North Haven.
“Allergies tend to cause itching of eyes and nose, and clear nasal discharge,” she said, “Except for a mild tingling sensation as an early symptom, itching and sneezing are not a prominent symptom of COVID.”
Another symptom of COVID-19 is a sudden loss of smell or taste, which does not generally occur in a patient who is experiencing seasonal allergies, according to Dr. Hsu. “With allergies a person just can’t breathe through their nose due to nasal congestion and obstruction,” she said. While there are allergy-related conditions that can lead to a decreased sense of smell and related taste, she explained, “those are generally chronic and slow in onset, not all of a sudden.”
The challenging symptoms to differentiate are cough and shortness of breath, especially in patients with asthma, according to Dr. Hsu. Both COVID-19 and allergies can cause cough, but for different reasons. “The ‘dry cough’ from infection with coronavirus is likely related to viral inflammation in the lungs,” she said.
“For many people with allergic rhinitis, the cough is secondary to post-nasal drip, and for some it is related to a flare of asthma, which may be associated with chest tightness or wheeze. Cough and shortness of breath from asthma may be triggered by either allergies or viral infections.” Dr. Hsu noted that a patient’s additional symptoms should be looked at to help determine what is likely going on.
Where can you get relief if you are suffering from seasonal allergies? Many allergy medications that used to require a doctor’s prescription are now available over the counter, including antihistamines, nose sprays and eye drops, said Dr. Hsu. It can be confusing, however, for people to know which ones are the best fit for their symptoms, so she recommends a call to a local board-certified allergist.
“We are available to guide you through this or offer other advice and therapies that are very effective for symptom prevention or relief,” she said. “Your allergist will likely be able to see you via telemedicine platforms. Even if they can’t perform testing at this moment, they can advise on likely triggers and treatment.”
Grief in the time of COVID-19
In collaboration with our Palliative Care Service, the Bereavement Service at Yale New Haven Hospital will offer a virtual bereavement seminar for those who have lost a loved one to COVID-19. The seminar is designed to provide education and support to those dealing with grief during an unprecedented time.
The seminar will be held on Tuesday, May 19 from 5:30 - 7:30 pm. There may be additional seminars in the future with the goal of eventually holding meetings in person once it’s safe to do so.
The free seminar will be hosted by Andrea Lucibello, LCSW, and Kelly Ford, LCSW. Both Lucibello and Ford are clinical social workers who host other bereavement support groups associated with Yale New Haven Health.
To register, call 203-415-8940 or email your name and telephone number to [email protected]. Once you call or email, you will have a conversation with Lucibello or Ford to discuss your particular circumstances. When you register, you will receive information about how to call in to the virtual seminar.
Avoid weight gain while staying at home
With restrictions during the coronavirus pandemic, you’ve been staying home for weeks. Stores, restaurants, gyms and fitness studios have been closed — but your refrigerator, pantry and cupboards are open for business. It’s no wonder that people are starting to worry about the so-called “quarantine-15” weight gain.
“If you are working from home or just in self-quarantine, you may have constant access to food. Sometimes eating gives us something to look forward to or breaks the boredom,” said Ellen Liskov, a registered dietitian at Yale New Haven Hospital.
The news also reminds us daily that those who are most vulnerable to the virus include people with chronic conditions — like diabetes and heart disease — that are related to diet and lifestyle factors. So what can you do to get on track and find the willpower to say “no” when the refrigerator beckons? Here are a few recommendations from Liskov:
- Give up grazing and pay attention to your hunger level. “One snack between meals is reasonable but if you are constantly grazing, it may be due to boredom, stress or other non-hunger issues,” said Liskov. “Before eating, ask yourself if you are really hungry.”
- Set reasonable meal and snack times. “If you feel the impulse to snack and it has been less than two hours since you last ate, drink a big glass of water and wait at least 10 minutes. The craving may go away,” she said.
- Stock up on canned vegetables. If fresh or frozen vegetables are difficult to access, remember that canned vegetables have fiber and vitamins and are low in calories. Look for “no-salt added” canned varieties if they are on your store’s shelves. If you can only find canned vegetables with salt, rinse them in a colander for 30 seconds and reheat in fresh water.
- Pick “smart” snacks. Foods such as fresh fruits, raw or roasted vegetables and air-popped popcorn give you the most bites for the least calories.
- Explore new recipes. Find a healthy vegetable recipe to add color to your plate. Consider heading outside to the grill and make a plate of vegetables, chicken and foil wrapped sweet potatoes. Make a smoothie with Greek yogurt, fruits and vegetables. “A smoothie can be very filling and even help with weight loss if used to replace less healthful foods or snacks,” said Liskov. Email Advancing Care for a smoothie recipe.
- Get some movement in your day. It’s important to try and move every single day, especially now. U.S. Dept. of Health and Human Services Physical Activity Guidelines recommend at least two and a half hours of moderate to vigorous aerobic activity per week and muscle strengthening activities at least two days per week for healthy adults. You don’t have to be drenched in sweat to get the health- and mood-boosting benefits of exercise. Go for walks or jog outside as long as you practice social distancing. If you don’t have any gym equipment at home, rely on your body weight for exercises, climb stairs, jog in place, add in jumping jacks, pushups, crunches, pull-ups and elastic resistance band exercises.
Looking for support? Virtual groups can help.
Coping with illness can be stressful to you and your family at any time, but perhaps most especially during these challenging days. Yale New Haven Hospital offers free support groups for patients and their caregivers or loved ones to help you to manage your feelings and concerns throughout your care. Support groups provide the opportunity to receive emotional and educational support and to talk with others who are undergoing similar treatment or who have successfully completed treatment.
YNHH’s social work team has transitioned many support groups to a virtual format where participants can gather through videoconferences. Many of the virtual groups are focused on specific cancer types, such as brain, breast, gastrointestinal (GI), gynecologic, head and neck, lung, melanoma, multiple myeloma, neuroendocrine, pancreatic and prostate. Others are intended for caregivers and surviving spouses. Current patients, survivors and families are welcome. Please call the appropriate contact number for the specific group and ask for details on how you can participate.
COVID-19 at YNHHS: By the numbers
How has YNHHS, its patients and staff fared during the pandemic? Here's a breakdown of numbers gathered by Yale Haven Health since the COVID-19 crisis began:
- Our COVID-19 Call Center, 833-ASK-YNHH (established on March 9) has answered more than 77,000 calls from the community and our staff.
- More than 1.6 million pieces of Personal Protective Equipment (PPE) have been donated by members of the community. Among those were 8,700 handmade masks and 107,000 N95 respirators.
- More than 16,000 N95 masks have been safely cleaned and reprocessed to be able to use again.
- Thanks to the support of state licensing boards, YNHHS has credentialed more than 800 new medical staff members to support our staff in caring for COVID-19 patients.
- Yale New Haven Health hospitals have admitted and treated nearly 3,000 COVID-19 patients.
- More than 2,000 COVID-19 positive patients have been discharged across our health system after being cared for by our healthcare teams.
- More than 100 nurses left their home hospital to assist patients at another system hospital.
- Nearly 53,000 meals have been either donated or promised to hospitals around our health system from local restaurants and community organizations.
- More than 91,000 outpatient telehealth visits have been conducted between Yale New Haven Health physicians and patients.
- In testing sites at all our hospitals, we have swabbed more than 35,000 people to test for COVID-19.
- YNHHS launched a Kudoboard on April 1 to encourage the community to post positive messages of support for our staff. Since then, we have received more than 1,400 notes of thanks and encouragement.
We continue to care for COVID and non-COVID patients in hospitals throughout our health system. We are starting to see the number of admissions slow down which is a very positive sign. Social distancing is helping and we encourage everyone to continue to do all they can to help end the spread of COVID-19 in our communities.
Thank you to our community
While we’ve been here for you throughout this pandemic, you’ve been here for us, too. Yale New Haven Health is grateful to our communities for the outpouring of love and support you’ve shown us throughout the COVID-19 pandemic.
Your messages of hope have inspired us. Your kindness has nourished us, protected us, and helped us keep our loved ones and our neighbors safe. For the personal protective equipment, the pizzas, the parades and everything in between – from the bottom of our hearts, thank you.
Here are some ways you can continue to show your support for caregivers on the front lines and contribute to donation efforts at our facilities.
Referrals for physicians and surgeons
YNHH provides free information about and referrals to more than 2,600 affiliated physicians 24 hours a day. Call 888-700-6543 or visit our Find a Doctor feature on the hospital website for information on physician specialties, office hours and locations as well as insurance plans accepted. YNHH physicians represent more than 70 medical and surgical specialties and subspecialties, including internal medicine/family practice, obstetrics/gynecology, orthopedics, pediatrics and psychiatry.
YNHHS patients: Do you have MyChart?
MyChart gives Yale New Haven Health System patients secure, online, 24/7 access to portions of your electronic medical record (EMR). There you can see your medical history, most laboratory and test results, appointment information, medications, allergies, immunizations and other health information. You can schedule appointments with your doctor, request or renew prescriptions, see your billing and insurance information and send and receive secure, confidential electronic messages with your doctor’s office. Sign up by using the activation code on the after-visit summary from your doctor, request a MyChart Activation Code at your next appointment or visit MyChart and follow the link for “Sign Up Now” under "New User?"
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Yale New Haven Hospital offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 203-688-2046.