In the weeks since the coronavirus pandemic started in earnest in the United States, many patients have either put off or stopped going to the emergency department for non-urgent medical problems, some out of a sense of civic duty and others because of fear of contracting the virus.
While this has helped clear the decks for treatment of the truly ill, some patients with potentially life-threatening illnesses are also opting to stay home and take their chances rather than risk infection.
The University of South Florida Comprehensive Stroke Center, based at Tampa General Hospital, is a major hub for stroke care and is typically one of the busiest such services in Florida.
State-of-the-art stroke treatment saves lives and can prevent lifelong disability, but in order to be effective, this therapy must be administered as soon as possible after symptoms appear.
Since the early beginning of the pandemic, the number of stroke patients seeking emergency care at Tampa General has dramatically declined, and those who do come have much more serious and established symptoms. This is almost certainly due to patients with stroke delaying or not seeking treatment until symptoms become severe, which is often too late. Our stroke colleagues in other Florida cities and around the United States report similar experiences.
A high level of anxiety about being in the hospital at this time is certainly understandable, however, medicine is all about relative risk. The overall risk of death from the coronavirus infection in this country has yet to be accurately determined, in part because we have not tested the vast majority of patients with mild or no symptoms, who may constitute as much as 86 percent of total infected according to recent data from other countries.
However, even among patients sick enough to qualify for a test in the United States — the clear minority of infected — the mortality rate appears to be about 2 to 4 percent. In contrast, the mortality rate for patients with untreated strokes ranges from 15 percent to 45 percent, and many more will be left with permanent disability.
The choice between seeking acute stroke treatment (and risking possible exposure to coronavirus) vs. continuing isolation at home and letting the stroke take its course is very clear: Get to the emergency room immediately. Time is Brain — for every minute a stroke goes untreated, a patient may lose up to 1.9 million brain cells.
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Always be aware of serious stroke symptoms — which usually begin abruptly — and remember the mnemonic F.A.S.T.: Facial drooping, Arm weakness, Speech difficulties and Time (time to get help as soon as possible by calling 911).
Patients with symptoms of a heart attack or other serious disease also need to seek emergency care immediately.
Dedicated medical teams are risking their lives every day to help save yours from all the usual suspects, not just coronavirus, and they are open for business 24/7.
Recognizing the greater threat, overcoming your fear and seeking help urgently can mean the difference between life and death.
Dr. Clifton Gooch is chair of neurology at USF Health, and Drs. David Z. Rose and Scott Burgin are vascular neurologists at the USF Health/Tampa General Hospital Comprehensive Stroke Center.