This story was originally published on March 27, 2020
Even as coronavirus cases surge in every borough, city Health Department statistics indicate that residents of some neighborhoods have been far more likely than others to show up at hospital emergency rooms reporting flu-like symptoms.
But the numbers highlight the challenges of getting that life-or-death message out in many pockets of the city. The figures also underscore how many New Yorkers head straight to the ER when health trouble strikes — a tendency that threatens to further overwhelm a health system triaging COVID-19 patients.
“I suspect a good chunk of the increase we see could just be due to people being concerned and going to the ER with mild symptoms caused by a different pathogen,” said Dan Weinberger, an epidemiology professor at Yale University.
City health officials have declined to release coronavirus infection or hospitalization rates by neighborhood — and ER visits don’t mean everyone who arrives with symptoms has COVID-19.
But THE CITY’s analysis of the city health department’s data on influenza-related emergency room visits offered a window into neighborhoods where residents venture out to emergency rooms besieged by a health crisis that has dangerously stretched medical resources.
A Sixfold Hike
The area covering Jackson Heights, Corona and Elmhurst, Queens, recorded 1,357 ER visits by residents reporting flu-like symptoms last week — the most of any section of the city and nearly six times as many as during the same period in previous years.
Elmhurst Hospital has been flooded with emergency room visits and COVID-19 cases.
Brooklyn’s Sunset Park also logged a sixfold spike in flu symptom ER visits, as did Pelham/Throgs Neck in the East Bronx. The Upper East Side of Manhattan went from just ten visits in past years to nearly eight times as many last week.
While every neighborhood has seen a rise in residents’ ER visits, the increase is more modest in neighborhoods that include Jamaica and Rockaway in Queens, Hunts Point and Mott Haven in The Bronx, and Williamsburg/Bushwick in Brooklyn, which have seen a roughly threefold increase.
The numbers represent trips to emergency rooms anywhere in New York City by people living in those neighborhoods.
Pleas to Stay Home
Last week’s ER visit numbers jumped even after Mayor Bill de Blasio began pleading for New Yorkers showing all but severe symptoms to remain at home — a reversal of his previous advice to go out to get tested for coronavirus if symptoms did not abate.
So far, the city has spent $10 million on advertising a general stay-at-home message for all New Yorkers, in the subway, on TV, in print and online, said a mayoral spokesperson. It has also made explicit avoid-the-ER pleas, in English, on social media.
“Emergency medical care should be reserved for persons who are severely ill, and persons with milder illness need to be strongly encouraged to stay home,” advises the Department of Health and Mental Hygiene.
The city guidance strikes a different note than Gov. Andrew Cuomo, who has urged New Yorkers to get tested, including at state-sponsored drive-through centers. Statewide as of Thursday, more than 18,600 people have been tested each day, according to the governors’ office.
“Each test requires a new mask, gloves, and gown, and that equipment could be better used in treating severely ill patients in a hospital,” said Michael Lanza, a spokesperson for the city Department of Health. “If you feel like you need to go to the hospital, please contact a health care provider.”
Yet New Yorkers keep showing up at ERs for help by the thousands, with more than 4,400 mobbing emergency rooms since Monday for flu-like symptoms, the Department of Health numbers show.
Overall for the month through March 24, New York City ERs have seen triple the number of visitors with flu-like symptoms over previous years.
The number of such ER visitors spiked citywide on Wednesday— with nearly six times as many heading into ERs complaining of flu-like symptoms than did on average on that date in the previous four years.
In many neighborhoods, public health experts say, going to the emergency room as the first stop for medical conditions is an ingrained habit for many people seeking care in an often indifferent health system.
“Low-income people know they can go, they’ll be treated, the law requires that the ER see them and at least stabilize or triage the situation,” said Michael Sparer, chair of health policy and management at Columbia University’s Mailman School of Public Health.
“New York City has been a place that historically and traditionally we have found that the ER really is part of the health delivery system for low-income populations,” he added.
Government officials keep trying to get the message out to stay away from besieged emergency rooms, in hopes of stemming the deadly bug’s spread.
“This is an urgent plea at a critical point in fighting this pandemic — stay home,” said Councilmember Andy Cohen (D-The Bronx), a Democrat on the City Council’s health committee.
“The responsibility is on all of us to keep health care access and emergency services available for those who critically need it,” said Cohen, whose district includes Kingsbridge and Riverdale.
Last week, 253 residents in the Kingsbridge-Riverdale area visited emergency rooms for flu-related symptoms, nearly five times as many as in previous years, the city health stats show.
Phone Hotline for Symptoms
The office of Bronx Borough President Ruben Diaz Jr. also has been urging borough residents experiencing mild symptoms to avoid the ER.
“The vast majority of sick people will self-resolve and must stay home taking all safety precautions for 14 days,” said spokesperson Alina Suriel, citing city Department of Health directives.
People experiencing severe symptoms, or symptoms lasting more than three or four days, are directed to get screened by a doctor via Facetime or Skype. If hospital admission is recommended, they will be admitted to the hospital by appointment.
The city Department of Health and Mental Hygiene urges anyone experiencing symptoms such as fever, cough or aches and have existing health conditions to call 1-844-NYC-4NYC to connect with services and to get screened for coronavirus testing.
“This story was originally published by THE CITY, an independent, nonprofit news organization dedicated to hard-hitting reporting that serves the people of New York.”
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