Volume and Acuity of Emergency Department Visits Before and After COVID-19

Butt, Adeel A.; Azad, Aftab; Kartha, Anand; Masoodi, Naseer; Bertollini, Roberto; Abou-Samra, Abdul-Badi

Abstract Background There are scant data regarding the change in volume and acuity of patients presenting to Emergency Departments (ED) after COVID-19 compared with the pre-COVID-19 era. Objective To determine ED volumes and triage acuity before and after COVID-19. Methods We determined the volume of patients presenting to four large EDs affiliated with a general, cardiac, cancer and obstetrics hospitals, and the acuity of presenting illness (using the Canadian Triage Acuity Scale, CTAS) for March and April 2020 and compared them with the same months in 2019 and January 2020. Together, these facilities see over 80% of the ED visits in Qatar. First COVID-19 patient in Qatar was diagnosed on February 29, 2020. Results A total of 192,157 ED visits were recorded during the study period. There was a 20%-43% overall drop in ED visits with significant variability across hospitals. The Heart Hospital experienced the sharpest decline (33-89%) while the National Center for Cancer Care and Research experienced the least decline in volumes. The decline was observed across all CTAS levels, with the largest decline observed in individuals presenting with CTAS 1 and 2 (26-69% decline month-on-month). No increase in overall number of deaths or crude morality rate were observed in the COVID-19 era according to national statistics. Conclusions Sharp declines in ED visits and the triage acuity seen in both general and specialty hospitals raise the concern that severely ill patients may not be seeking timely care, and a surge may be expected once current restrictions on movement are lifted.