Dominick Battel woke up with tightness in his chest. He brushed off the pain — figuring it was likely another bout of heartburn — and spent that Sunday in mid-April playing tag with his kids and painting the deck.
His wife, Cortney, wasn’t too concerned. Even when they started dating, Dominick had struggled with some heartburn that usually went away on its own. But later that night, after Cortney put the kids to bed, she heard him call for her to come downstairs. She took one look at her husband and knew it was something serious.
“I don’t know what’s wrong with me. I think I’m having a heart attack,” Dominick said.
Cortney grabbed the phone to dial 911, but Dominick was hesitant to go to the hospital.
At that time, the United States was just coming off the heels of what health officials called the “Pearl Harbor moment” of the coronavirus pandemic. Pennsylvania — where the Battels lived — was considered a hot spot state, with the number of cases rising daily. Cortney and Dominick often wondered what they would do if someone in the family needed to go to the emergency room.
“You’re not supposed to go unless you absolutely can’t breathe," Cortney said. "Maybe he just didn’t think whatever he was experiencing warranted that much of an emergency visit because we were told don’t go unless you’re about to die, these beds are reserved for COVID. That was the message that stuck with us.”
She listened to her gut and called anyway. Still, even when paramedics were at the house, Dominick dragged his feet about going to the hospital. Finally, he gave in.
“He stood up to go with them. We said, 'I love you.' We kissed.” Cortney recalled. "And he went down."
Paramedics immediately tried to revive him, but it was too late. Battel died of a heart attack in his home. He was 38.
Since the beginning of the COVID-19 crisis in the U.S., visits to the emergency room for reasons other than coronavirus dropped drastically, according to a recent Centers for Disease Control and Prevention report.
“People are terrified of the emergency setting,” said Dr. Reed Caldwell, an ER doctor at NYU Langone Health which saw up to a 50% reduction in the number of patients reporting to their emergency department. “Mostly, they don’t want to get COVID.”
Physicians are worried that the perception of the hospital has changed during the pandemic from a place that’s safe to one that’s dangerous.
“People were seeing images of body bags in hospital hallways and U-Hauls in New York. That became their reality,” Dr. Patricia Iris, medical officer of Lodi Memorial Hospital in California, said.
The message: Come back. It’s safe.
“We’re here, we’ll keep you safe and we’ll take really good care of you, I promise,” said Dr. Camilla Sasson, vice president of science and innovation for cardiovascular care at the American Heart Association. “If you think you’re having symptoms or signs of a stroke or heart attack or you see somebody drop in front of you, call 911, come to the hospital.”
Protecting patients from coronavirus
During the pandemic, thousands of people who would normally go to the ER for bone sprains, injuries and vomiting have stayed home. But doctors are most concerned about those avoiding care for America’s big killers: heart attacks and strokes.
Recent statistics show 911 calls for heart attacks are down 30% and for stroke, 20%. That suggests people aren’t calling for help when they need life-saving care. For both conditions, every minute counts.
“These are symptoms that don’t just go away on their own. That person is a ticking time bomb and needs treatment,” said Iris.
Dr. Alexander Merkler, a neurologist at NewYork-Presbyterian/Weill Cornell, has seen stroke patients who were afraid of getting coronavirus and came in too late for time-sensitive treatment.
“They’re deteriorating by the time they get here. We can’t preserve your brain if you don’t get to the hospital in time,” he warned.
His biggest worry are the ones he never sees.
“Some people never even become patients because they’re dying at home,” said Merkler. “That’s really scary and really tragic.”
More than 100,000 Americans have died from COVID-19. But it’s not yet known how many have died from other preventable causes either because they were afraid to go to the hospital or were told not to.
While the pandemic’s ripple effect may never be entirely known, there are lives that could have been saved. And still can be.
Lodi Memorial in California has experienced a 65% drop in emergency department visits during the pandemic compared to last year. The 150-bed hospital learned that people were avoiding the ER not only for fear of getting infected from other patients, but because they feared the hospital wouldn't be able to provide care for people who came in with other conditions and they worried that they would take resources away from someone more critically ill.
Many patients said they wanted information about what kind of cleaning and screening protocols the hospital was taking to keep patients’ safe.
Lodi Memorial has since physically divided the emergency department so patients with non-COVID related concerns are waiting, screened and treated in separate areas than those with respiratory symptoms. They’ve also widely communicated about special precautions they’re taking to reduce the risk of COVID-19 infection. It seems to be working. More patients are starting to trickle back to the ER. They’re now seeing a 25% drop in volume compared to the 65% drop they were seeing in April.
Despite fears of infection, it’s important to know the signs of heart attack and stroke.
Heart attack symptoms
- Chest pain
- Pain or discomfort in one or both arms, the back, neck or jaw
- Shortness of breath
- Sudden face drooping
- Weakness in an arm or leg
- Difficulty with speech
Cortney and her kids are now navigating life as a family of three.
“Our story wasn’t over," Cortney said. "This isn’t how it was supposed to be.”
She’s sharing her story with the hope that it might save others from the same heartbreak.
“Go to the ER, if you’re not sure. Do not let COVID get in the way.”