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Fewer patients showing up at ERs as hospitals prep for Covid-19 surge

The emergency departments at area hospitals will be the first to be hit with the expected surge in Covid-19 cases, so hospital officials are preparing by erecting tents in their parking lots, among other moves.

So far, the surge hasn't hit.

Emergency department patient loads have trended downward at area hospitals in the past week. At some hospitals, the number of emergency department patients plummeted.

At Erie County Medical Center, from Monday through Wednesday, the emergency department staff treated 247 patients, down from 389 during the first three days of last week – a 36.5% drop.

At Kaleida Health's hospitals, the number of visits decreased 20% from last week, senior vice president Michael P. Hughes said.

At Oishei Children's Hospital, the drop was 38%.

"Volume in the emergency department is a little bit lower, and I'm hearing that with other hospitals around our region," said Anne E. McCaffrey, CEO of Eastern Niagara Hospital in Lockport.

"I think it's probably going to be a week or two out before we see the number here that we're expecting," McCaffrey said. "What I'm hearing from the state is they expect the surge to come everywhere in the state.

"I think a lot of patients are trying to avoid the emergency room to free up those spaces for people who might have Covid-19," McCaffrey added.

She offered another possible reason: "People are trying to not come in contact with anyone who may have it."

A spokesman for ECMC, the region's leading trauma and fracture center, speculated the decreased emergency department use stems from people obeying the state's stay-home order and simply not getting hurt.

"There are fewer emergency department visits, which typically would include cases like fractures," spokesman Peter K. Cutler said.

Many fracture cases in ECMC's emergency room are transferred from other hospitals.

Another factor may be that crime seems to be down in Buffalo, police said this week. Last Saturday, there was only one arrest in the city.

But there has been one area of increase in the ECMC emergency department: people coming in fearing they have Covid-19.

There were about 50 patients in the ECMC emergency department with Covid-like symptoms in the past week, a number that doubled from last week.

Eight of those patients turned out to have the virus, Cutler said. Three of them have since been released, and five were admitted and remained hospitalized as of Thursday, Cutler said.

ECMC has patients in 24 ICU beds. It has increased the number of available ICU beds from 36 to 53 in response to state demands for more ICU beds.

While most emergency departments are quieter, the impact of Covid-19 already is being felt in regional hospitals. As of Thursday evening, Buffalo General Medical Center reported 11 confirmed cases, including seven patients in separated medical-surgical rooms and four in the ICU; 26 patients were suspected to have the virus and 37 others tested negative for it, Hughes said.

There were seven confirmed cases at Millard Fillmore Suburban Hospital in Amherst, including four patients in the ICU, 18 under investigation and 10 who tested negative.

At DeGraff Memorial, another Kaleida facility, there is one confirmed case.

As of Friday, ECMC had 10 Covid-19 patients, two of whom were in intensive care beds on respirators, Cutler said.

Catholic Health spokeswoman JoAnn Cavanaugh said there were 18 Covid-19 patients in that group's facilities as of Friday.

Kaleida now requires all staff, vendors and visitors – as well as patients suspected to have the novel coronavirus – to wear masks while in its hospitals.

“We continue to see and treat the majority of coronavirus cases across the community,” President and CEO Jody Lomeo said in a statement. “Our clinical leaders believe that universal masking is the best approach as we deal with this current stage of the pandemic.”

An exception to the trend of fewer emergency department patients is Catholic Health, where Cavanaugh said the patient load has increased.

The Catholic hospitals are preparing for an anticipated Covid-19 increase by erecting tents outside the emergency departments at Mercy and Sisters of Charity hospitals in Buffalo, as well as Kenmore Mercy Hospital, Mount St. Mary's Hospital in Lewiston and the Mercy Ambulatory Care Center in Orchard Park.

"The tents, which have heat, light and medical record capabilities, will allow us to safely triage and assess those who can be evaluated and discharged to home quickly, from those needing further testing or inpatient care," according to a Catholic Health statement.

For the same purpose, Cutler said ECMC also has erected two tents in a corner of its parking lot near the behavioral health outpatient building.

Kaleida intends to erect tents this weekend, Hughes said.

The pace has been slow in the emergency department at Niagara Falls Memorial Medical Center. Thursday morning, only four patients were treated. Last week at the same time, there were five. Wednesday afternoon, there was only one patient.

"I'm thinking the message is getting out there," said Patrick J. Bradley, Niagara Falls Memorial's director of communications and emergency management.

That message, shared by health officials since the virus outbreak began, stressed that those worried about their symptoms should call their primary care physician for advice and not go directly to an emergency department.

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