VANCOUVER -- After a 50 per cent drop in patients at many Metro Vancouver hospitals, one of the region’s top emergency doctors is urging people who need medical attention not to avoid emergency departments or doctors’ offices.

Dr. Daniel Kalla is head of emergency medicine at St. Paul’s hospital and Providence Health Care and says “staggering” drops of 40 per cent attendance at his hospital and 50 per cent at Mount Saint Joseph, which are consistent throughout the region, indicate serious health issues aren’t being addressed by medical professionals.

“Injuries we would expect to be down because people are working from home and sports are basically shutdown, so that’s not surprising, but it’s the other stuff that concerns us,” said Kalla. “We’re seeing a decrease in everything — from the number of strokes and heart attacks to mental health issues and we believe a lot of this is because people are afraid and cloistered at home.”

He points out many health problems, particularly cardiovascular issues like strokes, are time-sensitive and require immediate help from trained professionals, but he believes fear of contracting COVID-19 and a misguided belief that hospitals are too busy to see patients are keeping people away.

“Not only are we open for business, we have lots of space,” said Kalla. “We’re safely segregating COVID and infectious diseases from the non-infectious diseases and issues and we now have more capacity than we’ve had in 20 years to manage patients in the emergency department.”

Doctors of BC raised similar concerns about patients staying away two weeks ago and says as of April 21, visits to most doctors’ office are still 25 to 50 per cent below normal.

“I don’t want people to neglect any of their medical conditions. If you have a concern and you’re not sure if it’s serious or not, absolutely bother your doctor — that’s what they’re there for,” said Dr. Kathleen Ross, president of Doctors of BC, earlier this month.

In March, Dr. Linda Jando told CTV News her medical clinic was so swamped, they only had a fraction of personal protective equipment needed to see the volume of patients, but now her staff are following up with patients, especially those with chronic health conditions they haven’t heard from in a while.

“I would love it if all our patients picked the phone and called us,” said Jando, who worries that even relatively minor issues like skin conditions or mild infections could become worse. “Don’t wait. When you wait, things can get out of control and more difficult to manage.”

Like every doctor in the province, Jando is asking patients of her Aquarius Medical Clinic in Yaletown to call in advance to see if a video consultation over a secured service will suffice, or if an in-person consultation is required. Those who do go for an in-person appointment are kept separate from patients who may have COVID-19 symptoms and are immediately masked and taken into an exam room away from other patients.

Walk-in clinics may not survive pandemic

Family practices already operate with a full patient roster and are counting on patients getting the message they’re still open for business and will gradually come back, but for walk-in clinics they’re already dealing with layoffs and even temporary closures.

“People are spooked,” explained Mike McLoughlin of Clinics BC, who also operates his wife’s walk-in clinic in Kelowna, where business is down a crippling 60 per cent. ​

“It just doesn’t make sense to stay open so we’re going to be closed in May,” said McLoughlin, since his doctors are paid according to how many patients they see. “I’m sure a lot of clinics are suffering significantly because all of the problems small business are having, clinics are having and it’s going to be a challenge going forward.”

While the health minister has urged British Columbians to seek medical care as emergency room visits have plummeted, he hasn’t addressed the business challenges private practitioners face.

“The health care system is there for [patients],” said Adrian Dix. “There are many many people struggling with non-COVID19 conditions right now and that system is there for you.”

Doctors bracing for higher death rate

Since the pandemic began, many doctors have been bracing for a surge in deaths — which aren’t necessarily a direct result of COVID-19.

In the hardest-hit areas like Italy and Spain, officials have revealed the number of deaths far above the average, with many not attributed to the coronavirus, but rather a lack of access to medical care since their hospitals have been full of critical COVID-19 patients leaving doctors and nurses with little time to care for those with heart attacks and other acute problems.

Kalla already expects BC’s death rate to rise as a result of the fear of contracting COVID-19 at a hospital or doctors’ office or the reluctance to impose on a health care system that some wrongly believe to be overwhelmed.

“There’s so many factors but we knew right from the start with this [pandemic] that the collateral damage to other people and other conditions would be huge.”