Fear of COVID-19 keeping Hamiltonians from hospital, but staff say they're here to serve

COVID-19 has been a top priority at Hamilton hospitals for weeks, but now administrators are worried a new enemy may keeping people from the care they need — fear.

St. Joseph's Healthcare Hamilton closely tracks the number of visitors to it psychiatric emergency service and noted those numbers have plummeted since the pandemic began.

"It's very clear that right around the time that the emergency order started … there was a distinct drop and it's continued to now where we've calculated it out at somewhere between 30 to 40 per cent less volume depending on the day," said Peter Bieling, vice-president of mental health and addiction.

It's an abrupt change staff didn't necessarily predict, and one that's causing concern that people with serious needs are going without treatment, he added.

"It wouldn't have been crystal clear to us that a psychiatric crisis or emergency could be avoided in some way," Bieling explained. 

"We do worry that people are putting off coming because they're worried ... they could be afraid or they could think their needs aren't important right now and the hospital has other things to focus on."

Those fears are especially acute for populations vulnerable to the virus, said Maxine Lewis, joint-chief of mental health and addictions for St. Joe's and Niagara Health.

"We're hearing particularly that older adults are very fearful of coming to the emergency department so that's a particular concern really given their psychological and physical issues," she said.

Hamilton's mayor has even stepped up to encourage people to look after themselves and whatever conditions they may be living with.

"As much as COVID has been an overriding issue for a lot of people in our community … our healthcare system is also still there for critical health needs," said Fred Eisenberger during a virtual town hall Wednesday evening.

He pointed to reports of people not calling ambulances because of concerns about possible exposure, but said the city's hospital aren't overrun.

"You should not be ignoring your normal health-care issues because of the COVID issue," said the mayor. "There's no fear of going into the hospital."

That's a message Bieling wanted to share too.

While the effects of COVID-19 will likely be around for some time to come, the wave that was projected to swamp health-care services doesn't seem to be headed toward hospitals anymore.

Fifty-seven people with the virus have been hosptialized in Hamilton so far. Eleven people were being cared for at St. Joe's as of Thursday afternoon, with another 17 at Hamilton Health Sciences.

But that's no reason for patients to be afraid, said Bieling.

"We have careful screening, careful testing, lots of personal protective equipment and we can take care of people who come."

With all the attention on COVID-19 and making space for the anticipated surge in patients, some people might not even realize hospitals are still open to serve, according to Lewis.

About 75 per cent of treatment the hospital normally carries out is now being done virtually. Still, that leaves 25 per cent of patients who are difficult to stay in contact with online or by phone.

"There is a big worry about how they're managing right now," she said.

Mobile service meeting patients where they're at

To close that gap St. Joe's is trying to meet its patients where they are, launching a new van service that delivers medication to people struggling with psychosis at home so they don't have to come into the hospital. 

"It's definitely as a result of the pandemic that we're even even thinking about this," said Bieling.

Staff are balancing a return to regular service while maintaining services for those with the virus.

They're preparing for a different type of surge — the potential that when the pandemic is declared over and those who have been deferring their treatment return to hospitals en masse.

One group they're already noticing might need more support is health-care workers who have been on the frontline.

"This has forced people to work in circumstances that can be pretty extreme," said Bieling. "It might cause what we think of as moral injury where people are having to make difficult decisions ... and that may have a lasting effect."