Fallout from virus fear: Hospitals, clinics see plunging patient numbers

HARLINGEN — Fear of catching the coronavirus is keeping patients away from hospitals and clinics, spurring a financial crisis that’s threatening the nation’s health care system.

Amid patients’ fear, federal guidelines prompting a month-long ban on elective surgery have also cut deeply into hospital revenues.

Across the country, some hospitals are furloughing staff while many clinics and private practices are struggling to survive.

For about six weeks, many residents have been putting off health care, risking recovery — and even death.

“ The impact of COVID-19 on all hospitals in the Rio Grande Valley has been quite significant,” Jennifer Bartnesky-Smith, chief strategy officer with Valley Baptist Medical Center, said. “It’s pretty impactful to our industry.”

At the hospital, officials are furloughing an undisclosed number of employees.

“ Most were furloughed for 90 days. Some folks will come back earlier,” Bartnesky-Smith said. “We want to bring them back as soon as we can but there isn’t a definite time.”

Meanwhile, the month-long ban on elective surgeries cut deeply into hospital revenues.

At Valley Baptist Medical Center, the ban led to a 40 percent drop in revenue derived from surgeries, Bartnesky-Smith said.

Plunging patient numbers

As the COVID-19 virus spread across the country, hospitals geared up for a “surge” of patients — only to see plunging numbers.

“ Instead of seeing a surge, there has been a huge drop,” Dr. Edward Mason, part of a team of doctors operating Harlingen Medical Center’s emergency room, said. “It’s been one-and-a-half months. The volume has fallen off the cliff. We have all been very surprised.”

At the hospital, fear of the virus has led to a 63 percent drop in emergency room patients, leading the doctors’ group to “dramatically” cut employee salaries and hours, Mason said.

“ The longer this goes on and people are afraid to go out and seek medical care, the medical profession itself is injured,” he said. “There are practices in the medical profession that will not recover.”

At Su Clinica, where case loads fell 35 percent last month, “several million” federal dollars have kept the state clinic from shutting down while the stimulus bill has helped hold back layoffs, Dr. Elena Marin, the clinic’s chief executive officer, said.

“ If we hadn’t received that funding, we would have had to close our doors,” she said.

Meanwhile, she said the stimulus bill’s Payroll Protection Plan has pumped money to help the clinic avoid layoffs.

“ We haven’t let anyone go so far,” she said.

Privately-owned clinics

Across the country, fear of the virus has led privately owned medical clinics to lose as much as 50 percent of their patients.

“ We’ve seen a decrease,” Dr. Mario Sanchez, Willacy County’s medical director who operates clinics in La Feria and Raymondville, said. “They get concerned about (the virus) so people are sitting at home. A lot of them don’t want to come into a clinic or ER so there are less people coming in.”

In San Benito, the VHC Family Health and Night Clinic has seen patient numbers drop 30 to 40 percent, owner Israel Vega, a family nurse practitioner, said.

“ Their fear is getting the virus and the family fears (infecting) the elder mother and father,” he said.

Some patients, he said, believe they should isolate themselves to protect them against the virus.

“ They think they have to quarantine themselves,” Vega said.

Delaying medical care

At hospitals and clinics, doctors warned residents against delaying medical care.

“ People are terrified of coming in, especially if they’re not acutely ill and are not having symptoms,” Marin said.

“ Since the orders of social distancing and shelter-in-place and avoiding crowds, we’ve seen patients, especially those coming in for preventive illnesses, who we believe are not interested in coming into a crowded lobby where there might be COVID,” she said, referring to the recently lifted federal guidelines that led to state and local stay-home mandates while limiting gathering sizes to prevent the virus’ spread.

Many patients are delaying medical care until they believe the virus no longer poses a threat.

“ We have individuals we believe who want to ride out emergencies if they’re not having acute symptoms,” Marin said.

Doctors warn delaying medical care often worsens patients’ conditions, sometimes leading to death.

“ We see people coming in sicker than they’d usually come in because they’re afraid of going to the hospital,” Mason said. “The longer you wait, it’s sometimes harder for people to get well and sometimes they don’t get well — they succumb to illness.”

At his clinic, Vega is concerned patients suffering diabetes, heart disease and hypertension are delaying medical care.

“ A lot of my elderly patients haven’t come in,” he said. “Their symptoms are going to get worse.”

Vega said many of his patients also fear entering pharmacies to refill prescriptions.

“ We know these people are not getting their medicine at all,” he said.

Preventive measures

At hospitals, officials have implemented high degrees of preventive measures aimed to assure patients’ safety.

“ Hospitals are some of the safest places to be because we screen every single person who comes to our doors every single day,” Bartnesky-Smith said, referring to screenings for virus symptoms. “We have strong infection-control practices in place.”

At the hospital, patients who have contracted the virus are isolated.

“ We have dedicated units separated and isolated from the rest of the hospital,” Bartnesky-Smith said.

At Harlingen Medical Center’s emergency room, five rooms equipped to treat patients who have contracted the virus have been isolated and “blocked off” from the rest of the hospital, Mason said.

“ Everything is being done to protect you against the virus,” he said. “You don’t even get into the building without being screened.”

Meanwhile, staff is equipped with personal protective equipment.

“ People come in and out in full protective gear,” Mason said, referring to his staff.

At his office, Vega takes full precautions to protect patients and staff.

“ We sanitize every morning, after every patient — everything, even handles,” Adam Abrego, the practice administrator, said.

Transforming medical visits

The COVID-19 outbreak is changing the way doctors see their patients.

As a result of the pandemic, state officials have waived traditional in-person office visits, Marin said.

Now, doctors are conducting visits via telephones and telemedicine, which includes audio and visual features.

“ In April, we transformed operations to telephonic visits and telemedicine,” Marin said. “The bottom line is we’re making due to care for our patients.”

This week, Harlingen Medical Center plans to use its website to launch a telemedicine portal, Mason said.

“ For those people who are scared, they will have a method,” he said, adding, “It is no substitute for coming to the emergency room.”

Like Sanchez’s clinics, Vega’s office is also conducting teleconferences with his patients.

Outside, he’s seeing patients with symptoms “curbside.”

“ We don’t have any sick people in the building,” Abrego said. “Anyone with a cough or any symptoms is seen curbside, in full personal protective equipment.”

Media concerns

Many doctors believe the news media has heightened patients’ fear of the virus.

“ When you hear stories every single day in the media, that impacts feelings,” Marin said. “All of this is anxiety-producing.”

Mason said the media has focused on the COVID-19 virus unlike its coverage of dangerous viruses.

“ There’s so much fear generated by the media, it’s beyond the necessity,” he said.

“ There have been dangerous viral illnesses in the past that have infected populations and we have not had shutdowns and people were able to walk out of their house,” he said, referring to the business shutdown aimed at limiting gathering sizes and federal guidelines leading to state and local shelter-in-place orders mandating residents without justifiable reasons stay home.

Mason said the virus tends to lead to complications in elderly patients and those with underlying health problems.

“ The overwhelming majority are elderly and nursing home (patients) with chronic illnesses prior to this,” he said, referring to the majority of patients who have died after contracting the virus.

Waiting for a vaccine

Around the world, health care systems are counting on the development of a vaccine to end the COVID-19 crisis.

“ We expect to be dealing with this until there’s a vaccine and the pubic is immune,” Marin said. “We could be dealing with this for a couple of years.”