The missing A&E patients
The media has finally picked up on the truly unbelievable reductions in A&E attendances. Although this is something that I have already covered a month or so back, I thought it would be worth some quick comments.
It is only just dawning on the public that lockdown is forcing a choice between COVID patients and patients with life threatening yet treatable diseases such as early stage cancers. The latest data shows that A&E attendances were down by 57% in April, from 2.1 million in April 2019 to 917,000 in April 2020. There is a very real risk of increased non-COVID deaths, that could offset some of the benefits of lockdown. This continues to undermine the lockdown – which is still largely based on ‘scientific advice’ that is not available for critique.
Doctors of greater standing than I are pointing to the numbers suggesting that many of these missing patients have serious conditions – if the numbers of patients and their classifications are indeed correct. My observations of the initial figures are that the number of ‘missing’ A&E patients with serious conditions is very large compared to the current excess death rate.
Put another way, most of the patients presenting to A&E with serious symptoms are not actually dying. We have no idea how many are coming to harm – however I would suspect that it is only a minority of the missing presentations. In other words, there are a large number of patients for every patient we prevent coming to harm. We should seek to quantify this ratio when the COVID plague is over. It could enable us to ascertain how many A&E attendances are in fact non-life threatening or damaging and hence not as urgent as might be first supposed.
As previously stated, it is my belief that A&E should refuse service to presentations that are neither accidents nor emergencies as judged by medical staff, not the patient. Given how resource intensive A&E is, this could free up significant resources to plough into more preventative services, or indeed not spend at all.
The stated objective of the lockdown was to ‘flatten the curve’ to avoid overwhelming the NHS, not to stop the pandemic. For my money, I do not think we can economically survive lockdown until a vaccine is found. These latest figures make this even more evident.