Background On February 26, 2020, the first case of coronavirus disease 2019 (COVID-19) was detected in Israel. The Ministry of Health (MoH) instructed people to take isolation measures and restrict their movement. Similarly, there was a gradual decrease in the number of visits to our emergency department (ED).
Objectives To describe the decline in the referrals to the ED and in-hospital beds occupancy during the COVID-19 pandemic and to compare it to the H1N1 2009 pandemic.
Methods Employing a cross-sectional epidemiologic study, the pattern of visits to the ED during the COVID-19 was compared with the pattern of visits during the 2009 H1N1 pandemic, as well as a year without a pandemic. The data was adjusted to consider changes in population size. The Welch t test for unpaired, unequal samples was used to analyze the data.
Results Within 2 months of the COVID-19 outbreak, the average number of visits to the ED dropped by 30.2% and the hospital occupancy by 29.2% (a minimum of 57%), compared to the same period, the year before. In comparison to the same period during the H1N1 outbreak, we witnessed a significant decline in the number of visits to the ED during the COVID-19 outbreak.
Conclusion The behavior of people during the COVID-19 pandemic was different from their behavior during the H1N1 pandemic. People seemed to avoid visiting the ED. The boundary between precaution and panic in the generation of the media could be very thin. Decision-makers must take this into account.
Giunta DH, Pedretti AS, Elizondo CM, et al. Analysis of Crowding in an Adult Emergency Department of a tertiary university hospital. Rev Med Chil. 2017;145(5):557-563. doi:10.4067/s0034-98872017000500001
Schull MJ, Mamdani MM, Fang J. Community influenza outbreaks and emergency department ambulance diversion. Ann Emerg Med. 2004;44(1):61-67. doi:10.1016/j.annemergmed.2003.12.008
Xu RH, He JF, Evans MR, et al. Epidemiologic clues to SARS origin in China. Emerg Infect Dis. 2004;10(6):1030-1037. doi:10.3201/eid1006.030852
Trifonov V, Khiabanian H, Rabadan R. Geographic dependence, surveillance, and origins of the 2009 influenza A (H1N1) virus. N Engl J Med. 2009;361(2):115-119. doi:10.1056/NEJMp0904572
Central Bureau of Statistics. https://www.cbs.gov.il/he/settlements/Pages/default.aspx?subject=%D7%90%D7%95%D7%9B%D7%9C%D7%95%D7%A1%D7%99%D7%99%D7%94. Accessed April 2020.
Schanzer DL, Schwartz B. Impact of seasonal and pandemic influenza on emergency department visits, 2003-2010, Ontario, Canada. Acad Emerg Med. 2013;20(4):388-397. doi:10.1111/acem.12111
Costello BE, Simon HK, Massey R, Hirsh DA. Pandemic H1N1 influenza in the pediatric emergency department: a comparison with previous seasonal influenza outbreaks. Ann Emerg Med. 2010;56(6):643-648. doi:10.1016/j.annemergmed.2010.03.001
Sivey P, McAllister R, Vally H, Burgess A, Kelly AM. Anatomy of a demand shock: Quantitative analysis of crowding in hospital emergency departments in Victoria, Australia during the 2009 influenza pandemic. PLoS One. 2019;14(9):e0222851. doi:10.1371/journal.pone.0222851
Bishop JF, Murnane MP, Owen R. Australia's winter with the 2009 pandemic influenza A (H1N1) virus. N Engl J Med. 2009;361(27):2591-2594. doi:10.1056/NEJMp0910445
Isaacs D. Lessons from the swine flu: pandemic, panic and/or pandemonium? J Paediatr Child Health. 2010;46(11):623-626. doi:10.1111/j.1440-1754.2010.01912.x
Srinivasan R. Swine flu: is panic the key to successful modern health policy? J R Soc Med. 2010;103(8):340-343. doi:10.1258/jrsm.2010.100118
Ahmad AR, Murad HR. The impact of social media on panic during the COVID-19 pandemic in Iraqi Kurdistan: online questionnaire study. J Med Internet Res. 2020;22(5):e19556. doi:10.2196/19556
Basis F, Or J. Emergency department under missile strikes: emphasizing the intrinsic factors for overcrowding. Emerg Med. 2012;2(6):118. doi:10.4172/2165-7548.1000118
Sarit A-A. The closure has a price: a 22% increase in mortality at home; Patients do not come for treatments. https://www.ynet.co.il/health/article/SyuSs5t008. (Hebrew). Accessed May 2020.
Solomon MD, McNulty EJ, Rana JS, et al. The Covid-19. N Engl J Med. 2020. doi:10.1056/NEJMc2015630
Basis, F., Zeidani, H., Hussein, K., & Hareli, S. (2022). Drastic Reduction Inpatient Visits to the Emergency Department in a Hospital in Israel During the COVID-19 Outbreak, Compared to the H1N1 2009. International Journal of Health Policy and Management, 11(4), 429-433. doi: 10.34172/ijhpm.2020.151
MLA
Fuad Basis; Hisam Zeidani; Khetam Hussein; Shlomo Hareli. "Drastic Reduction Inpatient Visits to the Emergency Department in a Hospital in Israel During the COVID-19 Outbreak, Compared to the H1N1 2009". International Journal of Health Policy and Management, 11, 4, 2022, 429-433. doi: 10.34172/ijhpm.2020.151
HARVARD
Basis, F., Zeidani, H., Hussein, K., Hareli, S. (2022). 'Drastic Reduction Inpatient Visits to the Emergency Department in a Hospital in Israel During the COVID-19 Outbreak, Compared to the H1N1 2009', International Journal of Health Policy and Management, 11(4), pp. 429-433. doi: 10.34172/ijhpm.2020.151
VANCOUVER
Basis, F., Zeidani, H., Hussein, K., Hareli, S. Drastic Reduction Inpatient Visits to the Emergency Department in a Hospital in Israel During the COVID-19 Outbreak, Compared to the H1N1 2009. International Journal of Health Policy and Management, 2022; 11(4): 429-433. doi: 10.34172/ijhpm.2020.151