Abstract
On March 13, 2020, the United States declared a national emergency to combat coronavirus disease 2019 (COVID-19). As the number of persons hospitalized with COVID-19 increased, early reports from Austria (1), Hong Kong (2), Italy (3), and California (4) suggested sharp drops in the numbers of persons seeking emergency medical care for other reasons. To quantify the effect of COVID-19 on U.S. emergency department (ED) visits, CDC compared the volume of ED visits during four weeks early in the pandemic March 29-April 25, 2020 (weeks 14 to 17; the early pandemic period) to that during March 31-April 27, 2019 (the comparison period). During the early pandemic period, the total number of U.S. ED visits was 42% lower than during the same period a year earlier, with the largest declines in visits in persons aged ≤14 years, females, and the Northeast region. Health messages that reinforce the importance of immediately seeking care for symptoms of serious conditions, such as myocardial infarction, are needed. To minimize SARS-CoV-2, the virus that causes COVID-19, transmission risk and address public concerns about visiting the ED during the pandemic, CDC recommends continued use of virtual visits and triage help lines and adherence to CDC infection control guidance.
Highlights
Morbidity and Mortality Weekly ReportAn increase of >100 mean visits per week from the comparison period to the early pandemic period occurred in eight of the top 200 diagnostic categories (Table)
74% are reported within 24 hours, with 75% of discharge diagnoses typically added to the record within 1 week
An average of 3,173 hospitals reported to National Syndromic Surveillance Program (NSSP) nationally in April 2019, representing an estimated 66% of U.S emergency department (ED) visits, and an average of 3,467 reported in April 2020, representing 73% of ED visits
Summary
An increase of >100 mean visits per week from the comparison period to the early pandemic period occurred in eight of the top 200 diagnostic categories (Table) These included 1) exposure, encounters, screening, or contact with infectious disease (mean increase 18,834 visits per week); 2) COVID-19 [17,774]; 3) other general signs and symptoms [4,532]; 4) pneumonia not caused by tuberculosis [3,911]; 5) other specified and unspecified lower respiratory disease [1,506]; 6) respiratory failure, insufficiency, or arrest [776]; 7) cardiac arrest and ventricular fibrillation [472]; and 8) socioeconomic or psychosocial factors [354].
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