COVID-19: what happened to all of the otolaryngology emergencies?
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LETTER TO THE EDITOR
COVID‑19: what happened to all of the otolaryngology emergencies? Matteo Gelardi1 · Lucia Iannuzzi2 · Eleonora M. C. Trecca1 · Brandon Kim3 · Nicola A. A. Quaranta2 · Michele Cassano1 Received: 14 April 2020 / Accepted: 10 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Keywords Emergency medicine · Critical care · Hospital administration · Ambulatory care · Primary health care · Otolaryngology · COVID-19 To the Editor, COVID-19 is a global pandemic caused by the novel coronavirus SARS-CoV-2, and Italy was the first European country to experience a large-scale outbreak. With this, every aspect of healthcare, the economy, and society has been deeply affected in Italy, so much so that fundamental changes are expected in the post-COVID-19 era. One aspect is that access to emergency care in Otolaryngology (ORL) patients has already changed in the month following the onset of the COVID-19 outbreak, and, seemingly, many non-COVID illnesses have been disappearing. Although the government did not enact any limitations or prohibitions to emergency access for patients afflicted by acute ORL pathologies, the number of daily urgent consultations to the ORL Departments in Bari and Foggia University Hospitals has significantly reduced and, on some days, was even zero. One possible reason for this change may be patients’ fear of acquiring a nosocomial COVID-19 infection. Even so, it is difficult to believe that some acute diseases, such as massive epistaxis, otitis, or pharyngotonsillitis, could have occurred so rarely or not at all or, alternately, could have been treated at home by patients or their families. Rather, most certainly, primary care physicians, who have been * Eleonora M. C. Trecca [email protected]; [email protected] 1
Department of Otolaryngology‑Head and Neck Surgery, University Hospital of Foggia, Viale Pinto, 1, 71121 Foggia, Italy
2
Department of Otolaryngology‑Head and Neck Surgery, University of Bari ‘Aldo Moro’, Bari, Italy
3
Department of Otolaryngology‑Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
performing telehealth consultations in accordance with the guidelines from the Higher Institute of Health (ISS), have been providing an invaluable service [1]; it is posited that patients who received primary care services this way may have been able to delay or even forego specialist evaluation. This telehealth treatment has not only helped to keep patients at home but has provided other benefits and should be considered in the future. Table 1 shows data regarding the number of emergency department consultations by diagnosis in the 30 days preceding (from February 8th to March 8th, 2020) and 30 days following (from March 9th to April 9th, 2020) the onset of the COVID-19 outbreak at the two main tertiary referral centers in the Puglia region, as well as the percentage reduction for each diagnosis. The data revealed an overall decrease in the number of ORL emergency consultations by 80.8%.
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