Up to 100 patients a day used to walk through the door at Sharp Rees-Stealy's urgent care clinic in Rancho Bernardo, but that average fell by almost half in March to 55. This month, Sharp projects about 23 patients a day.
The drop is occurring system-wide and at other medical facilities in San Diego. The county's public health orders to reduce the spread of coronavirus has limited interactions and activities that could lead to other illness or injury. But there are concerns the restrictions are causing some people to avoid public spaces like medical facilities and forgo necessary treatment.
Sharp Rees-Stealy Urgent Care Director Dr. Phil Yphantides said the reduction is partly due to cancellation of routine non-emergency medical procedures, such as colonoscopies, but it's also a sign residents are listening to stay-at-home orders. He said the limitations on travel and engagements translate to fewer urgent medical needs.
"People are not in close proximity to each other and they're getting sick less often, and we're also seeing decreased rates of trauma," he said. "We're seeing decreased rates of heart attacks and even strokes."
Sharp's five urgent care facilities the county used to see a total up 600 patients a day but he said that's down to around 150. Representatives for Palomar Health and Kaiser Permanente also reported lower patient volumes at their local emergency departments, which handle more severe problems.
Still, the county’s chief medical officer Dr. Nick Yphantides — Dr. Phil Yphantides' older brother — said in some cases non-COVID patients may be putting off care they may need.
"There seems to be a little bit of a growing sense and an observation that some of the non-COVID — there are individuals that have health issues completely unrelated to COVID-19 — are coming in potentially with a higher acuity of illness," he said during a Wednesday news conference.
He was especially worried about people with cardiac issues or stroke symptoms and encouraged them to utilize emergency care.
A Sharp spokesman said he had personal experience with the problem. John Cihomsky said his 85-year-old mother recently experienced a sudden onset of slurred speech, often a sign of a stroke, but didn't initially seek medical care because she was worried about contracting coronavirus while in a doctor's office. A week later after Cihomsky and his siblings convinced her to get checked out, she learned she had a ministroke.
Sharp's Yphantides agreed part of the drop could be due to safety concerns around entering a facility during the pandemic, but said Sharp and many other medical providers are significantly expanding telehealth appointments to make sure patients get the help they need.
Sharp's medical staff members are providing up to 2,500 video or phone appointments a day. However, Yphantides said that's still below the 6,000 to 8,000 daily in-person visits they used to see across all Sharp facilities.
A Kaiser Permanente spokeswoman said in an email the health system's physicians are also using telehealth to regularly check in with patients who have chronic conditions, but its emergency rooms are "fully open, available, and safe" during the outbreak.
