Doctors Concerned COVID-19 Keeps Patients Away as Heart Attack Hospitalizations Plummet

Rosalind Palmer Ono sits with her husband Michio Ed Ono at Kaiser Hospital in Oakland after she was treated for a heart attack on May 14. (Courtesy of Rosalind Palmer Ono)

Last Thursday, after Rosalind Palmer Ono finished eating lunch — sausage, crackers and 7 Up — she went upstairs to do some ironing and started feeling gas pains.

She took a Gas-X and an aspirin, but the pain got worse. Her husband insisted on calling the advice nurse, who told them to call 911 and go to the hospital because people often confuse indigestion with symptoms of a heart attack. But Rosalind didn’t want to go.

“I said, ‘Oh, no. I don't want to go down there where the coronavirus is. I don't want to go down there where all the other people are,’ ” Palmer Ono recalled. “I said, ‘All I have is gas, let’s not bother.' ”

She did go, but a new data analysis of Kaiser Permanente’s 4.4 million patients in Northern California shows that Palmer Ono is far from alone in her reluctance to go to the emergency room.

Since the first COVID-19 death was reported in early March, the number of weekly hospital admissions for heart attacks dropped 50%.

“There is no intervention that we know of that can reduce heart attack rates by 50%,” said cardiologist Matt Solomon, who conducted the study released Tuesday using Kaiser’s extensive electronic medical record system.

If anything, heart attack rates tend to go up in times of societal stress, he said, as they have after earthquakes or terrorist attacks.

During the shelter-at-home orders, patients over 65 and those with a history of heart disease were the least likely to come in, the Kaiser data showed.

“These patients were repeatedly messaged that they were higher risk if they did contract COVID-19, and we worry that they stayed at home and suffered their heart attacks without getting any care,” Solomon said.

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That fear only compounded an existing trend of patients discounting or dismissing heart attack symptoms, especially if they’re mild.

“They may mimic indigestion, they may mimic musculoskeletal pain in the chest, and patients might be reluctant to follow up and seek care,” Soloman said. “But if it is truly a heart attack, those can be just as deadly as a severe heart attack.”

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Now Solomon is trying to reframe the pandemic messaging to remind people that the hospital is safe. If people don’t get care right away, he said, they could suffer repeat heart attacks, heart failure or life-threatening arrhythmias — if they survive the heart attack at all.

Rosalind Palmer Ono said she got to the hospital just in time. She had a heart attack in the emergency room.

“They put the nitroglycerin under my tongue, and in 10 minutes, they're pushing me into this area to perform this cardiac catheterization and put the stent in me,” she said.

Rosalind is at home recovering now, eager to get back to her retirement projects and neighborhood walks. Even after telling her friends what happened, some of them still confess they wouldn’t want to go to the hospital.

“Don’t hesitate,” she tells them. “I did, but I’m one of the lucky ones.”