Canadian emergency room visits dropped 25 per cent in early stages of pandemic: report

TORONTO -- Emergency room visits dropped by 25 per cent between January and March during the early stages of the COVID-19 pandemic when compared to the previous year, according to new data from the Canadian Institute for Health Information (CIHI).

The new data released Monday suggests that emergency departments had a decrease of 318,000 visits between Jan. 1 and March 31 when governments and health agencies began implementing measures to control the spread of the novel coronavirus.

During the last week of March when travel restrictions were imposed and schools closed across much of Canada, the data found that emergency department visits decreased by 49 per cent compared with the same week in 2019.

In March 2019, emergency departments reported 1,299,110 visits while there were 981,069 visits in March 2020.

The data is based on more than 80 per cent of emergency room visits in Canada reported to CIHI from hospitals in B.C., Alberta, Saskatchewan, Manitoba, Ontario, Quebec, Nova Scotia, Manitoba, P.E.I. and Yukon.

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In some hospitals, daily emergency room visits drastically dropped. The number of emergency visits on March 31, 2020 were approximately 50 per cent lower than the number of visits on March 31, 2019 (20,427 visits and 40,803 respectively).

The data also looked at Canadian Triage Acuity Scale (CTAS) levels, which health professionals use to organize and prioritize patients in Canada’s emergency departments by severity of illness.

According to the CIHI, the largest volume reduction in emergency room visits was seen in CTAS level 4 or less urgent patients with visits down 29 per cent across Canada during March. Even among the most seriously ill or injured patients -- those in CTAS level 1 who require resuscitation -- there was a 14 per cent decrease.

Greg Webster, director of Acute and Ambulatory Care Information Services at the CIHI, said in a press release that Canadians were staying away from hospitals at the start of the pandemic. While some may visit emergency departments for minor issues, he said avoiding them when there is an actual medical emergency may result in worsening conditions.

"We've heard anecdotally that visits to emergency departments for issues other than COVID-19 have significantly decreased during the pandemic. The data released today confirms this," Webster said.

"When we compare to last year, it's clear that many Canadians avoided visiting emergency departments in the initial weeks of the pandemic, which may have had serious consequences for some patients."

Hospitals reported that there were less Canadians coming into emergency departments between January and March for abdominal or pelvic pain, throat and chest pain, gastroenteritis, colitis, back pain, urinary infections, headaches, head injuries, nausea and vomiting compared to the same three months in 2019.

Despite reporting less visits overall, emergency departments saw an increase in some conditions, especially those that may be symptoms of COVID-19.

According to the data, emergency rooms saw an increase in patients for acute upper and lower respiratory infections, viral infections, influenza, coughs, pneumonia, medical observation and evaluation for suspected diseases, and screening exams for infectious diseases than in 2019.

The CIHI says the data only represents the number of emergency department visits, not the number of patients. The data does not distinguish between patients who were transferred from one facility to another or readmitted.

The CIHI is currently compiling emergency department data for April and May 2020 and plans to release their findings in the fall.