Coronavirus in Scotland: Heart patients becoming 'much sicker' as they delay going to hospital amid Covid crisis

READ MORE: First Scottish NHS worker dies of Covid-19

It comes after figures from National Records of Scotland revealed there had been a spike in deaths of 27 per cent in the two weeks to April 5 compared with the five-year average for the same period.

Of the 662 extra deaths, only 282 mentioned Covid-19 on the death certificate, leading to warnings from medical leaders that patients may be risking their health by ignoring potentially serious symptoms.

Professor Hany Eteiba

Prof Eteiba, a consultant cardiologist and associate medical director at the Golden Jubilee Hospital in Clydebank, said: “What we’re seeing in this pandemic is unprecedented and we’ve never seen anything like it.

“What we have witnessed is a slight decline in the number of people who are presenting acutely for emergency and urgent care who have heart conditions.

“Is that a snapshot or a true reflection of what is happening? We are gathering data both locally, nationally and internationally, because this phenomena has been also witnessed all over the UK and also in Europe and the States.

In heart patients who present with a heart attack, the most important determinant for a successful outcome is how soon they present to hospital or seek medical advice.

“But we noticed that some of them come much later than they should have and when we ask them why the answer varies from ‘we did not want to press the already stretched resources and put pressure on our staff’ to some who would say ‘I thought I’d be safer at home rather than exposing myself to the virus in hospital’.”

Public health campaigns have repeatedly urged the public to stay at home, but there are concerns that this messaging may have inadvertently deterred those in need of medical attention for issues unrelated to coronavirus from coming forward.

On Wednesday, Scotland’s interim chief medical officer Dr Gregor Smith, said some parts of the NHS not treating patients for the virus were “eerily quiet”.

At the beginning of the outbreak there was also repeated messaging about the need to “flatten the curve” in terms of Covid-19 admissions to prevent the NHS from becoming overwhelmed.

But there are now suggestions that enough additional capacity has been created and that the new 300-bed NHS Louisa Jordan field hospital at the SEC in Glasgow may not even be needed.

As of yesterday there were 212 Covid-19 patients in intensive care in Scotland out of a total of around 500 beds, though the Scottish Government has set a target to create 700.

Of the 3000 acute hospital beds ring-fenced for non-ICU patients, 1569 were occupied by patients with confirmed or suspected coronavirus infection.

READ MORE: How is Covid 19 affecting my area?

It comes amid speculation that the UK deaths from the disease could peak over the Easter weekend, although Nicola Sturgeon has said that she has not seen evidence from modelling that this would be the case for Scotland.

Prof Eteiba said patients should not feel as though they were going to be a burden on the NHS.

He said: “Patients should not feel that staff are pressed. These are misconceptions.

“We have enough workforce to cope with Covid and non-Covid conditions in a timely manner.

“It’s also not safe to stay at home because the hospital might have the virus but at the same time they have protective equipment to keep the staff and the patients safe in terms of infection prevention and control.

“Anecdotally, we found people presented much later than they would have and therefore they are much sicker and in a much more serious condition than they would have been if they had presented maybe 12 hours earlier. “

Asked whether he believed that untreated heart problems could be contributing to the spike in non-Covid deaths seen in Scotland at the end of March and beginning of April, Prof Eteiba said he feared this could be the case – but it was still to early to say.

He said: “It’s difficult to give a firm conclusion as there is not enough evidence and data to understand fully what is happening yet, but all professional societies, Royal Colleges, they are all collecting live data and comparing it nationally and internationally with respect to previous years to better understand what is happening.

“Intuitively I am concerned, but we need to wait on the research.”

Attendance at A&E departments in Scotland has more than halved since the epidemic began, with a record low of just over 11,000 people seeking emergency care in the week ending March 29.

Lockdown measures for the UK had been announced by the Prime Minister on Monday March 23.

The previous week saw 16,425 attendances. Since February 2015, when the current records began, it has never been lower that 21,865.

Health Secretary Jeane Freeman said this showed that the public were listening to guidance about “only going to A&E if illnesses are immediate or life threatening”, adding that the drop in attendance was “helping to free-up vital resources to allow NHS staff to be redeployed”.

The Royal College of Emergency Medicine (RCEM) in Scotland said the number of people turning up with injuries related to alcohol and drug consumption or violence had “gone through the floor”. A similar pattern is also being seen in England and Wales.

However, the organisation also warned that too many who needed medical attention were avoiding hospitals.

Dr David Chung, vice president of RCEM Scotland, said: “Across the UK, Emergency Departments are now seeing patients with complications from leaving critical conditions untreated for too long.

“We want to reassure the public we are very much open for business for all of the usual accidents and emergencies people will continue to have and we will treat patients in a way which protects them from Covid-19.”

The widespread cancellation of routine care, such as outpatient appointments, dental check ups, hip and knee replacements, and non-urgent cancer operations, is also seen as having given an impression that hospitals are ‘closed’.

Professor Jackie Taylor, the president of the Royal College of Physicians and Surgeons of Glasgow, said: “While the NHS has postponed many routine or non-urgent appointments in order to accommodate the Covid-19 pandemic, this does not apply to urgent or emergency illnesses.

“What we’re concerned about is that our experience from previous epidemics tells us that there is a danger of increased harm and deaths from issues that are not related to Covid-19 simply because patients have delayed or not sought medical assistance for other urgent or serious health problems.”

The number of known coronavirus cases in Scotland has risen to 4,957 with 447 deaths in people who have a laboratory-confirmed infection. That is an increase of 81, the biggest daily rise in deaths to date.

It came as the First Minister said “no one should feel under pressure” to sign do not resuscitate (DNR) orders, amid reports of letters being distributed out of the blue to care home residents, the elderly and people with life-limiting conditions such as motor neurone disease.

Ms Sturgeon said: “People who feel aggrieved that they’ve had a letter like that can take that up through their health boards.

“We will take steps to disseminate that advice and information more widely to GPs and care homes as well.”

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