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Virus kept ER patients home

Emergency room visits in the U.S. for chest pain and heart attacks fell early this spring, according to a June study that supports fears that the coronavirus outbreak scared away people from going to the hospital.

ER visits were up for respiratory illnesses and pneumonia, but were down for nearly every other kind of injury or ailment, according to the Centers for Disease Control and Prevention (CDC).

Overall, fewer ER patients showed up: Visits were down 42% in a four-week period that stretched from late March through most of April, compared to the same time last year.

At the time, hospitals in some U.S. cities — most notably New York — were overwhelmed treating COVID-19 patients. But the CDC study covered 43 states and saw big declines, particularly in visits involving preteens.

Some of that may be good news — there may have been fewer injuries from some types of accidents, for example, because people were staying at home and not doing as many risky things at work or play.

But some experts worry about the CDC’s finding of 1,100 fewer visits per week for heart attacks and 24,000 fewer for chest pain.

The finding seems to parallel death certificate reports. In each of the first three weeks of April, the nation saw 2,000 more deaths than normal in a category comprised of primarily heart attacks.

That may be the result of some patients worrying more about catching the coronavirus at a crowded ER than their heart problems, some experts think.

 “There’s a lot of evidence that suggests people are afraid to interact with medical care, and are deciding not to act on their symptoms,” said Wayne Rosamond, a University of North Carolina researcher who studies heart disease and stroke trends.

The CDC report echoes research in the U.S. and Italy, which showed reductions in heart-related hospital admissions and use of labs to clear clogged arteries. There has been no drop of heart attack deaths during coronavirus.

The latest study found a small increase in people arriving at the ER in cardiac arrest — their heart had stopped. One possible explanation: “They could have been people with heart attacks who waited too long,” said Dr. Harlan Krumholz, a Yale University cardiologist and researcher, in an email.

“If someone is having acute chest pain and think they’re having a heart attack, they should call 911,” Rosamond said. “You shouldn’t ignore these things. You should seek help.”

Masks and social distancing work

Masks and social distancing can help control the coronavirus, but hand washing and other measures are still needed, according to a new analysis.

Researchers concluded single-layer cloth masks are less effective than surgical masks, while tight-fitting N95 masks provide the best protection. 

A distance of 1 meter (more than 3 feet) between people lowers the danger of catching the virus, while 2 meters (about 6 ½ feet) is even better.

Eye protection such as eyeglasses or goggles can help, too. None of the strategies work perfectly, and more rigorous studies are needed, according to the analysis published in June in the medical journal Lancet.

With the coronavirus still new, health officials have relied on studies involving its cousins, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). 

The findings come from a systematic review of 44 studies, including seven involving the virus causing COVID-19. The other studies in the analysis focused on SARS or MERS.

Still to come are results from more rigorous experiments in Canada and Denmark that are testing masks in randomly assigned groups of nurses and the general public. 

Until then, the new study provides reassurance that masks do help.

Public health officials have given conflicting advice about masks. The World Health Organization, which funded the new analysis, has said healthy people need to wear a mask only if they are caring for a person with COVID-19. 

The CDC wants everyone to wear at least a cloth mask when grocery shopping or in similar situations where keeping distance is difficult. 

Cancer and coronavirus are dangerous mix

New research shows how dangerous the coronavirus is for current and former cancer patients. Those who developed COVID-19 were much more likely to die within a month than people without cancer who got it, two recent studies found.

They are the largest reports on people with both diseases in the United States, the United Kingdom, Spain and Canada. 

In one study, half of 928 current and former cancer patients with COVID-19 were hospitalized, and 13% died. That’s far more than the various rates that have been reported in the general population. Results were published in Lancet in May.

A second study in Lancet

from researchers in England of 800 patients with various types of cancer and COVID-19 found an even higher death rate: 28%. The risk rose with age and other health problems such as high blood pressure.

The studies have big implications: More than 1.6 million new cancers are diagnosed in the United States each year, several million Americans are in treatment now, and about 20 million are cancer survivors.

Dr. Jeremy Warner, a Vanderbilt University data scientist who led the first study, said the results show the need for people treated in the past to be extra careful now. “They want to do anything they can to avoid getting it,” he said.

“We’re trying to minimize trips to the clinic” and telling older cancer patients and those with lung problems “to be extra vigilant, extra isolated, to stay at home, be careful with family members,” said Dr. Howard Burris, president of the American Society of Clinical Oncology.

Men seemed to fare worse — 17% of them died versus 9% of women. That might be because breast cancer was the most common tumor type in this group, and women with it tend to be younger and with fewer health problems. Many cancers seen in men that are typically diagnosed at later ages, and smoking also is more common among men.

Large COVID-19 vaccine study underway soon

The first experimental COVID-19 vaccine in the U.S. is on track to begin a huge study in July to prove if it really can fend off the coronavirus — a long-awaited step in the global vaccine race.

The vaccine, developed by the U.S. National Institutes of Health and Moderna Inc., will be tested in 30,000 volunteers —some given the real shot and some a dummy shot. Moderna said it has made enough doses for the pivotal late-stage (Phase 3) testing. 

  —AP