The fear unleashed by the pandemic paralyzes even in the face of serious emergencies – Science and Health



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Stroke (CVA) is a serious medical emergency. The time from the appearance of the first symptoms until receiving medical treatment is essential, not only to avoid the sequelae that the disease can leave, but also to reduce the risk of death. However, a study conducted as part of the quarantine imposed in the country revealed this only 34% of the respondents who experienced symptoms compatible with a stroke had a consultation at a medical institution.

“Half didn’t do it because they didn’t care about the symptoms and the rest were afraid to leave their home or go to a medical institution”, is explained in the report of the work done by Fleni, in which more than 10,000 people from the metropolitan area of ​​Buenos Aires were interviewed online.

Another alarming data from the survey, titled “SIPHON-Covid”, is that 62% of respondents believe that hospitals do not comply with all safety regulations to protect them from possible coronavirus infections.

Likewise, 76% reported not continuing with their usual medical check-ups during mandatory preventive isolation, despite 39% having a history of certain vascular risk factors such as hypertension, diabetes, high cholesterol, cardiac arrhythmias, or a previous stroke or heart attack.

It is estimated that in the country there are between 40,000 and 60,000 strokes per year, 18,000 deaths associated with this disease, while about 2 percent of the Argentine adult population lives with the consequences of stroke.

“This survey with thousands of participants gave us a very accurate picture of a problem that worries us: the severe decline in treatment for serious health problems in addition to those related to the pandemic”said Dr. Sebastián Ameriso, head of the Fleni Vascular Neurology Service.

For her part, Dr. Virginia Pujol Lereis, deputy head of the Fleni Comprehensive Center for Cerebrovascular Diseases, pointed out in an interview with The print what “At the beginning of the pandemic, both in Argentina and in the rest of the world, doctors who dealt with chronic non-communicable diseases – I mean doctors specializing in cerebrovascular and cardiovascular diseases, metabolic diseases such as diabetes, oncological diseases, among others – we noted a sharp decline in consultations for health checks. This is serious because these types of diseases, to improve their prognosis, require the patient to be diagnosed in time and monitored correctly “.

In that sense, he confessed that the fear of specialists in this type of pathology “It is that in the future we will see a ‘third wave’ of pandemic represented by the increase of all the consequences on the health of the population due to the lack of adequate controls during this period of quarantine”.

– What do you attribute to the fact that 62% believe that health centers will not protect them from possible infections?

It is likely that people have unfortunately interpreted that health centers would not protect them or would not be safe places to consult during the pandemic, for fear of the contagiousness of the coronavirus. What needs to be clear to the population is that medical centers have adapted our daily work to protect both the patient and health care personnel from Covid-19. Several circuits have been generated in patient care, promoting a safe working environment. This is something we need to keep saying to the population so that they lose this fear. It is understandable that they had this feeling at the beginning of the pandemic, but it is time for them to start consulting again and carrying out the appropriate checks.

– How was it that only 34% of those who had symptoms compatible with a stroke resulted in medical treatment in Fleni had a consultation?

– Obviously, the drop in consultations in the survey was reflected in a decrease of up to 60-70% in consultations in external offices at the start of the quarantine. It was also reflected in a 25% decrease in hospitalizations for cerebrovascular events during the March / July period, particularly for ischemic strokes and transient ischemic attacks, which achieved a reduction of 40% and 60%, respectively. This means that there is a considerable number of people who, faced with a symptom compatible with a stroke, have preferred to stay at home and spend the acute moment of the stroke at home. Not consulting a stroke in time removes the possibility of early diagnosis and treatment, bearing in mind that we have a few hours to be able to offer them to the patient. Early diagnosis and treatment of stroke increases the chances of surviving with as few sequelae as possible and avoiding early relapses of a new stroke.

– Was there an increase in stroke mortality during quarantine?

– Mortality data in Argentina take several months to collect and analyze, they are complex data from an epidemiological point of view. Therefore, we do not yet have official data to know whether there has been an increase in general and even specific mortality due to stroke associated with the pandemic.

Yes, we can anticipate provisional data from a Latin American registry of acute stroke care during the pandemic in which seven countries in the region participated, the LASE-COVID registry. A small increase in hospital mortality of stroke patients was observed during the pandemic. But, to know what specifically happened in Argentina, we still have to wait for the official data.

– What consequences will this scenario of delay in medical treatment and checks have for the health system?

– We know that stroke is among the top three or four causes of death in Argentina and the Western world and is a leading cause of disability in adults. Likewise, it is a very important burden for the health system which consumes a non-negligible percentage of its resources (human and financial).

If the population facing a stroke does not consult or does so late, this is directly reflected in a worse prognosis for patients and, therefore, in a greater burden on the health system.

On the other hand, not carrying out preventive health checks increases the risk of seeing more stroke cases than we could potentially have prevented.

Both situations (the lack of health checks and the lack of consultation in case of acute stroke) will unfortunately have a negative impact on the population and on the health system

– What measures do you consider necessary to take to reverse this worrying scenario?

– I believe it is necessary that all representatives of the health system, health professionals, institutions, representatives of the different areas of government, must work together to educate the population on the importance of continuing to take care of ourselves from the contagion of COVID 19 but at the same time not abandoning control of all the rest of the diseases and pathologies because we will begin to see the catastrophic consequences of this lack of care.

People need to know that medical checkups can be done, that medical studies can be done safely. It is imperative not to forget that there are many diseases whose prevention, early treatment and rehabilitation are essential for a better prognosis, a better quality of life and also to save lives.

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