“This is not a good time to need stitches,” Maria G., a 26-year-old Californian, tells SELF. She’s speaking from experience. Maria recently had to go to the emergency room after cutting her hand while using a knife to open a package. The cut was deep. So deep, in fact, that she knew she needed immediate medical attention. “I was so scared that I might catch coronavirus, so I almost didn’t go [to the emergency room],” she says. “If it wasn’t such a deep cut, I definitely wouldn’t have.”
We’re all so focused on the new coronavirus pandemic that it can be easy to forget people have medical emergencies that have nothing to do with COVID-19. Before this crisis hit, dealing with health emergencies was pretty clear-cut: It was best to get to the E.R. if at all possible. But…what about now? Many hospitals are already overwhelmed by trying to care for people with COVID-19 and preparing for an influx of more cases. It’s gotten to the point where experts are asking even people with the new coronavirus to not go to the emergency room unless they have severe symptoms, like potentially life-threatening trouble breathing. Beyond capacity issues, you might be nervous that going to the emergency room would raise your risk of getting the new coronavirus by putting you in close proximity to a lot of people with it, along with staffers who are constantly treating it. So what is someone with a non-coronavirus health emergency right now supposed to do?
Well, it depends on the exact health issue you’re dealing with. According to Jaimie Meyer, M.D., an infectious disease specialist and assistant professor of medicine at Yale School of Medicine, health care systems in the U.S. generally fall into three major buckets: primary care, urgent care, and, of course, emergency care.
“It is important during the COVID-19 pandemic to use each of these types of resources appropriately so as to not add to system-wide burdens and to reduce the risk of exposure to COVID-19,” Dr. Meyer tells SELF. Here’s how to know which of these three systems you should use for your non-coronavirus health issue.
In some cases, you can consider calling your primary care doctor for advice.
Primary care is usually meant for routine check-ups and nonemergency treatment, Dr. Meyer explains. Things like rashes, minor infections and pain issues, preventive screenings, and the like. Typically, primary care providers (PCPs) will act as your first contact for medical care and refer you out for specialty care as needed. However, during the COVID-19 pandemic, many primary care facilities have been offering services for more urgent issues than normal to help take the stress off of emergency rooms, Sharon Chekijian, M.D., M.P.H., an emergency medicine doctor and professor at Yale Medicine, tells SELF.
One of the “bright” sides of our current situation has been how the rest of the medical community has really stepped up in this way, Dr. Chekijian says. So, depending on exactly what you’ve got going on, it might make sense to give your doctor a call before going anywhere. They could then set up a tele-health appointment to talk about your health, Dr. Meyer says. A virtual visit may be enough for them to adequately assess your symptoms so that you don’t even have to go into the office, which is really helpful for limiting your exposure to people outside your home. (At the bottom of this story, there are a few tips for protecting yourself as much as possible from the new coronavirus if you have to venture outside for medical care.)
With that said, there are a few major caveats here. Sometimes it’s clear that you should absolutely skip this step because your health issue is too urgent. For example, if you’re dealing with symptoms of a heart attack like chest pain (especially on your left side), extreme fatigue, heartburn, and pain in your back, arms, or jaw, you don’t want to waste precious time calling your primary care doctor for advice—you should go to the emergency room instead. (More on that in a bit.) Beyond that, your primary care office might not be open when you need help. And if you don’t have a primary care doctor, this clearly isn’t an option for you either. That’s one situation where going to an urgent care facility might be helpful.
Urgent care can be good for relatively minor but still pressing health issues.
Generally, urgent care is meant for conditions that require prompt attention but don’t seem life-threatening, Dr. Meyer says: things like strep throat, persistent colds or fevers that won’t respond to treatment, sprains and minor fractures, urinary tract infections, minor burns or allergic reactions, and small cuts that won’t stop bleeding but aren’t quite gushing blood either. Different urgent care clinics will have varying abilities to diagnose and treat different conditions depending on what resources are available on-site, like X-ray and electrocardiogram machines.
Urgent care clinics can come in handy if you don’t have a primary care provider or if your PCP says your health issue requires care they can’t provide. And, the experts note, while urgent care centers aren’t usually open 24 hours like emergency rooms, they do tend to stay open longer than primary care offices, along with often having weekend and holiday hours too. This can be super helpful if your PCP is closed when you need help.
Although urgent care centers take walk-ins by their very nature, it’s still a good idea right now to call ahead if you can. “[Even some] urgent cares are overwhelmed with potential COVID-19 patients,” Dr. Chekijian says. Calling ahead will help you see if they have room for you and how much going to that particular clinic might expose you to COVID-19. You’ll also have a chance to describe your symptoms and ask if they think they’ll be able to help you based on the resources they have.
Go to the emergency room if you feel like your life is in danger for any reason.
Whenever you’re dealing with a health issue that you feel like is potentially life-threatening, you need to go to the emergency room, Dr. Meyer says. Yes, even now, during the pandemic, she adds.
Emergency care is designed for health issues that are severe enough to require immediate and serious attention, Dr. Meyer explains. That means things like heart attacks, strokes, bad physical trauma from something like a fall, head injuries, difficulty breathing, severe bone fractures, deep cuts that may need stitches, appendicitis, and pregnancy-related complications. Here are various signs you should go to the emergency room, but it basically boils down to anything that threatens life or limb. Depending on what exactly is going on, if you or a loved one can call the emergency department before you go or while you’re on your way in, it could be helpful to give a heads up—but don’t feel like you have to take time for this step if you’re in a truly life-threatening situation and it would slow your arrival.
In the past several years, emergency medicine has become “the safety net for a faltering health care system,” with people coming to the emergency room for more routine situations such as coughs, colds, and sore throats, Dr. Chekijian says. Right now, it’s even more important than usual that people not go to the emergency room for this kind of care, she explains. Somewhere like an urgent care clinic would be a better option.
You’re probably wondering what the actual experience of going to the E.R. for a non-coronavirus health emergency is like. It’s a good question since things clearly aren’t business as usual for emergency departments. (Let’s be real, basically nothing and no one is operating normally right now.) Your experience can be different depending on where you go, but emergency rooms are often first screening potential patients at the door to find out more about their health situation, Dr. Chekijian says. “If you are deemed to not have an emergency condition, you may be asked to leave after a brief screening examination and interview,” she adds.
Maria went through this screening process when she arrived at the E.R. for her deep cut that needed stitches. “There were hospital staff members waiting at the door who evaluated me before I was even allowed to go in, and they wouldn’t let me sit in the waiting room,” she says. “Many emergency departments are trying to keep potential COVID-positive patients away from other patients in both the waiting rooms and the treatment areas, but as the numbers grow, this is harder to do,” Dr. Chekijian explains.
After the staff evaluated her, Maria waited in her car. When a doctor was available, hospital staffers sent Maria a text informing her that she could come in by herself. “They wouldn’t let my cousin (who brought me to the E.R.) go in with me,” she says. While all of this can add more stress to someone who’s already in a scary situation, Maria saw the benefits of the new protocols. “I did appreciate the stricter measures they had in place,” she says. “It made me feel more comfortable because I wasn’t exposed to anyone in the waiting room.”
Dr. Chekijian explains that while this isn’t how emergency rooms normally take care of patients, it’s necessary right now to keep everybody as safe as possible. “Hopefully we will return to normal operations soon,” she says.
