Go to the hospital if you have these COVID-19 symptoms, experts say

Medical experts are urging individuals with life-threatening COVID-19 symptoms to recognize the risk and visit the hospital for treatment after a Beaumont Health epidemiology specialist said Thursday that some patients are waiting too long. 

With better treatments and more knowledge of the disease, some people experiencing severe symptoms can get earlier treatment that can help them sidestep more extreme interventions and shorten hospital stays.

Beaumont Royal Oak's ER Dr. Jim Getzinger noted some of the symptoms that call for an immediate trip to a hospital emergency center include:

• Chest pain that is severe or does not improve.
• Shortness of breath that occurs even at rest or with minimal activity.
• Decreased consciousness.
• Severe nausea and/or vomiting.

Delaying treatment could mean longer stays at the hospital than would have otherwise happened if people with these symptoms had come to the emergency center earlier, experts said.

Most people don't have equipment to measure their oxygen levels to discern whether a hospital visit is necessary, said Dr. Brad Uren, an emergency department doctor and University of Michigan associate professor of emergency medicine. But there are some simple markers that could help.

If someone with COVID is unable to say more than a few words without taking a breath when they were able to rattle off whole sentences before, they should head into the emergency department, Uren said.

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Or if an individual usually capable of walking to the mailbox and back without being short of breath is suddenly winded by much shorter distances, they should go to the emergency department, he said.

Another indicator is changes in color to fingertips and lips, particularly if they turn purple. 

"That would be a very late finding," Uren said about the purple lips and fingertips. "I wouldn’t recommend they wait for that; however, if they notice that, that would also call for evaluation.”

Even as hospital beds fill up, people should not be discouraged from visiting the emergency department if they believe their condition could be life-threatening, he said.

"If people believe that they are in genuine distress, they should come into the emergency department," Uren said. 

The issue of delayed hospital visits isn't unique to Metro Detroit. Doctors at Michigan Medicine in Ann Arbor are seeing some COVID-19 patients delay emergency care as well, Uren said.

"I’m aware of three people in the last several days that I personally have had to put on a ventilator, and all of that happened in pretty short order, meaning they came in a very advanced stage of respiratory distress,” he said. 

"We know some of the things that could be helpful, particularly steroids, that those people may have benefited from had they come in a little sooner.”

Patients entering the emergency department during Michigan's third surge of coronavirus cases are younger and, in some cases, sicker than they were in the past, said Dr. Nick Gilpin, Beaumont’s medical director of infection prevention and epidemiology.

“Some younger patients also seem to be waiting longer to get care, thinking they can beat the virus," Gilpin said. "By the time they come to the hospital, we’re seeing intense illness with pneumonia, blood clots and severe lung injury. This trend does not seem to be slowing down.”

Those aged 20-29 and 30-39 have the highest COVID case rates in the state. There are more than 5,500 new cases per day from these age groups, according to state data.

Cases among kids ages 10 to 19 continue to rise in schools and youth sports. From January to March, there have been 291 outbreaks from youth sports resulting in at least 1,091 infections, said Dr. Joneigh Khaldun, the state's chief medical executive.

From March 3 to April 3, the state recorded 670 deaths and 19%, or 129, occurred in those under 60 years of age.

Hospitals across the state are at an average of 82% bed capacity, 21% are occupied by COVID patients, according to the Michigan Department of Human Services database.

In Metro Detroit, hospitals at the 90% threshold or more include St. Joseph Mercy Hospital, Livingston; the University of Michigan Health Center; the Detroit Medical Center's Detroit Receiving Hospital; as well as Henry Ford's Macomb, West Bloomfield and Wyandotte hospitals. Beaumont's Troy hospital is listed as filled (100%).

Outside of the Detroit area, hospitals at 90% capacity or more include Hurley Medical Center in Flint, Sparrow Hospital in Lansing, UP Health System in Marquette and mid-Michigan's Sheridan Community Hospital at 100%.

More:Michigan Gov. Whitmer: COVID surge appears to be 'slowing down a bit'

While some hospitals have canceled elective surgeries, Gilpin said Beaumont has held the line as much as possible not to cancel necessary procedures despite the surge.

But the health system might postpone a scheduled elective knee replacement if it would "challenge our staff" because of hospital capacity issues, he said.

"We're looking at each and every one of these situations on a case by case basis, which is incredibly resource-intensive, but we feel that's the right thing to do," Gilpin said. 

Pediatric hospitalizations have also seen a spike in recent weeks, he noted.

"We are seeing severe disease in our younger population and even our youngest children," he said.

"Our pediatric infectious disease physicians have said that when we see surges in the communities where thousands of patients a day are coming down with COVID, you're going to have sick younger people in the mix and that's exactly what we're seeing."

srahal@detroitnews.com