Guest column: Delays in seeking care can make matters worse (Missoulian,
	 April 20. 2020)
By JOYCE DOMBROUSKI and KEVIN EICHHORN
First of all, we would like to thank the people of Missoula, Polson and
	 Montana for the sacrifices you have made to help minimize the spread of
	 COVID-19. The swift and selfless actions and sacrifices made by Montanans
	 have kept our Big Sky state as one of the lowest case rates of COVID transmissions
	 in all of the United States.
Throughout this pandemic, hospital and emergency department volumes have
	 been extremely low as people have been unable to have "elective surgeries"
	 or see their doctors in person for most non-emergent problems.
Many people have appropriately jumped through the hoops of COVID testing
	 at the designated outpatient sites. Montanans have had to think through
	 whether or not to even leave their homes, much less seek medical attention
	 where there is the possibility of exposure to COVID.
With this, however, there is the risk that people in need will not seek
	 timely medical care out of perceived risk of exposure. One of our cardiologists
	 recently cared for a man in his forties with days of chest pain who had
	 stayed at home suffering a heart attack. He finally came to our Emergency
	 Department with heart failure. In the ED, we cared for a 90-year-old woman
	 with a stroke who was so afraid of getting COVID in the hospital that
	 she seriously contemplated going home alone rather than risk a night in
	 the hospital.
Many of the patients we encounter have delayed care for too long and often
	 result in hospitalization or emergency surgery — and their delay
	 as the root cause. This can be avoided.
COVID fears have provided some patients the needed pause as they determine
	 if emergent care is actually required and this has been beneficial in
	 managing clinical demand. And, while we are grateful that so many of you
	 are staying home to take care of yourself and others, we want to remind
	 you to come to the ED to take care of yourself and others, as appropriate.
	 We want to make it clear that if you are having serious medical and potentially
	 life-threatening symptoms, please do not avoid care out of fear. We are
	 here for you and are doing our best to minimize any potential risk for
	 you, from COVID or any possible harm.
Our hospitals, clinics and emergency departments have taken aggressive
	 measures to protect both patients and staff from exposure. These range
	 from aggressive use of personal protective equipment with universal masking,
	 triaging respiratory patients from non-respiratory patients, routing trauma
	 patients through a separate bay and limiting all but essential visitation.
With the loosening of Montana’s directives, we urge you to continue
	 to do your part by washing your hands, social distancing appropriately
	 and making educated choices while re-engaging. We are here to provide
	 you the highest quality health care — before, during and long after
	 the COVID pandemic is over.
As always, patients who are experiencing life-threatening symptoms should
	 call 9-1-1 or go immediately to the nearest emergency room.
COVID-19 by state