More people are waiting too long to get help with minor medical issues, with potentially tragic consequences.

More than 25 people have been hospitalized and four people have died as of the latest Covid-19 numbers for Monterey County, but there is a hidden number of serious illnesses—including the possibility of at least one death—since the shelter-in-place order was enacted.

They aren’t people who contracted the disease, they are those who waited too long to seek medical help for chest pains, abdominal pain, post-surgery complications and other physical issues.

The trend has doctors worried and they want to get the message out: Don’t wait if you have pain or feel really sick; emergency rooms are safe and ready to care for non-coronavirus medical issues.

Those who let minor health issues go too long without care are the “unexpected victims of coronavirus,” says Casey Grover, medical director of the emergency department at the Community Hospital of the Monterey Peninsula, part of Montage Health.

“We've seen a number of cases of people (trying to do) the right thing by staying at home when they actually needed to be in the hospital,” Grover says.

People took to heart the messaging at the start of the pandemic to stay home, but Grover says there’s been a realization in the medical community that the messaging fell short by not reminding people to continue to get help for other types of immediate health issues.

“We assumed erroneously that people, when they thought they were sick, they would still come in,” he says.

Part of the problem is that not a lot was known about the virus nor its magnitude. Health officials also had no idea how long shelter-in-place might last.

“We’re being forced to fly a plane and yet we're building and redesigning the plane as we fly it,” Grover says, crediting the analogy to a national webinar meant to keep doctors abreast of the latest information.

Grover says he and other CHOMP doctors are seeing patients who would have required minimal care had they come in earlier, but wound up having serious complications.

“I can't give you any hard numbers, but normally these cases where they wait too long, they stand out to a physician because you say to yourself, ‘I wish they had come in earlier.’”

One person potentially died as a result, after not seeking help for symptoms related to a heart attack, Grover says. 

Eight national heart-health and emergency medical organizations released a joint statement on April 22, sounding the alarm about people who do not call 911 or head to an emergency rooms while experiencing the symptoms of a heart attack or stroke.

"Calling 911 immediately is still your best chance of surviving or saving a life. It is safe for everyone to call 911. It is safe for anyone to go to the hospital," said leaders of the American Heart Association, American College of Radiology and six others.

Grover shared other examples of cases at CHOMP where patients experienced complications after waiting too long. They include: a case of appendicitis that developed into sepsis; post-surgery bleeding that required the patient to receive a blood transfusion and more surgery; a mild intestinal infection that would've only required antibiotics early on, but the patient needed surgery after waiting more than a week to get help.

Some people are putting up with pain thinking it will go away, some are trying to do the right in the pandemic thing by staying home. 

“If you don’t feel that bad you don’t need to get checked out but if you feel that something is really wrong then by all means get help,” Grover says.

There are ways to get medical help beyond physically coming in, including the increased use of telehealth, which is healthcare delivered at a distance by electronic means, either by email, phone or video.

Earlier this month Peter Oppenheim, a physician with the PrimeCare Medical Group, part of the Salinas Valley Memorial Healthcare System, told the Weekly that they had been seeing patients fearful of coming into clinics and emergency rooms because they might be exposed to Covid-19. Oppenheim said protocols are being followed to keep patients with respiratory illnesses out of offices and emergency departments and there are disinfecting procedures making medical facilities safe to those without Covid-19.

“I’ve been stressing with patients, we are a safe place,” Oppenheim said.

Natividad hospital is also reporting seeing people fearful of getting medical help because of the virus and urged people to continue to seek medical help in a press release on April 23. 

"The Natividad Emergency Department remains open and safe for any emergency," Chief Medical Officer Craig Walls said in a statement.

Natividad is also seeing expectant mothers worried about giving birth in the hospital. Keeping patients with respiratory illnesses out of the hospital by treating them in medical tents is meant to keep the rest of the hospital population safe.

Similar strict protocols are being followed at CHOMP and Grover says the hospital's emergency department prepared itself in the event of caring for both a surge in Covid-19 patients and those experiencing other emergencies. The large numbers of coronavirus patients haven’t materialized yet but the emergency department remains ready, he says.

South County's Mee Memorial Hospital in King City doesn't have a tent for respiratory triage like the other three hospitals but the staff there devised its own "tent" said Robert Valladares, interim chief medical officer at Mee Memorial on a recent Monterey County press briefing call.

Valladares said they transformed the hospital's dormant intensive care unit—shut down last year in a reorganization—into an emergency respiratory unit. Like other hospitals, screeners meet patients outside and direct those with suspected Covid-19 to the new unit.

Normally the CHOMP emergency department sees an average of 155 patients a day. The first two weeks of March the average was 158 per day, but that  dropped dramatically to 97 patients per day the last two weeks of March. In the first two weeks of April, that number dropped to 77 a day.

The trend is being seen locally as well as across the state and country, Grover says.

For more information about how to get medical help for any health issue click on the following links:

Montage Health (Monterey Peninsula)

Natividad (Salinas)

Salinas Valley Memorial Healthcare System

Mee Memorial Hospital (South County)