COVID-19 Incidence After Emergency Department Visit

Jonathan Balakumar; My-Phuong Pham; Selene Mak; Kathleen Yip

doi:10.12788/fp.0384

COVID-19 Incidence After Emergency Department Visit

Fed Pract. 2023 Jul;40(7):224-227. doi: 10.12788/fp.0384. Epub 2023 Jul 12.

Authors

Jonathan Balakumar^{1

2}, My-Phuong Pham¹, Selene Mak¹, Kathleen Yip^{1

2}

Affiliations

¹ Veterans Affairs Greater Los Angeles Healthcare System, California.
² David Geffen School of Medicine, University of California, Los Angeles.

Abstract

Background: The emergency department (ED) at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS) saw a decrease in the number of visits during the early stages of the COVID-19 pandemic. Little is known whether risk mitigation procedures may help reduce the spread of COVID-19 infections for veterans visiting the ED. Therefore, we reviewed patient visits to the ED for diagnoses other than COVID-19 to assess whether these patients had an increased COVID-19 positivity rate within 21 days of the initial visit.

Observations: Risk mitigation procedures instituted by the VAGLAHS ED included a COVID-19 outdoor testing tent, immediate isolation of persons under investigation for COVID-19, disinfection protocols between high-risk patient encounters, dedicated training in donning and doffing personal protective equipment, implementation of 2-physician airway teams for COVID-19 intubations, use of electronic tablets to communicate with COVID-19 patients, and implementation of social distancing initiatives in the waiting room to minimize COVID-19 exposures. The average positivity rate at the VAGLAHS ED during this time frame was 0% to 6.7%, compared with 6.9% to 33.3% within the wider VAGLAHS.

Conclusions: Implementing risk mitigation procedures in the VAGLAHS ED helped minimize exposure and subsequent diagnosis of COVID-19 for veterans who visited the VAGLAHS ED for symptoms not associated with COVID-19 infection. Seeking acute medical care in the ED did not put patients at higher risk of contracting COVID-19.