State health officials urge against ER visits


With an uptick in coronavirus cases, the arrival of flu season and the onset of holiday parties, the amount of sore bodies and runny noses is expected to explode in the next two months.

Public health officials, however, say not every symptom requires a visit to the emergency room.

“Emergency departments are perfect for emergency situations,” said Dr. Nicole Alexander-Scott, director of the Rhode Island Department of Health. “If someone is experiencing a serious health issue, they should absolutely call 911 or go to an emergency department right away. However, emergency departments treat patients with the most serious health issues first, which means that people with less severe conditions will experience long waits.”

Newport County, for example, identified 157 new cases of the coronavirus for the week ending Nov. 17, which marked the highest weekly number since April. With 16 cases, Jamestown recorded the most significant spike from the six municipalities, and its highest weekly total since January.

According to Alexander-Scott, family physicians and urgent care sites often are cheaper and more convenient than emergency rooms. She was joined at a press conference last week by colleagues in the medical field to urge patients to choose the appropriate setting for their healthcare.

“It has become abundantly clear that hospital overcrowding has emerged as a priority concern,” said Ana Novais, assistant secretary of health and human services in Rhode Island.

According to Alexander-Scott, occupancy levels at hospitals are hovering around 95 percent capacity, and utilization of intensive care units is “at or near 100 percent.” Dr. Stephen Traub, an attending physician of emergency medicine at Rhode Island Hospital, said the Providence facility “normally has 60 to 80 beds open for patients” in a typical November, but this year there are fewer than 10 beds on some days. Dr. Paari Gopalakrishnan, chief executive of Kent Hospital, said his Warwick facility has 47 ER beds, but he has witnessed as many as 90 patients waiting when the capacity is full.

According to Gopalakrishnan, in an effort to mitigate the problem, his hospital erected a military-grade tent in the parking lot with 10 beds. The workforce shortage, however, adds another level to the crisis.

“The challenge is still the same,” he said. “It’s staffing.”

While Gopalakrishnan was referencing Kent, Alexander-Scott called the shortage a statewide concern.

“Our heroes who have been healthcare workers on the frontlines can only take so much,” she said. “Burnout is a normal part of this process, and we have to be able to support them.”

According to Alexander-Scott, health issues that do not require a trip to the emergency room include mild cases of the flu, back pain, minor cuts, sore throats, low-grade fevers and most cases of norovirus. These ailments can “be treated quickly and effectively” at urgent care facilities, she said.

Dr. Jeremiah Schuur, the chief physician of emergency medicine for Lifespan, said the public can help by being vaccinated against the flu and coronavirus. Americans at least 5 years old are eligible for the COVID-19 vaccine, he said, and everyone older than 6 months should get a flu shot every year. Schuur also said preventative care can alleviate the overcrowding.

“We urge patients to keep up with their regular medical appointments so that minor issues do not become major ones,” he said.

While doctors across Rhode Island are urging patients to seek the appropriate setting for their sicknesses, Alexander-Scott said there are symptoms that require a visit to the emergency room. These include trouble breathing, persistent chest pain, weakness in an arm, leg or face, difficulty speaking, confusion, inability to wake up, inability to stay awake, and pale, gray or blue-colored skin, lips or nail beds.