Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea

Abstract

Purpose In May 2015, South Korea experienced an epidemic of Middle East respiratory syndrome (MERS). This study investigated the impacts of MERS epidemic on emergency care utilization and mortality in South Korea. Materials and Methods A natural experimental study was conducted using healthcare utilization and mortality data of the entire Korean population. The number of monthly emergency room (ER) visits was investigated to identify changes in emergency care utilization during the MERS epidemic; these trends were also examined according to patients' demographic factors, disease severity, and region. Deaths within 7 days after visiting an ER were analyzed to evaluate the impact of the reduction in ER visits on mortality. Results The number of ER visits during the peak of the MERS epidemic (June 2015) decreased by 33.1% compared to the average figures from June 2014 and June 2016. The decrease was observed in all age, sex, and income groups, and was more pronounced for low-acuity diseases (acute otitis media: 53.0%; upper respiratory infections: 45.2%) than for high-acuity diseases (myocardial infarctions: 14.0%; ischemic stroke: 16.6%). No substantial changes were detected for the highest-acuity diseases, with increases of 3.5% for cardiac arrest and 2.4% for hemorrhagic stroke. The number of deaths within 7 days of an ER visit did not change significantly. Conclusion During the MERS epidemic, the number of ER visits decreased in all age, sex, and socioeconomic groups, and decreased most sharply for low-acuity diseases. Nonetheless, there was no significant change in deaths after emergency care.

Cross-sectional study of paediatric case mix presenting to an emergency centre in Cape Town, South Africa, during COVID-19

“…The overall reduction in paediatric emergency centre visits is similar to experiences from the SARS and MERS pandemics, as people tend to avoid or delay attending hospitals due to the fear of contracting the communicable disease. 9–11 Anecdotal evidence do suggest that attendance to the primary healthcare services also decreased. This is of concern and child health needs to be monitored closely over the coming 12 months.…”

“… 6–8 However, paediatric-related presentations decreased by up to 40% during the 2015 Middle East respiratory syndrome (MERS) epidemic in Korea. 9 10 A more pronounced decrease (80%) was witnessed during the 2003 severe acute respiratory syndrome (SARS) epidemic in Taiwan. 11 A decline in trauma cases presenting to emergency centres across South Africa has already been noticed, 12 but the effect of the national lockdown on paediatric presentations remains unclear.…”

The impact of the COVID‐19 lockdown in Italy on a paediatric emergency setting

“…tings1 and limited access to the PED may have helped to limit the spread of COVID-19. It is hard to estimate whether it was the fear of contagion or the lockdown that kept people from accessing PED.Reports from general emergency departments have showed reduced visits during epidemics, even without lockdown 2. During the study period, more than 3000 people in our region tested positive for the virus and at least 280 died.…”

The clinical characteristics and prognosis of COVID-19 patients with cerebral stroke：a retrospective cohort study

“…This is especially critical for stroke patients who lose consciousness and spontaneous respiration, while mechanical ventilation is required 17 . Coinfection will in turn aggravate the illness condition of COVID-19 patients 1,18 . In this study, a higher incidence of consciousness disorder in stroke patients might be an early sign related to their poor outcome.…”