Avoiding A&E Because Of The Coronavirus Pandemic Almost Cost This Man His Life

Heart attack survivor Paul Robson's warning comes as figures reveal A&E attendances for April 2020 were down 57% year on year.
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A man who dismissed his heart palpitations and chest pains because he didn’t want to put pressure on the NHS during the coronavirus pandemic has revealed how he was minutes away from death after collapsing with a heart attack.

Fears have emerged that people suffering emergencies such as heart attacks and strokes may be putting their lives at risk during the Covid-19 outbreak by delaying seeking medical help.

Latest figures from NHS England show that attendances at A&E units in England have fallen to their lowest figure on record in the face of coronavirus.

The data shows 0.9m attendances were recorded at A&Es in April 2020 – a decline of 57% from 2.1m in April 2019.

The number is the lowest for any calendar month since current records began in August 2010 and has raised concerns that people are not seeking the lifesaving care they need.

Experts fear it could mean thousands of indirect deaths resulting from the coronavirus crisis as people are either anxious not to burden the NHS with symptoms or are too scared of being in a medical setting during the pandemic and being exposed to Covid-19.

Paul Robson, 46, collapsed at home with a heart attack during the coronavirus lockdown and was taken to hospital where doctors told him that if he had got there 30 minutes later, he wouldn’t have survived the ordeal.

He admitted to HuffPost UK that he had ignored heart palpitations for a few weeks before the heart attack as he didn’t want to burden the NHS during the crisis.

“I didn’t want to bother the NHS at such a time of crisis when coronavirus was all over the news and I thought they wouldn’t be able to cope with anything else.”

- Paul Robson

Paul, who lives in Berkshire, said: “I had been suffering from some heart palpitations for a couple of weeks beforehand, but I foolishly tried to ignore them.

“I didn’t want to bother the NHS at such a time of crisis when coronavirus was all over the news and I thought they wouldn’t be able to cope with anything else.

“I thought my doctor would be inundated with other patients and I didn’t want to add to the pressure.”

Paul Robson
Paul Robson

Paul, a veterinary administrator for the British Horseracing Authority, describes the palpitations as a racing heartbeat and he felt dizzy and uncomfortable. He also took his pulse on a few occasions and it was over 100, which he knew wasn’t right. However, it would calm down after a while so he convinced himself his symptoms were caused by anxiety.

“I know heart palpitations can be a sign of anxiety and like many people, I was worried about coronavirus and worried about my job so I just put it down to that.

“Ordinarily, if it hadn’t been for the situation with the virus, I would have gone to the doctor to get it checked out. In hindsight, I was stupid not to do this, but I didn’t know what was around the corner.

“I kept thinking it would go away and that if not, I might go to the doctor when things had quietened down a bit with coronavirus.”

The drama unfolded during the first weekend of the UK coronavirus lockdown when Paul, who had no previous history of heart issues, was struck by the palpitations while watching television with his housemate.

“This time, it felt different and as well as the heart palpitations, I was getting pins and needles sensations in my arm too.” he said.

Paul went to bed, but struggled to sleep and began experiencing chest pains. He went to the bathroom at around 4am on the Sunday morning and suddenly collapsed hitting his head on the side of the bath and recalls having an agonising pain in his chest and arm and feeling sick.

“I shouted for my housemate and he got up, realised something was badly wrong and called an ambulance.”

Paul realises he is very lucky not to have been alone as he was in so much pain and felt so disoriented, he believes he would have struggled to get to a telephone to alert help.

Paul says it took an hour and 20 minutes for the ambulance to arrive as they were under so much pressure and during his agonising wait, he managed to crawl to the bottom of the stairs.

When paramedics arrived at the scene, Paul was lying on the floor of his hallway. Ambulance staff quickly questioned his housemate about whether Paul had any coronavirus symptoms as they prepared to examine him.

“They did an ECG test and told me there was an abnormality.” said Paul. “I said: ‘I’m having a heart attack aren’t I?’ and the paramedic said yes, she thought I was and they needed to urgently get me to hospital.”

“I was fearful of going into a hospital and the risk of potentially being exposed to coronavirus. But I was dying.”

- Paul Robson

Paul confesses he was anxious about going into a hospital amid the coronavirus pandemic, but knew he had no choice. “I was fearful of going into a hospital and the risk of potentially being exposed to coronavirus was on my mind.” he said.

“But I was dying and was in no position to deliberate about going into hospital. I had no option.”

Paul was taken straight to the hospital theatre from the ambulance where a team was awaiting his arrival. His temperature had dropped and his blood pressure was dangerously low.

He underwent an angiogram, a special type of X-ray where dye is used to allow doctors to look at the coronary arteries and see how well blood is flowing and identify any narrowings.

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It was discovered that one of Paul’s main arteries was 100% blocked and medics performed angioplasty, a procedure which uses a balloon to widen blocked coronary arteries and inserted stents to allow blood to flow more freely.

Paul said: “Doctors told me quite categorically that if I had got to the hospital even half-an-hour later, I would not have made it – which just shows how much of a near-death experience it was.

“Knowing this makes me feel incredibly lucky and I am just glad the ambulance arrived when it did and I managed to get the treatment I needed in time.

“I was just 30 minutes away from death and that is a disturbing realisation.”

Despite Paul’s initial fears and reservations about going into a hospital during the coronavirus pandemic, he was pleasantly surprised to find he was taken straight to the cardiac unit where the environment was calm.

“I think a lot of people are frightened that if they go to hospital, they will be met by a sea of people in hazmat suits. But this isn’t the case at all.”

- Paul Robson

“I thought the NHS would be rushed off their feet in hospitals and not have any time to deal with anyone apart from Covid patients.” he said. “But the cardiac ward was quite empty and there were only three or four other patients there.

“I received first-rate treatment and care and everything felt relaxed and well-run.”

Paul remembers feeling concerned after he noticed a woman with chest pains in the same ward had a cough and he expressed his fears to the ward sister that she may be displaying coronavirus symptoms.

However, he was reassured that everyone was screened before they were admitted and anyone with the slightest symptoms of coronavirus would not be allowed in the cardiac ward.

Paul Robson
Paul Robson

Paul was only in hospital for 36 hours as he made a good recovery following the procedure, and he is now recuperating at home.

He wants to allay any fears and misconceptions that people might have about going to hospital during the pandemic and is urging them to seek medical help when they need it.

“I think at the moment, a lot of people are frightened that if they go to hospital, they will be met by a sea of people in hazmat suits.

“But this isn’t the case at all and there is a real conscious effort to keep Covid patients completely separate from other patients.

“Normal hospital services are still running and not every single resource has been diverted to coronavirus.

“Your symptoms could be a matter of life and death and if you are a medical emergency, you are just as important as anyone else and won’t get cast aside.”

He added: “If I had had my symptoms investigated a few weeks earlier, I might still have ended up having the same procedure but I might have had it a lot sooner instead of minutes away from death.

“I am just glad I got the medical attention I needed before it was too late.”

Emily McGrath, senior cardiac nurse at the British Heart Foundation, says Public Health England figures show there has been a 50% fall in the number of people attending hospital with heart attacks raising concerns that people are not getting the urgent medical help they need.

“A heart attack is a medical emergency and delays in seeking treatment and not getting to hospital soon enough leads to a higher risk of death and also of heart damage and failure.”

- Emily McGrath, British Heart Foundation

She told HuffPost UK: “This is a significant drop in emergency attendees for heart attacks and although we would like to think it is because people are not experiencing them, the reality is that they are scared and are avoiding and delaying treatment.

“A heart attack is a medical emergency and delays in seeking treatment and not getting to hospital soon enough leads to a higher risk of death and also of heart damage and failure.”

Emily McGrath, senior cardiac nurse at the British Heart Foundation
Emily McGrath, senior cardiac nurse at the British Heart Foundation
Emily McGrath

McGrath said that some people experiencing symptoms showing an issue with their heart might ignore them thinking they will go away of their own accord. But she says anyone having chest pains which they are unsure about should seek help.

The British Heart Foundation, which has launched an online coronavirus support hub to provide information for those living with heart and circulatory diseases during the pandemic, says the 50% drop is equivalent to approximately 5,000 of the expected people every month or more than 1,100 people every week with possible heart attack symptoms not being seen in emergency departments.

The charity organisation fears this will lead to unnecessary deaths and more people living with debilitating heart failure if they do recover.

They say heart attacks don’t stop for a global pandemic and are urging anyone experiencing sudden chest pain which spreads to their arms, back, neck or jaw and feels heavy or tight or if they become short of breath or start to feel sick to call 999.

Juliet Bouverie, chief executive of the Stroke Association, told HuffPost UK they are similarly concerned that people who have suffered a stroke or transient ischemic attack – a mini-stroke – are not calling 999 amid the coronavirus pandemic.

With stroke striking every five minutes, she fears thousands of people could be at risk of stroke-related death or severe disability if they don’t act FAST on symptoms.

Latest emergency department attendance figures for stroke related symptoms for last week show a massive 66% decline compared to the same week last year, with 51,738 attendances for the week ending April 19 2020 compared to the same week in April 2019.

“People are frightened of catching coronavirus and we are concerned they will be having strokes at home and not getting the vital treatment they need.”

- Juliet Bouverie, chief executive of the Stroke Association

“The number of people presenting at A&E with stroke related symptoms has reduced dramatically.” said Bouverie.

“We think it is either because people are not wanting to burden the NHS when they know it is prioritising coronavirus – or because they are frightened of being in a hospital setting during this pandemic.

“Our message is very clear. If you or a loved one are experiencing symptoms of a stroke, you must dial 999 as it is a medical emergency.”

Juliet Bouverie, chief executive of the Stroke Association
Juliet Bouverie, chief executive of the Stroke Association
Juliet Bouverie

Bouverie explained that stroke is the biggest single cause of adult disability and by delaying calling 999 and getting treatment, people are potentially putting themselves at risk of death or disability.

“The golden time to receive treatment is a four-hour window from the onset of a stroke to actual medical treatment.” she said. “If people get clot-busting treatment, it saves lives and reduces the risk of long term disability.

“People are frightened of catching coronavirus and we are concerned they will be having strokes at home and not getting the vital treatment they need and there will potentially be deaths and disabilities that could have been prevented.”

Bouverie told HuffPost UK that the NHS is equipped to treat both stroke and coronavirus and that patients can be assessed by telephone or FaceTime and may not even need to attend hospital.

“If someone is having a mini-stroke, they might not necessarily need to go to hospital and could be put on preventative medication.

“But if it is suspected they are having a major stroke, an ambulance will be called to take them to hospital.”

The stroke charity is highlighting the stroke acronym FAST urging people to familiarise themselves with the symptoms of a stroke: Face, Arms, Speech and Time (to call an ambulance).

NHS chief executive Sir Simon Stevens has stressed that the NHS is still there for patients without coronavirus who need urgent and emergency services for heart attack, stroke and other killer conditions.

Seeking medical help is one of the four reasons people can safely leave home during lockdown in line with government guidance.

Stevens said: “While NHS staff have pulled out all the stops to deal with coronavirus, they have also worked hard to ensure patients who don’t have Covid-19 can safely access essential services.

“Ignoring problems can have serious consequences – now or in the future.”

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