David J. Altschul

The pandemic associated with COVID-19 had a dramatic impact on all aspects of our daily lives. While much of the fear of the disease and its spread was appropriately focused toward the virus itself, this reaction had an impact on other disease states in the people in our communities. We as health care professionals have an obligation to raise public health awareness to these reactionary repercussions and to continue to strive to get stroke patients back into the hospitals at faster time intervals, which will then improve outcomes and increase the number of people eligible for interventional therapies. We have used these data to remind physicians and community members of the importance of coming into the hospital if someone has focal stroke symptoms and that time is of the essence.

Since the publication of our article, there has been further corroboration of our data that the outcomes of stroke patients during the height of the pandemic were much worse compared with prior historical data, and that not only did patients come in a delayed fashion, but also fewer patients came into the hospital altogether. While patients with COVID-19 also had a higher risk of having stroke complications, and those who suffered from stroke had higher mortality rates, delay to hospital presentation is a straightforward and addressable issue in our communities. A number of the health care system’s issues were exposed during the worst of the pandemic, whether it was EMS capabilities, ED capacity and surge management, or increasing fear or mistrust of the health care system by patients, that can be explored and addressed if and when another major surge should arise. Expansion of the research done has a clear direction toward trying to see as we slowly come out of the pandemic whether these delays in presentation for stroke patients have improved yet or not. Further research could also be done in exploring various public health initiatives to see if they might have an impact on improving time to presentation for patients with stroke symptoms.

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