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Health-Care Officials Urge People Not to Delay Medical Help

By Tammy DanielsiBerkshires Staff
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PITTSFIELD, Mass. — People delaying their medical care is emerging as a byproduct of the novel coronavirus pandemic. 
 
It's become so apparent, that six Boston teaching hospitals have partnered on a series of public service announcements urging people not to put off contacting their doctors or avoid emergency rooms because of COVID-19 fears. 
 
"We're not seeing the same number of patients coming to our emergency departments with strokes, with heart attacks, with traumas," said Dr. Michael Apkon, CEO of Tufts Medical Center, who with two other hospital officials spoke at Gov. Charlie Baker's daily COVID-19 update on Thursday. "In fact, we're seeing about half of the activity that we would normally see during the month of April."
 
Part of the reduction can be explained by the stay-home advisories that are keeping people off roads and at home. But all three said there has been a significant dip in emergency room admissions regarding stroke and cardiac symptoms, and delays in treatment for children. 
 
"Our concern is that fear is leading to adverse outcomes," Apkon said. "We've seen children coming to the hospital after having several days of abdominal pain and coming with a ruptured appendix. We've seen patients with symptoms of stroke that are staying at home, long beyond the point at which medications that would markedly improve their outcome could safely be delivered."
 
There's definitely a sense of fear in the community about going to a hospital because that's where COVID-19 patients are being treated, said Dr. James Lederer, chief medical officer of Berkshire Medical Center in a recent interview.
 
"If you think you need help then come to the emergency room, come to our urgent care centers, that's what we're here for," Lederer said last week. "We are wearing our protective equipment, we will place a mask on you and your loved ones when they come into our facility so they're protected."
 
Lederer said Berkshire Medical is taking precautions to make it as safe as possible for people seeking care for medical issues other than the novel coronavirus. Berkshire County has high incidences of heart disease, diabetes, strokes and other chronic diseases that won't get better by ignoring them. 
 
"We've seen some deaths in the community that are very upsetting to us because they were young patients, and they were preventable and our fear is that ... they were concerned about coming here because this is where the COVID virus is," he said. 
 
Nancy Shendell-Falik, president of Baystate Medical Center in Springfield, speaking in Boston on Thursday said her hospital has seen an 80 percent decline in patients with stroke symptoms over the past month.
 
"Those patients are starting to arrive at Baystate Medical Center. They are seriously ill. And many of them have lifelong debilitating consequences to waiting," she said. The cardiac care unit has not seen as much of a drop off, but many patients are coming in after waiting two or three days.
 
And, as Greg Meyer, chief clinical officer for Partners HealthCare, also described, Baystate has seen an increase in amputations because people are waiting too long to address vascular diseases. Western Massachusetts' largest hospital normally sees 120 children a day in its pediatric emergency department; now it's averaging about 25 to 30.
 
Baker said the dramatic increase in intensive care capacity across the state to address the pandemic means hospitals are better prepared to deal with coronavirus patients as well as other acute medical cases. 
 
"We don't want people getting sicker or exacerbating an illness or an injury," the governor said. "And it's important that people are cared for when they're sick, whether that's for COVID-19, or for something else."
 
Lederer, speaking last week, said Berkshire Medical's emergency department, urgent care center and physician practices are there to provide some comfort and capacity to "re-engage" with the health-care community. The governor's admonitions to stay home are correct, but not if you're in a health-care crisis, he said.
 
"Health care is what we do, we're here for our community and we're here for your needs and staying home sometimes might seem like the safest to you and it's certainly listening to what the governor says, but sometimes, you know, you need to recognize when it's beyond something you can manage on your own and come in and get help," he said. 
 

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Joint Transportation Panel Hears How Chapter 90 Bill Helps Berkshires, State

By Tammy Daniels iBerkshires Staff
BOSTON — A bill proposed by Gov. Maura Healey would bring $5.3 million more in state Chapter 90 road aid to the Berkshires.
 
Testimony before the Joint Committee on Transportation on Thursday (held in person and virtually) pointed to the need to address deferred maintenance, jobs, infrastructure battered by New England winters and climate change, and communities burdened by increasing costs. 
 
"I know that transportation funding is so, so important. Infrastructure funding is so integral to the economy of the state," said Healey, appearing before the committee. "It's a challenging topic, but we took a look at things and think that this is a way forward that'll result in better outcomes for the entirety of the state."
 
The bill includes a five-year $1.5 billion authorization to enable effective capital planning that would increase the annual $200 million Chapter 90 aid by $100 million.
 
More importantly, that extra $100 million would be disbursed based on road mileage alone. The current formula takes into account population and workforce, which rural towns say hampers their ability to maintain their infrastructure. 
 
"This is an important provision as it acknowledges that while population and workforce may be elastic, our road miles are not and the cost of maintaining them increases annually," said Lenox Town Manager Jay Green, who sat on the Chapter 90 Advisory Group with transportation professionals and local leaders. "This dual formula distribution system addresses community equity by assisting municipalities that do not normally rank high using the traditional formula that is a large number of miles but a small population and often a bedroom community.
 
"These are rural communities with limited ability to generate revenues to augment Chapter 90 funds for their road maintenance."
 
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