The impact of emergencies on access to emergency cardiac care: Lessons from COVID-19

A new study uncovers how the COVID-19 pandemic reshaped emergency care for acute coronary syndrome, with a sharp decline in hospital visits nationwide. Analyzing over 61,000 cases, the research reveals that older adults, particularly women, were disproportionately affected, avoiding critical care during periods of high virus transmission. These findings shine a light on the unseen toll of public health crises, underscoring the urgent need to build trust and ensure access to life-saving care for vulnerable populations in future emergencies.

A new study led by Alexander Kagan, as part of his MPH studies at the Hebrew University, under the guidance of Professor Hagai Levine and Dr. Donna Zwas. highlights the significant impact of the COVID-19 pandemic on emergency department visits for acute coronary syndrome. The research provides valuable insights into how public health emergencies can alter healthcare-seeking behavior and emphasizes the importance of maintaining public trust in medical systems during crises.

The study analyzed data from 61,349 emergency visits for acute coronary syndrome across Israel between January 2018 and December 2021. By examining trends during three distinct periods—the pre-pandemic phase (January 2018 to February 2020), the early-pandemic phase (March 2020 to January 2021), and the late-pandemic phase (February 2021 to December 2021)—the researchers observed a notable reduction in visits during times of high COVID-19 morbidity and mortality.

During the early-pandemic phase, which included lockdowns, the largest decrease was seen among women aged 65 and older, with visits falling by 18.4 percent compared to pre-pandemic trends. Men aged 25 to 64 experienced the smallest decline, with a reduction of 7.2 percent. In the late-pandemic phase, which was characterized by high vaccination rates and no lockdowns, visits by women aged 25 to 64 showed a decline of 20.1 percent.

“These findings underscore the profound effect health crises like the COVID-19 pandemic can have on access to critical care,” said Professor Levine. “Older adults, particularly women, were disproportionately affected. This highlights the urgent need for public health strategies that ensure healthcare remains accessible and trusted during future emergencies.”

“The study highlighted that multiple and complex factors can influence people's health behaviors during times of crisis and pandemics.”, said Alexander Kagan. “It is crucial for both public health specialists and policymakers to comprehend the interplay between environmental and sociodemographic factors, health behaviors, and public health interventions to respond in a better and more effective way to future public health emergencies.”
 The study on the impact of COVID-19 on access to emergency cardiac care highlights critical lessons for shaping resilient and inclusive healthcare strategies. Key findings reveal that vulnerable populations, particularly older adults and women, avoided critical care more frequently during the pandemic, emphasizing the need for targeted, demographic-sensitive interventions. It underscores the importance of rebuilding public trust through transparent communication, engaging community leaders, and ensuring consistent messaging. 
Moreover, the study’s data-driven approach, analyzing over 61,000 cases, highlights the need for real-time monitoring systems and predictive modeling to anticipate healthcare trends during crises. Tailored public health messaging at different phases of emergencies is crucial to reassure safety, reduce hesitancies, and encourage follow-up care. The broader implications point to the necessity of designing adaptable, crisis-resilient systems that address systemic inequities and reduce preventable harm during future health emergencies and other catastrophes. These insights emphasize the importance of proactive, inclusive strategies in ensuring equitable access to life-saving care.