COVID-19 and Acute Medical Care: Impact on Dementia Patients

Abstract.The SARS-CoV-2 virus has resulted in hundreds of thousands of deaths across the globe andoverwhelmed many health systems. In Massachusetts alone, there have been over fivethousand deaths over a two month period attributable directly to COVID-19, i.e., the diseaseresulting from viral infection. Lacking a vaccine or definitive treatment, slowing disease spreadsuch that daily demand falls within the capacity of local medical systems is the immediatepriority for this outbreak, but the changes involved with such mitigation efforts could be costly.For example, many hospitals have implemented changes to increase capacity for COVID-19patients, e.g., delaying elective procedures and shifting resources across service lines, whichcould impact care for other conditions requiring time-sensitive care, e.g., strokes or heartattacks. There currently is limited information on the impact of the outbreak on non-infection,acute medical conditions. There also is little information on how hospital responses impactpatient outcomes. Given concerns about future outbreaks in other states, as well as additionalrepeat outbreaks (or waves of disease transmission), there is a critical need for these types ofinformation. In this project, we will address two aims: 1) to examine the impact of the COVID-19demand shock on acute medical care received in the Emergency Department (ED) or hospital;and 2) to examine hospital responses to the demand shock and their impact on clinical eventrates. We will use novel, linked real-time data sources to address these questions overall andfor vulnerable population subgroups such as patient with dementia. Indeed, the early reportssuggest that the elderly are disproportionally affected by COVID-19 itself and potentially thehealth system's changes in response to the outbreak. These data could inform preparation forfuture COVID-19 outbreak waves occurring later this year, as well as future transmissibledisease outbreaks.