Several of New Jersey's major hospital systems are out this week with warnings not to ignore potential life-threatening health symptoms, like those of a heart attack or stroke, for fear of contracting the novel coronavirus in a hospital.

Dr. Chris Freer, chair of the emergency department at St. Barnabas Medical Center in Livingston and assistant director of emergency services for RWJBarnabas Health, said with most of these serious ailments, time is of the essence when it comes to treatment.

"We've definitely seen a decline in non-COVID patients," Freer said, adding that it was "concerning, because we don't think that strokes and heart attacks and different types of medical emergencies have stopped. We do think that since we're seeing such a drastic decline in those, that they didn't go away but people might just be fearful of coming to the hospital now."

Hackensack University Medical Center on Friday cited a study out of Seattle showing emergency admissions at six large hospitals in that city's metro area dropped between 10 and 20% from February through March. Hackensack's doctors are on the same page as Dr. Freer: The difference between life and death might come down to every second a patient is not receiving hospital care.

That reality could soon become another chilling statistic in this crisis. New data issued Wednesday in a county-by-county report from the state Department of Health indicated that provisional death counts for both March and April 2020 exceeded any singular month in the five years prior, with March's 7,600 deaths just barely outpacing the 7,505 in January 2018.

The 11,029 April deaths counted through last Friday represented nearly 150% of March's total, and even with a week's worth of data still to be processed, the month was already the deadliest in at least the last five years for 13 of New Jersey's 21 counties.

While those numbers encompass deaths from all causes in the state, COVID-19 is known to be responsible for more than 6,000 New Jersey deaths in April alone, as the coronavirus had claimed just 267 lives as of Gov. Phil Murphy's March 31 update. Still, there may be just as many non-COVID deaths logged in April, a month that has averaged just under 6,100 fatalities in New Jersey since 2015.

On Wednesday, state Health Commissioner Judith Persichilli confirmed the reports from around New Jersey that many patients are opting not to be seen for urgent issues, and said she and New Jersey Hospital Association President Cathleen Bennett would be filming a public service announcement to tell New Jerseyans not to neglect serious ailments that may arise.

"If you're experiencing signs and symptoms that could be a heart attack, or a stroke, or unrelenting abdominal or back pain, you should not delay in seeking care," Persichilli said. "Call 911 and go to your nearest emergency room."

There is good news about hospital capacity, according to Freer, as the wave of positive cases continues to flatten and begins to decline.

"Fortunately, the volumes are down significantly with COVID patients, and we're just concerned that patients could be having adverse outcomes in their house," he said.

Hospitals in the RWJBarnabas system, and surely elsewhere throughout the state, are taking extra precautions to put potential patients at ease about cleanliness and sterilization should they need treatment, something Persichilli also echoed.

"We have triage process set up up front, where we have separate entrances so that patients are completely separated, but also as I walk around the ED, I see more housekeepers than I've ever seen," Freer said, also noting that all admitted patients, emergency department or otherwise, are tested for COVID-19.

If you are still unsure about seeking medical attention in person, hospitals implore you to not let a warning sign go completely unnoticed and undocumented. AtlantiCare, in South Jersey, recently announced an expansion of its telehealth services for primary and urgent care, plus a plethora of specialties including behavioral health, cancer care, diabetes, OB/GYN, and pediatrics.

AtlantiCare said its declines in emergency and urgent care visits had been expected due to the pandemic.

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