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As hospitals across Washington are grappling with capacity challenges due to rising COVID cases, health problems brought on by delayed care, winter weather-related accidents, and the inability to discharge patients to nursing homes, an all-too common mistake is causing emergency rooms to be overrun.

State health officials and hospital leaders say people with mild COVID cases are showing up at emergency rooms for care.

“If you feel … more or less like you have the flu, stay home. Do not come to the emergency room,” said Cassie Sauer, president and CEO of the Washington State Hospital Association, at the association’s weekly briefing on Thursday.

Snohomish County says save testing for those with symptoms, exposures

Dr. Frank Riedo, medical director for Infection Control and Prevention at EvergreenHealth Hospital in Kirkland, noted at the WSHA briefing that some primary care doctors are sending patients to emergency rooms with the mistaken idea that they can get omicron-specific monoclonal antibody treatment there.

“That’s an unrealistic expectation,” Riedo said.

Sauer explained that every minute spent on someone with a non-emergency takes time and resources away from people with severe COVID or other serious conditions.

“There’s a federal law that requires us to screen and stabilize every patient who comes in, and it is causing a huge backlog in our ERs, it’s jeopardizing care for people with true emergencies, and it is totally burning out our staff,” Sauer said.

Some of those people with mild COVID, she said, are under the impression that with high demand at test sites, they should get tested at emergency rooms.

“We have way, way, way too many people coming to the emergency room to get testing,” Sauer said. “Emergency rooms are not testing sites.”

“[An emergency] does not mean that you go to the emergency department to get tested, that does not mean that you go to the emergency department because you had a positive test and you’re thinking that you might want to get it confirmed,” said state Secretary of Health Dr. Umair Shah at the Washington State Department of Health’s Thursday briefing.

He explained that there are certain cases in which you should absolutely seek emergency treatment as soon as possible for COVID, such as if you are feeling chest pain or are having trouble breathing.

Please do not defer care when it’s needed – know the signs of a heart attack or stroke and seek care for serious and life threatening conditions. Avoid the ER unless you really need it.

If you test positive at home and you have mild symptoms and can manage at home, don't go out.

— Office of Dr. Umair A. Shah, WA Sec of Health (@WaHealthSec)

If you do feel cold-like symptoms and cannot get a test, Shah said you should assume that you are positive, isolate, and notify your recent contacts.

“If you’re not sure or if you can’t get the test, then act as if you have what you are otherwise concerned about,” he said. “So in this case, if you’ve got symptoms and you can’t get a test, instead of frantically saying, ‘I’ve got to go and clog up an emergency department’ when your symptoms are mild and further that strain on that health care system, you stay home, you isolate.'”

Snohomish County Health District leaders said Wednesday that with new cases hitting record highs, health departments will not be able to reach out to everyone who tests positive with advice on what to do next; people will need to take responsibility for themselves.

Part of that includes reporting positive tests. Sauer said the state’s daily case counts are likely lower than is accurate due to the difficulty some COVID-positive people are having finding tests, and because “people are also doing home tests and finding positives” without reporting them.

The state Department of Health encourages people to report their positives via the , 1-800-525-0127. Additionally, anonymously reporting it on the free WA Notify app lets your close contacts know they have had an exposure, without giving your identity away.

Shah said this information gap between known and unknown positives will be an ongoing issue as cases skyrocket, but he noted that it is not the most important statistic that he and his colleagues are watching.

What to do if you test positive for Covid-19

“One, you focus on hospitalizations and deaths, and number two is you focus on outbreaks. … It’s not as much about the numbers of cases, it’s really about the severity of those cases, and that’s what we’re really wanting to focus on,” he said.