Stroke concern rising amid COVID-19 crisis warns top charity

Concerns are mounting that people across the UK who have a stroke or TIA/mini-stroke (transient ischaemic attack) are not calling 999 amid the coronavirus pandemic.

With stroke striking every five minutes, the Stroke Association fears that thousands of people could be at risk of severe disability, or even stroke-related death, if they don’t Act FAST on stroke symptoms.

Dr Deb Lowe, NHS National Clinical Director for Stroke and Consultant Stroke Physician at Wirral University Teaching Hospital, said: “We’re beginning to see some quite striking reductions in the number of people coming into hospital with the symptoms of stroke. It appears that people aren’t seeking emergency help or going to hospital when they suspect a stroke, possibly due to fear of the virus or not wanting to be a burden on the NHS.

“Stroke is a medical emergency and it’s essential that you call 999 straight away if you suspect you or someone around you is having a stroke. Our hospitals are equipped and ready to treat stroke patients. Given the emergency changes being made across the NHS, it’s possible that a patient’s treatment or journey might be a bit different while we put measures in place to deal with coronavirus safely.  But these are to keep patients and NHS workers safe and the most important thing to remember is to dial 999 if you suspect a stroke.”  

Latest figures from Public Health England showed attendance to Emergency Departments in England has dropped by over a third (34.5%) on the same week last year, from 136,669 to 89,584. Latest figures fromPublic Health Scotland report attendance to emergency departments has dropped by over a third (40.1%) on the same week last year. While figures for emergency admissions aren’t available yet, the charity and senior stroke professionals expect similar declines.

In 2019, there were almost 90,000 strokes in England alone. Meanwhile, almost 21,000 patients were admitted to hospital with a TIA/mini-stroke. The charity warns that any delay in getting help will jeopardise your ability to rebuild your life after stroke.

Juliet Bouverie, Chief Executive of the Stroke Association said: “The fear of contracting the virus or feeling like a burden on the NHS might be the main reasons putting people off seeking treatment. But I am reassured that the NHS is well equipped to treat both stroke and coronavirus. The best thing for you and the NHS, is to call 999 and say you (or the person in front of you) is having a stroke. Assume stroke until told otherwise.

“Equally concerning is people who experience mini-stroke and then dismiss it as ‘just a funny-turn’. A mini-stroke is a warning that major stroke is on its way, so you shouldn’t ignore the signs; and you need to seek help.

“By acting FAST and getting access to world-class treatments, you can help save lives.  Acting FAST can also reduce the misery for thousands of stroke survivors and their families and the impact on the NHS associated with stroke, as the UK’s leading cause of adult disability. Now more than ever, during this pandemic we must remain focused on making and keeping stroke a priority for the UK.”

The UK’s leading stroke charity is highlighting the world-famous stroke acronym, FAST, urging the public to familiarise themselves with the signs and symptoms of a stroke: Face, Arms, Speech and Time (to call an ambulance) – Act FAST.  The signs of a TIA/mini-stroke are the same as a stroke, but only last up to 24 hours. 

Professor Rustam Al-Shahi Salman, President of the British Association of Stroke Physicians (BASP) and honorary consultant neurologist in Edinburgh said: “Strokes and mini-strokes are medical emergencies. The quicker many stroke treatments are given, the better. As we say, 'time is brain'. So it’s important to recognise the signs of a mini-stroke or stroke and act immediately.

"In this phase of social distancing during the COVID-19 pandemic, family and friends can do the FAST test on the phone or via video chat.  Many stroke services have also adapted to the pandemic rapidly: rather than calling patients with mini-stroke up to a hospital outpatient appointment, they are using phone or video chat to diagnose and recommend treatment for patients.”

Dr David Hargroves, National Clinical Lead for the GIRFT NHSE/ I Stroke and Consultant Stroke Physician at East Kent University Hospitals added: “There may be many different ways in which the excellent stroke care we have in the UK will be delivered in the coming months. This may include different environments patients are cared for in, virtual assessments, therapy advice or interventions delivered by telephone or video link. 

"Members of the public should be reassured that these changes will help reduce the transmission of the virus, whilst continuing to provide the care that will save lives and reduce disability. It is so vitally important that they continue seek help when they first spot the symptoms or signs of a stroke.”

In 2001, the Stroke Association funded research to help paramedics spot the signs of stroke using the Face Arm Speech Time (to call an ambulance) test. This research lay the foundations for one of the most successful public health awareness campaigns in the UK, the Act FAST campaign. Symptoms such as facial drooping, arm weakness and speech difficulties are the most common, (but not exclusive), signs of a stroke.

Other signs of stroke can include

  • Sudden weakness or numbness on one side of the body, including legs, hands or feet.
  • Difficulty finding words or speaking in clear sentences.
  • Sudden blurred vision or loss of sight in one or both eyes.
  • Sudden memory loss or confusion, and dizziness or a sudden fall.
  • A sudden, severe headache.

For more information about stroke and the Act FAST campaign go to www.stroke.org.uk.