Why were hospital admissions from the ER decreased during the initial covid wave?

https://www.sciencedirect.com/science/article/pii/S073567572031038X?via%3Dihub#f0005

This is an interesting article. To understand the data, you have to understand the entry into a hosptial bed.

1. You arrive at the ER as a sick person, you are triaged in the ER, and they determine you need inpatient care for your illness or injury. People arrive to ER via ambulance, car, helicopter, etc.

2. You arrive to the hospital from ANOTHER hospital because the hospital you were at does not have the ability to treat the severity of your illness, and they request transfer to a hospital with greater treatment capabilities for severely ill or injured people. Example: you are in a bad car accident in a rural part of the state, you arrive at the nearest ER for triage, they see that you are severely injured but they are only a level 3 trauma center and you need a level 1 trauma center. They stabilize you and chopper you to a hospital that has the ability to better treat you.

**the majority of hospital admissions are scenario #1. Scenario #2 is few compared to #1.

“We observed a 32% decrease in admissions during weeks 11 to 36 in 2020, (January to September 2020) with significant decreases in admissions for chronic respiratory conditions and non-orthopedic needs. Decreases were particularly acute among women and children, as well as patients with Medicare or without insurance. The most common diagnosis during this time was SARS-CoV-2. Our findings demonstrate decreased hospital admissions through EDs during the pandemic and suggest that several patient populations may have deferred necessary care.“

This does not correlate to the number of people who died of covid during the initial wave of the pandemic. How did the majority of those people end up in the hospital? Via the ER. This data was gathered from 12 hospitals in the state of Massachusetts. This was not a multi-state data review.

Have a look at this data? What is interesting is that during the peak of flu season (week 1-12), hospital admissions were relatively flat. And they dropped massively when covid arrived, yet the number of covid arrivals was nearly 20%. What was also interesting is that respiratory illness and respiratory failure and traumatic brain injury admissions were higher than average. So my question becomes yet again: how did the ER admission numbers drop so significantly when covid cases and people dying in the hospital were off the charts (according to the “tv data”), so why were ER admissions so low? And why were they so flat during flu season coming into covid season? These numbers were from a state that claimed, much like New Jersey, to have exceedingly high covid cases due to being in close proximity to New York, where the death trend was really high.

They are blaming the decline in people not coming to the ER for basic health issues that they previously went to the ER for. That is the story they are trying to sell. My question is did the rise in covid cases actually originate from the ER, as in people coming into the ER due to illness……..or did these 12 hospitals take covid cases from outside hospitals as direct admits? Does this show how they “spread” covid rather than truly look at decreased hospital ER admissions? Two weeks to flatten the curve time period here……New York nearby…….were covid cases direct admitted from other hospitals to spread it?