U.S. hospitals, many past the peak
coronavirus crush, are relying on plexiglass dividers, advance testing of patients
and limited elevator traffic to convince people, especially those needing
urgent care, that the facilities are safe.
Hospitals put lucrative elective procedures and other nonessential operations
on hold weeks ago as they geared up for the coronavirus onslaught.
But fear of the highly contagious virus, which has killed over 63,000 people
and infected more than one million in the United States, has kept even
victims of serious health crises like stroke and appendicitis away from
emergency rooms.
“We have to convey to the public that we are safe ... and to defer
medical care in urgent situations will cause more harm,” said Mark
Solazzo, chief operating officer at Northwell Health, New York’s
largest healthcare provider.
In addition to urgent care, medical providers are beginning to tell patients
they can come back for more routine care, and are spelling out new precautions
they are taking in order to regain the public’s trust.
Efforts put in place due to the pandemic - like screening people for symptoms
of COVID-19 - the illness caused by the coronavirus - taking the temperature
of everyone entering a healthcare facility, making people wear masks,
and supplying disinfectant wipes, will continue.
Hospitals will still rely heavily on “telemedicine” visits
by video chat to help triage patients and determine whether they need
to be seen. Patients are automatically tested for coronavirus infection
before they are admitted for scheduled surgery or other inpatient procedures.
Northwell and other hospital systems have launched marketing campaigns
to explain how they are making visits safer.
In an email sent to nearly 3 million New York area residents, Northwell
reminds patients that visitors are not allowed at its hospitals, that
all staff wear full protective gear, and that patients can wait in the
parking lot and check in to appointments on their phone to avoid waiting
room crowds. Plexiglass barriers are being used in reception areas to
separate patients from office staff and the health system plans to share
information about how facilities are being deep-cleaned.
UCHealth, Colorado’s largest health system, is limiting elevator
capacity, normally around a dozen people, to four at a time, and is asking
them to maintain their distance, with one person in each corner. To avoid
sharing pens, UCHealth urges patients to fill out their paperwork online
ahead of a visit.
Risk of Delaying Care
U.S. hospitalization rates fell in March compared to February for a range
of critical conditions, according to claims statistics from health insurer
Cigna Corp.
Downturns ranged from 11% for acute coronary syndromes such as heart attack,
to over 30% for patients experiencing stroke or irregular heartbeat. For
a stroke, getting to the hospital very quickly is critical to recovery chances.
U.S. medical tests for detecting and monitoring cancer and other conditions
fell by as much as 68% in mid-March through mid-April, according to a
report from Komodo Health.
Several recent
stroke patients at Hoag Hospital in Newport Beach, California had delayed care
for days after their first symptoms, citing fear of the virus,
Dr. Michael Brant-Zawadzki, the hospital’s senior physician executive, told Reuters.
One young man experienced weakness due to a rare lesion in his brain, but
did not come to the hospital until he was paralyzed on one side. In another
case, an elderly man had an acute stroke, but put off going to the hospital
because he is in a high risk category for contracting the coronavirus.
Both patients now have brain damage.
Cedars-Sinai Medical Center in Los Angeles is emailing patients to assure
them that people diagnosed with COVID-19 are kept separate from the general
hospital population, that staff members are screened daily and that everyone
is required to wear face masks.
“We are encouraging people to seek urgent care. We still have the
capacity,” said Dr. Richard Riggs, chief medical officer at Cedars-Sinai.
Hospitals are redesigning waiting rooms to space out seating, which in
some cases is being replaced with furniture made of easy-to-clean materials.
“It is important that we don’t see ongoing delay of care. We
worry about the escalation of chronic disease,” Dr. Robert Hart,
chief medical officer at Ochsner Health, Louisiana’s largest hospital
system, said in a phone briefing.
Ochsner is determining how to reschedule surgeries put on hold during the
crisis in order to avoid “doing more harm than good,” he said.
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