At Sanford Health, addressing health care needs is not something that should be complicated by the presence of the coronavirus.
In other words, it is OK to keep regularly scheduled appointments. In fact, it is encouraged.
The national conversation regarding the coronavirus is shifting from the disease itself to the gradual reopening of our communities. Meanwhile, within the region, states have increased testing, monitoring and tracing of the virus.
“It’s very important for people to understand that our hospitals and clinics are safe places,” said Dr. Jeremy Cauwels, Sanford Health senior vice president of clinic quality.
“We have the ability to keep our COVID patients in one part of the hospital and the patients without COVID in a different part of the hospital. We now have the testing ability, the protective equipment and all of the things we need to appropriately screen and separate those people.”
That includes handling a “second surge” of the virus that health officials expect as a result of the gradual re-opening of stores, restaurants and other public venues. It is an unavoidable part of the process.
“We’ve planned for this. Our modeling has predicted this,” said Sanford Health Chief Medical Officer Dr. Allison Suttle. “We do have capacity to handle what comes our way. We have flattened the curve.”
Health care needs amid pandemic
In this case, effectively flattening the curve at Sanford Health comes with assurances that there should be no hesitation in seeking out medical attention.
“We’re able to say with a fair bit of certainty that we’re going to have enough people and beds and places to take care of people,” Dr. Cauwels said. “The things that were slow initially were things like protective equipment — masks and gowns and things like that — were disrupted because many of those things were made in China. The places that made them that aren’t in China weren’t prepared to make up the difference.”
Hence, the region became a place where people were encouraged to stay home and practice social distancing.
“This time that people have spent indoors hunkering down for the last month has really bought us the time to make sure we have all the pieces in place,” Dr. Cauwels said. “Now we know we have what we need to care of people.”
Your medical history
Maintaining appointments and seeking care for nonpandemic issues is especially important for people with ongoing medical issues that demand regular monitoring.
“Everybody has come into this pandemic with their own medical history,” Dr. Cauwels said. “For some people that is very benign, and for others that is a lot of medical history. Those kinds of medical problems are exactly the things that put you at a higher risk for complications if you get COVID.”
Managing conditions like diabetes, heart failure or high blood pressure is as important as avoiding the coronavirus itself. Avoiding medical attention for something like heart failure, for instance, can make you more vulnerable should you become infected with the virus.
“If you don’t know how your heart is functioning, if you don’t know if your medications are right, the odds of you ending up in the hospital during this two- or three-month period where COVID is running through the community is extremely high,” Dr. Cauwels said. “Checking in with your doctor and making sure your heart failure is being managed is absolutely critical.”
Decline in vaccinations
Nationwide, health care providers are seeing a troubling decline in well child care visits. Vaccinations, in particular, have become a trouble spot.
In the month of April alone, vaccination rates dropped off by 50 percent from a year ago within the Sanford Health system. Numbers for annual screenings for cancer have also declined.
“The American Academy of Pediatrics has put out several articles indicating they’re very concerned about vaccine-preventable illnesses causing outbreaks,” said Dr. Vanessa Nelson, a pediatrician at the Sanford Children’s Clinic in Bismarck, North Dakota.
“In Bismarck, we’ve seen whooping cough in the last month. That can be fatal to infants. For all of the other vaccine-preventable illnesses, as well, we want to avoid outbreaks.”
Well child checkups are not just about vaccines, either. Dr. Nelson and her support staff have been busy fielding questions from parents who wonder if it’s OK to bring their children into her clinic.
Those curious parents then learn about all the precautions in place to keep pandemic issues separate from nonpandemic at Dr. Nelson’s clinic. They hear about the thorough cleaning the facility undergoes daily. In addition, they hear about how waiting until pandemic numbers improve is a strategy that comes with its own complications.
“When everything opens back up, there will be a big demand,” Dr. Nelson said. “Like with the hair salons, when they open up, they’re going to have large wait-lists. So if you’re not coming into the clinic right now, when things start getting back to normal there is likely to be a rush to get in.”
‘We don’t have to do everything face-to-face’
On the plus side, dealing with the pandemic has been accompanied by the increased popularity of telemedicine. This includes use of virtual care for both COVID-19 and everyday concerns. There were more than 34,000 video visits and 4,500 e-visits within Sanford Health completed in April alone.
“We’ve learned that we don’t have to do everything face-to-face,” Dr. Cauwels said. “We can get a lot of medicine done in a phone call or a video visit to help a patient without necessarily coming in for it. I think the part that is most telling, as we continue to improve, is that people are not going to have drive two and a half hours to see a specialist quite as often. That could be a game-changer for a lot of people, especially those with limited mobility.”
Not everything going back to the way it was. That goes for hospital guidelines — pandemic visitor policies are still in place at Sanford — and for those negotiating everyday life as healthy as possible.
“If I’m out in a public place, I’m still wearing a mask,” Dr. Cauwels said. “Washing your hands is still going to be very important. I really liked the way New Zealand described how we start the process. It’s a bubble. We’ve been dealing with a small bubble that includes just your family. Now we’re able to increase the size of the bubble a little bit and include a few more people. But we don’t want to go from a tiny bubble to no bubble at all.”
As communities move forward in overcoming pandemic circumstances, tilting things back toward a pre-coronavirus state will take some time. Accommodating those conditions should not include making a decision on seeking medical assistance based on the coronavirus.
“Your health care needs are going to continue on,” Dr. Cauwels said. “It might be a mammogram or a colon cancer screening, or if you’re a kid, getting a physical for sports or an immunization. All of those things continue to be needs. We want to make sure you’re healthy and doing as well as you can be even during the pandemic. Sanford is open and ready to help you with those needs.”
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