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 DELAYED 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.