Good news from the COVID count this morning. The St. Louis task force released the latest numbers and they are continuing to come down. After an initial plateau, seeing a definite decrease last week has been good to see. If this trend continues for the current week, society will likely start to open up more fully next week. "Life as we knew it" is not likely to ever be completely the same again. Our long term success in maintain the health of both our bodies and our economy will depend on the decisions that we make in the next few weeks. Here are some of my thoughts.
1. When and how should I access the health care system? In my office, we are seeing patients with acute problems that are best served by an evaluation in the office. In order to keep our office as safe as possible for the patients who come, anyone with respiratory symptoms are seen in an affiliated, "respiratory clinic." We are not yet seeing routine visits but will start next week by seeing those under 65 without serious medical issues. If the numbers in the community continue to come down, we'll start seeing more.
We, like other industries, are trying to rethink our usual operating policies. How do we limit the number of patients in the waiting room? How do we space out visits to reduce too many people coming together at the same time? What is the best way to draw labs? perform X-rays and other tests? We are finally figuring out how to check patients in remotely. Labs are being done by a "drive by process" at the hospital.
2. What is the best way to shop? Now those of you that know me well may laugh that I am being audacious enough to offer any such opinion. Certainly on line sales will remain robust. Curb side pick up will likely be here to stay as well. It cuts out those that like to simply browse while they shop which sounds good to me! (Sorry Mom). The bottom line is to find ways to reduce groups while still allowing commerce to happen.
3. Will we ever be able to gather again in large groups? Of course we will, but not in the short term. If 50,000 people gather in a stadium to watch a baseball game, there will be asymptomatic carriers of the virus who touch the same door knobs, use the same bathrooms as all the others. Touch-less doors will help as well as similar towel and soap dispensers. The risk will never be zero, but I can foresee it being low enough to make such events possible.
4. Can we ever expect children to truly self isolate as they go back to school? Not really, no. This is perhaps the more difficult scenario to control. It is not the kids we worry about, or even their parents, it is their grandparents. To me, the only way to move forward is to have good community testing. If we can quickly identify a hot spot, schools can be shut down quickly in the area that has been identified. We have learned that on line studies can be continued. Even better is to have such good tracking so that discrete exposed families can be isolated without shutting down the whole school.
Above all else, we need to develop a culture of personal accountability and honesty. We had a patient show up to our office yesterday without an appointment who had cough, fever and shortness of breath. There is a high chance this person was infected with the virus. The patient was asked the appropriate screening questions at the front door but must not have been completely honest. Thankfully, there was no one else in the waiting room at the time and was quickly given a mask and sent to our respiratory clinic. If individuals do not stay away from gatherings when ill, our system will be overrun again. We can and should get out of this lock down but we need to do things a bit different. Let's all be strong, let's all be safe.
1. When and how should I access the health care system? In my office, we are seeing patients with acute problems that are best served by an evaluation in the office. In order to keep our office as safe as possible for the patients who come, anyone with respiratory symptoms are seen in an affiliated, "respiratory clinic." We are not yet seeing routine visits but will start next week by seeing those under 65 without serious medical issues. If the numbers in the community continue to come down, we'll start seeing more.
We, like other industries, are trying to rethink our usual operating policies. How do we limit the number of patients in the waiting room? How do we space out visits to reduce too many people coming together at the same time? What is the best way to draw labs? perform X-rays and other tests? We are finally figuring out how to check patients in remotely. Labs are being done by a "drive by process" at the hospital.
2. What is the best way to shop? Now those of you that know me well may laugh that I am being audacious enough to offer any such opinion. Certainly on line sales will remain robust. Curb side pick up will likely be here to stay as well. It cuts out those that like to simply browse while they shop which sounds good to me! (Sorry Mom). The bottom line is to find ways to reduce groups while still allowing commerce to happen.
3. Will we ever be able to gather again in large groups? Of course we will, but not in the short term. If 50,000 people gather in a stadium to watch a baseball game, there will be asymptomatic carriers of the virus who touch the same door knobs, use the same bathrooms as all the others. Touch-less doors will help as well as similar towel and soap dispensers. The risk will never be zero, but I can foresee it being low enough to make such events possible.
4. Can we ever expect children to truly self isolate as they go back to school? Not really, no. This is perhaps the more difficult scenario to control. It is not the kids we worry about, or even their parents, it is their grandparents. To me, the only way to move forward is to have good community testing. If we can quickly identify a hot spot, schools can be shut down quickly in the area that has been identified. We have learned that on line studies can be continued. Even better is to have such good tracking so that discrete exposed families can be isolated without shutting down the whole school.
Above all else, we need to develop a culture of personal accountability and honesty. We had a patient show up to our office yesterday without an appointment who had cough, fever and shortness of breath. There is a high chance this person was infected with the virus. The patient was asked the appropriate screening questions at the front door but must not have been completely honest. Thankfully, there was no one else in the waiting room at the time and was quickly given a mask and sent to our respiratory clinic. If individuals do not stay away from gatherings when ill, our system will be overrun again. We can and should get out of this lock down but we need to do things a bit different. Let's all be strong, let's all be safe.
I think we can find ways to open back up - but what worries me most is the angry and fear driven responses that are feeding conspiracy theories and violent responses.
ReplyDelete