Saturday, November 7, 2020

Family Medicine: Straddling COVID-19, Influenza and Life

 What can we and our patients do as the cold and flu season nears and COVID-19 lingers?

First is to check what Dr. Google says about these infections, all of which are viruses.  What do we know about viruses?

Physicians have read a lot recently about SARS-CoV-2 also called COVID-19, coronavirus, Rona and other nick names.  Formally SARS-CoV-2 is the name, but COVID-19 is widely accepted and used, so I'll refer to it as COVID-19.  In spite of our reading and a wide variety of ongoing research, there are many mysteries about COVID-19.  With over 200,000 deaths in the United States attributed to COVID-19, it has generated a myriad of responses and expense from our whole society and its leaders. Most recently, schools have reopened with variations on the learning models including a lot of online and home learning.  

There is at least one dashboard for school data about the models of learning and COVID-19 impact.  School COVID-19 related data

How will physicians adjust the COVID-19 oriented systems we've organized for the Pandemic to respond to cold and flu season?

This question and many more pop up as we start to think about coughing, aching, febrile miserable patients who want to see their physician.  Will video visits suffice  for the coming viral onslaught this winter?  Will patients want to enter an office where coughing people have been?  Will we further develop the parking lot approach to patients with a drive through, service in your car approach?  Or a drive through or walk through tent in the parking lot for privacy during the physical exam?  Will we still do the ENT- ears, nose, throat - part of the exam or the lung exam which includes "take a deep breath in and out through your mouth" for each lung area? 

Many questions and many options arise as we ponder our response to the waves of mucous, droplets and mists of microbes that will greet us from our patients.   

One aspect of the viral mucous challenge is a major concern for physicians- the being unavailable for 14 days of practice.  Many patients will have needs for care during those 2 weeks of quarantine.  What will they do?  Will the physician have enough energy and focus to offer phone or video visits during the 14 days?  Will revenue generated or not generated during the time away from practice combined with losses during the first two months of the Pandemic lead to closing or selling the practice?  

Lots of family physicians went out of business already during the Pandemic.  There is very little in financial reserves for many who made it through the first half of 2020.  What's next?

Flu shots.