Commentary: A year into COVID-19, a physician pauses to reflect
It is hard to believe the intense changes initiated to manage the COVID-19 pandemic have become our new normal.
A year ago, we were all scrambling, glued to the news, adjusting our lives daily to accommodate another recommended behavior to stay safe during the pandemic. No one would believe that one year later, with many of our fears settled, most people have adjusted to the new ways of working, socializing and living.
As primary care doctors working through the pandemic, our office has found the balance between caring for patients during the most medically challenging time in our professional lives and trying to help our patients get back to better health.
Last spring, we had to support our patients’ needs in any way available to manage their ongoing health concerns, refilling medications and providing medical care. We quickly dropped into telemedicine visits, allowing patients to safely stay at home, as we completely shut down for a time to in-person patient visits.
As I wrote here in May, most physicians during this crisis started out sprinting to take care of COVID-19 concerns. Then, the race became a marathon, with many doctors’ offices struggling to meet the demands of patients stranded at home.
Professionally, we realized that vital parts of patient care were missing and turned to a hybrid process with in-person visits to allow for accurate blood pressure readings, the diagnosis of skin conditions and the care most patients preferred. Since early summer, our practice directed patients with potential COVID-19 illness through outside testing and care, while establishing extensive safety measures to keep our in-person patients and staff protected.
Working through COVID-19 has been a challenge in both arenas, with telemed visits limited by inadequate Wi-Fi signals and missed labs and X-rays, as some patients refused to leave their homes for the care they needed. Our schedules changed hourly, accommodating the switch from an office visit to telemed visit for patients exposed to COVID-19. Many visits went past the allotted times, so we could discuss with patients their fears, safety concerns or symptoms that could be COVID-19. Our elderly patients had the greatest hurdles, needing to stay safe at home but unable to utilize a telemed visit due to the lack of modern technology.
The care of patients with the virus brought a variety of different issues. We had to keep up with the changing Centers for Disease Control and Prevention guidelines, directing patients and their employers to the standards of needed care and appropriate quarantine limits. Thankfully, many patients in the primary care world did well, with a few directed to emergency rooms for a better evaluation and to get the necessary labs and X-rays that were not available to any patients with the illness on the outside. The health care professionals in the hospitals and urgent-care settings have been on the front line. Having most front-line workers vaccinated takes a burden off the system crushed by the marathon it has run.
I do believe the emotional care needed by patients has been the most profound difference between normal life before the pandemic and where we are today. Fortunately, the increasing availability of the vaccine has had a calming effect on patients’ worries, and the seniors who have had both shots are starting to venture out of their homes. Unfortunately, our community’s health has declined in the past year. We have seen a generalized weight gain, with elevated blood pressures and blood sugars, as many patients found comfort from food.
Besides recommending the vaccine, my advice at this time to patients has been to push people of all ages toward better health habits. The one thing we can learn from the pandemic is how to change our personal risk factors, and now is the time to take that knowledge and make choices that put our health first. Studies have shown that those with obesity, high blood pressure, diabetes and heart disease have been the most vulnerable.
One year later, I feel lucky to see the horizon on the other side of the pandemic. Like most businesses, we had COVID-19 scares and worked with less than the full staff. My partner and I appreciate the team around us and are proud of the work we did through difficult times. We are thankful that most of our patients stayed healthy and that those with COVID-19 survived, many having had milder illnesses and a good recovery. I do hear a similar message from my patients, as they feel thankful to be healthy, working and often more appreciative of the good people by their sides.
Dr. Kristine B. Diehl is a family physician with Delaware Family Care in Wilmington and is board-certified in family practice and integrative medicine. She is also a member of the Medical Society of Delaware’s Public Health Subcommittee.
