Moving Forward In the Face of COVID-19

Over the past two months, I have joined with colleagues from across the country — Seattle, Los Angeles, New York, Chicago and Houston — to create webinars for fellow healthcare advocacy professionals on the impact of COVID-19.

One fascinating aspect of working in the healthcare industry during this unprecedented time is the just-in-time learning that is occurring as individuals with COVID-19 are being tested, diagnosed and treated in our healthcare system. Because this disease is new, no evidenced-based protocols specifically designed to treat the virus existed. Instead, symptom management has been the goal, with real time research contributing to new revelations and continuously improved and evolving care.

The Data (So Far)

Thanks to my colleague Io Dolka from Seattle, for the following information:

  • Approximately 55% of those who contract COVID-19 are between 18 and 64, but the majority (85-90%) of those who die from the virus are over the age of 75.
  • Those with underlying medical conditions, across all age groups, are more likely to pass from the virus.
  • Men die from COVID-19 more than women (60% vs. 40%) and the virus disproportionately impacts individuals of color.
  • An estimated 20% of individuals with COVID-19 are hospitalized; a subset (approximately 6%) of those require ICU care.
  • The virus spreads through close, prolonged contact with someone who may be symptomatic, pre-symptomatic (the 2-3 days before symptoms develop) and completely asymptomatic.
  • Breathing, speaking, loud talking, yelling, coughing, sneezing, and singing can spread the droplets of COVID-19.

What To Do Now

One thing is certain: We are living in an evolving environment, one that continues to necessitate behavioral change in all of us. Here are my recommendations for how to function, be prepared, and stay as safe as possible into the foreseeable future.

Regarding resuming normal activity

Know the facts, assess your personal risk, and mitigate that risk using your own decision making. Here are some questions to consider before you leave your home to mingle with others, return to work, etc.

  • What’s going on in my community regarding the incidence of cases and the capacity for healthcare, especially ICU beds?
  • How old am I?
  • Do I have chronic conditions such as heart disease, pulmonary issues, chronic kidney or liver disease, diabetes, or obesity?
  • Am I immunocompromised?
  • What is my gender and race?
  • How is my physical condition and overall health?
  • When I leave the house, where do I plan to go and with whom do I anticipate interacting?
  • What’s the space like that I will be in, how long will I be in it, and how far apart can I be from others?
  • If I chose to be with others, can we all agree to do a temperature and symptom check beforehand and commit to not participate if anyone has a temperature or has any symptoms, as minor as they may seem?

Regarding accessing healthcare

Communicate pro-actively with your primary care physician and follow the protocols their team has put in place to manage patients with COVID-19 symptoms. This may include testing recommendations and locations for physical assessments if needed, appreciating the turnaround time for receiving results. Use the Patient Portal to stay connected.

Overall, when seeking care for issues unrelated to COVID-19, asking about the protocols in place in each healthcare environment can ease anxiety, as you will know what to expect. For example, recently I had to drop my husband off at the door for a surgical follow-up appointment. Thanks to some pre-planning, I was able to attend the appointment via FaceTime.

Regarding your mental health

The presence of the virus and the required physical distancing can trigger new problems, such as anxiety or exacerbate existing problems such as depression. There have been increases in the incidence of mental health, substance abuse and related disorders.

If you are experiencing any of these issues, your primary care physician is a great place to start. Telehealth appointments with mental health professionals have made care more accessible and state-sponsored websites also list resources.

Consider developing a “ Gratitude Journal to note things you appreciate and are grateful for each day. I restarted one of these in April and reading through it always makes me smile! Things I’ve written about include being thankful for my health, my (wonderful) Healthassist team, and the peaceful protests that continue to raise awareness of the inequities in our world. But I’ve written as well about simple things, such as the color of a bird or a flower seen on a walk. Overall, a gratitude journal can provide a boost in mood and help to restructure negative thoughts.

Regarding advanced life planning

The pandemic has created greater opportunity and need for discussions regarding life planning documents. If you don’t have any of these in place, start with the easy ones.

You can download a HIPAA release form and a Health Care Proxy online (for free) and complete these yourself. Then consider seeking out the services of an attorney and your physician for those documents that are more involved. The important thing is to get started!!

Regarding insurance

In the event you experience any symptoms of COVID-19 that require testing and any form of outpatient or in-patient care, please keep very careful records of dates of service, care you received, and calls made to your insurance company (including what you were told and by whom). The variability of how insurers are dealing with these claims leads me to believe there will be confusion. Good recordkeeping will facilitate troubleshooting in the future.

Final Thoughts

As we approach the summer months and learn to live within the confines of this pandemic, I urge you to be conscientious about your choices so that you remain healthy and virus-free. Please continue to wash your hands frequently, try not to touch your face, physically distance and wear a mask to protect others and demonstrate leadership by modeling the way.

In the event you require healthcare, don’t hesitate to reach out to those who normally deliver it to you. Staying as healthy as you can is the greatest gift you can give yourself.