Bob Roth

The past seven months have been transformative, as we strive to learn in real time the subtle nuances between living and surviving in a pandemic. 

In early March, when many were wiping down every grocery item they brought into the home, I can’t help but think of the lovable neurotic character played by Ben Stiller in the movie “Along Came Polly.” Reuben Feffer, a professional risk analyst, is ruled by fear. He even avoided subway grates, because there is a one in 46,000 chance of falling through. 

This begs the question: Can extreme fear undermine your ability to stay healthy during the pandemic? Specifically, are your missed doctors’ appointments for routine or more pressing medical care putting you at risk? 

The coronavirus caused an unknown number of missed or delayed diagnoses for conditions unrelated to COVID-19. This parallel epidemic of harm is one of the

yet-to-be-told stories of the pandemic.

The temporary suspension of some medical services beginning in March caused some patients to avoid seeking medical care altogether. There were dramatic declines in the emergency department because patients who really did need emergency services stayed home. Heart attack and stroke teams, always poised to rush in and save lives, were mostly idle.

Watching the news reports from Italy and New York with the hospitals overloaded may have subliminally planted the seed that health care facilities were places of peril. Navigating the uncertainty for at least the next year, we must remember that it is imperative to maintain our health by continuing medical care. 

The U.S. National Cancer Institute studied pandemic-related delays in screening and treatment for breast and colorectal cancer and projected there will be approximately 10,000 “excess” deaths over the next 10 years. Ignoring life-threatening non–COVID-19 conditions such as cancer for too long may turn one public health crisis into many others.

One of the good things that has come out of this pandemic is advancement of telemedicine. It’s a great way for physicians to stay in contact with their patients. With the arrival of COVID-19 and stay-at-home orders instituted across the country, physicians who had not used telemedicine were forced to quickly adopt it so that they could remain engaged with their patients. 

This form of real-time, audio-video communication that allows physicians and patients to connect from different locations existed prior to the pandemic, but certain restrictions limited widespread usage. But now physicians are adopting this as a regular alternative. It is great for older adults that only need to visit their physicians in order to get prescription refills extended. 

The Centers for Medicare and Medicaid Services relaxed the restrictions relative to the telemedicine platforms, and now allow all types of video conferencing capabilities for both providers and their patients. This gives physicians and patients flexibility; CMS allowed providers to bill at full rates when previously they were paid a fraction of what they were paid for in-person visits.  

COVID-19 is something we are just beginning to understand. In a pandemic, it is difficult to assess or measure risk. In general, from what I have heard and seen in clinical settings, a doctor’s office will be instituting the most stringent precautions with guidance from the CDC to keep patients protected. Importantly, the social interaction that a physician and their support staff provide can be a welcome reprieve from the isolation experienced by many older adults. 

The lovable risk manager Reuben Feffer ultimately dealt with his fears, and we can too. I offer a simple strategy of the four Ps: Avoid people in prolonged, poorly ventilated proximity. And whatever you do, wear a mask. JN

Bob Roth is the managing partner of Cypress HomeCare Solutions.

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