Medical Care in Connecticut Adapts to the Coronavirus

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A week ago, I was about to leave for my cardiology appointment when I received a call. It was the receptionist, and the appointment was canceled.

“Do you know if I can reschedule?” I asked her. She wasn’t sure.

After a couple unexplained fainting episodes, a possible arrhythmia and a month of appointments it was weird to be left with no conclusion. The constant refrain had been, it’s probably nothing, but it could be serious, so we just want to cover all our bases. Now that caution was thrown out the window as concerns about COVID-19 came rushing in.

Yesterday, I received another call. My next appointment, scheduled for this Friday, would be virtual.

“Just download the app on your phone, login at your appointment time and you should be all set,” the receptionist told me. Just out of curiosity, I asked her how many of the Cardiology Practice’s appointments would be virtual. “As many as possible,” she said.

And that office is by no means the only one.

Across the state – and the country — thousands of appointments and procedures classified as “non-urgent” or “elective” are being canceled, postponed or moved online, following the guidance of the Centers for Disease Control and Prevention.

“We have postponed elective procedures for the time being. Non-urgent clinic appointments are being transitioned to virtual video visits via webcam as appropriate,” said Gil Peri, the President and COO of Connecticut Children’s Medical Center. “We feel this helps to protect our patients and families and team members from COVID-19. We’ve had extremely positive feedback from our patient families and providers.”

Hartford Healthcare has done the same, moving all primary care and most specialty services to virtual appointments this week.

“It is a critical step that we remain available to the community, that we connect with them and take care of the non-COVID related issues that our members face,” said Dr. Ajay Kumar, the Chief Clinical Officer for Hartford Healthcare. Moving to virtual appointments, “really does help with social distancing.”

The goal, Kumar explained, is to keep the doctors, nurses and other medical staff healthy so that they can continue to serve patients with and without COVID-19. It may not seem like a problem for each individual patient, but for health professionals to be interacting with dozens of patients everyday would greatly increase their risk of contracting Coronavirus.

“Physicians are on the front line of the current COVID-19 pandemic and the American Medical Association is working to ensure they have the information, resources and advocacy they need to care for patients and keep themselves safe,” said Patrice Harris, the president of the AMA.

The limited appointments and patient-interaction is all about safety, both Peri and Kumar said.

“We at Connecticut Children’s prioritize safety in all that we do. Decreasing risk to our patients, families and team members is our priority. Technology has enabled us to stay connected with many patients during this time of uncertainty,” Peri said. 

At Hartford Healthcare locations operating room space and recovery areas that have opened up due to the elimination of elective surgeries are being repurposed for acute care, Kumar said. “We are looking at how to convert our other areas – meeting rooms, auditoriums – into usable patient space once more and more Coronavirus patients start coming in.”

When care can’t wait

For some conditions – like cancer and pregnancy – the disease or baby is not going to stick to a preferred timeline. Appointments can’t be pushed off and must be in-person.

“Those that have time sensitive or more urgent needs are scheduled as usual. The health system has implemented many preventive measures to keep patients and team members safe in the hospital and in our remote site locations,” Peri said.

For these patients, several steps have been added to the appointment process at every hospital or office location in the state.

A COVID-19 screening, separate staff for non-COVID-19 patients and separate areas of the facility for those suspected of having Coronavirus.

For pregnant patients, the typically bustling and visitor-friendly rooms have changed. No partners are permitted at any prenatal appointments, according to Yale Medicine. Instead, patients are allowed to bring photos of their ultrasound home to show their families.

For those in the first trimester, the number and frequency of appointments has been reduced and instead remote measures are being taken to determine the health of the baby and mother, according to Yale.

For those nearing delivery, birth looks quite different as well.

“You will be asked to stay in your car until you are greeted by a nurse who will provide you with a surgical mask and escort you into the hospital,” according to Yale. “Only one support person will be allowed to come with you for the duration of your delivery hospitalization in order to reduce transmission of the COVID-19 virus.”

With appointments and procedures constantly changing, Kumar acknowledged that this can be a stressful time for patients.

“It might seem overwhelming, and I can understand that,” he said. “This is an unprecedented time for all of us, but we are very confident we will be able to meet the demand of the community.”

Children’s, Yale New Haven Health and Hartford Healthcare have all established 24-hour COVID-19 hotlines that are staffed by physicians and nurses every day for members to call and ask questions or voice their concerns.