There is a lot of fear surrounding the coronavirus. From empty grocery store shelves to the hoarding of toilet paper, the panicking has undoubtedly resulted in more panicking. To help resolve some of this, The Daily Citizen recently asked Dr. W. David Hager, M.D., a member of Focus on the Family’s Physicians Resource Council, six questions about what the medical community is doing and what you can do to support their work.
Q: As a physician, what have you been hearing about the coronavirus and its response?
A: Covid-19 is obviously at the forefront of conversation among the entire population. The most frequent questions are a) What are the symptoms? (fever, cough, shortness of breath, muscle aches and fatigue); Should I be tested? (persons in direct contact with infected persons, and those with symptoms should be tested, while asymptomatic persons are now not being tested); Is social distancing really necessary? (yes, in an effort to prevent the transmission of the virus this emphasis is essential); How long will the pandemic last? (we don’t know, but looking at MERS, SARS and Ebola history, several months before we see a plateau in cases).
Q: Physicians have been asked to evaluate surgeries to determine what is emergent and what is urgent, how difficult is this process?
A: Based on the Stanford University classification, cases are divided into Emergent, Urgent and Elective. Emergent means surgery must be done immediately in order to save life and prevent adverse consequences (e.g. a ruptured appendix with peritonitis). Urgent means that if the surgery is not done there may be short-term or long-term consequences to health and survival (many cancer surgeries would fall into this category). Elective means the surgery can be delayed without impacting either short-term or long-term health (cosmetic surgery and routine colonoscopy would fall into this category). Those of us who are asked to make these decisions for either in-patient or out-patient surgery have no trouble deciding what is emergent, but some of the decisions about what is urgent vs. elective are not as easy. Most surgeons have been very cooperative with supervisors in dealing with this issue.
Q: What is the morale like in the medical community right now?
A: The entire medical community has rallied around the efforts to curtail this pandemic infection. We realize that we are most at risk of infection but know that this is what we are called to do. Most providers are abiding by all of the recommendations and guidelines including cancelling routine appointments and ensuring that needed prescriptions for such patients are being filled.
Q: How can we encourage the medical professionals that we know are looking at potentially working long and difficult hours to treat those with the coronavirus?
A: I think that the best way to encourage the medical community is to cooperate with the recommendations for social distancing and the need to cancel routine appointments and elective surgeries. Saying thank you to your physician, NP, PA and nurses for all of their efforts with a brief note is appreciation enough. We are all in this together, and we will get through this together.
Q: There has been some talk about the shortness of supplies. Is your hospital prepared?
A: I don’t think any of us were totally prepared for this pandemic. One of the biggest problems is allocation of resources with shortages of personal protective equipment (PPE) such as masks, gloves, gowns and of a lack of respirators/ventilators. We have had to restrict use of these supplies among our personnel by keeping them in restricted areas and in some cases locked cabinets. We screen every patient for risk factors (symptoms, exposure, travel); we are limiting visitation in the hospital to one person per patient except for newborns where both parents may visit, and we restrict visitors accompanying outpatient clinic visits. We will allow patients to remain in the vehicle in the parking structure and only call them in when they’re specific exam room is ready. There will be tough decisions regarding the allocation of supplies or what is called “priority setting” related to potential therapies and ultimately vaccination for those infected or at high risk of infection such as health care workers. The World Health Organization (WHO) emphasizes the basic principle of allocation of resources to save the greatest number of lives when these decisions have to be made.
Q: Abortion clinics remain operational with abortions being considered “non-elective surgery,” what are your thoughts?
A: The procedure has always been termed elective abortion to indicate that it was not therapeutic to save the life of the mother. So, by definition it is an elective procedure wherein there is always a mortality involved. The argument being put forward is that the mother would be forced to give birth to an unwanted baby. Both the short-term and long-term consequence of elective abortion is the death of a baby.
The future of the country remains uncertain, as the nature of the outbreak changes from day-to-day. But rest assured, medical professionals are doing all that they can to help protect patients and communities.