So if you have a patient calling with possible symptoms of COVID and with a
travel history, meaning to one of the countries labeled as a level 2 or level
3 alert by the CDC, or a known contact or them being a close case with a COVID
patient , you would ask the patient to stay at home and you would call your
local County Health Director, Medical Director and talk over the case. Ideally,
the patient would be tested at home by the county, if that's not possible then
with the county's help, you would direct the patient to a health care facility
that had an airborne isolation room, calling ahead so they would be alert and
have them tested at that healthcare facility. The testing would, of course, go
to the state of North Carolina.
At the present time we have built into Epic a screening tool. So the
screening tool asks every patient as they come to a clinic,
when they're in front of you in the clinic, it asks first do they
have symptoms, second did they have travel and third do they have potential
exposures. If the answers are travel or exposures, plus symptoms than at the
present time that patient is given a mask, immediately moved back to a private
exam room, the healthcare providers are to wear a mask gowns glove and a face
shield, they take further evaluation of the
patient regarding history and symptoms. They would then call their infection
control practitioner professional, which depends on which of our hospitals or
affiliates that is, but that pops up in a BPA on Epic, so they follow the Epic
guidance and they would call the local health department.
So we believe our current screening process is safe and efficient and it's
done as soon as the patient arrives at a clinic or an emergency department. There
is no need for our health care providers to routinely be wearing masks or in
95 respirators, they only need to wear a mask when they're dealing with
a patient with a potentially droplet spread disease like COVID, or other
respiratory diseases, if they consider the patient might have RSV or influenza
or another respiratory virus or some bacteria such as pertussis, then before
they have any contact with the patient they should be wearing a mask. Now in a
clinic, it's also important to put a mask on the patient and even if the patient
has a mask on, the healthcare providers when they're in the same room should
also wear a mask for double protection. Finally, I do want to say that these
masks are single-use disposable items, they should not be worn around the neck
they should be left in the pocket, once they use they should be immediately
disposed of.
So the goal here is to keep any possible COVID patient or even a patient with
known COVID at home. About 80% of patients with COVID have mild to
moderate disease and can be managed at home. They would be under quarantine by
the state in terms of their travel and we are looking into the means of using
telemedicine to provide appropriate care for those people, while they're at home,
because they may have other diseases such as diabetes and we may need to test
them for other diseases that they could have such as influenza that we want to
provide therapy to. So telemedicine will be a key way of providing safe care to
those people while they're at home.
So I certainly think it's reasonable, I think telemedicine is the future. There
are issues regarding reimbursement and there are issues regarding ability to
actually get the information that you need, some patients will have to be
physically examined, but I certainly think telemedicine is a wave of the
future if we can solve some of the logistic and reimbursement issues and to
the extent we can provide telemedicine, patients will be happy to get that
service at home. So I see that expanding not only for this epidemic, both for
initial evaluation of patients with respiratory symptoms, patients that may
be possible rule out cases for COVID or patients actually with COVID, but I see
that in the future we'll have a vast expansion of telemedicine just in
general.
COVID-19, obviously, is a new coronavirus to humans, probably came from bats.... there are
other coronaviruses in humans. Certainly it is mutating and changing,
but we've not seen that's affected either its transmission or had any
effect on the clinical symptoms or their outcome over time.
you