Dr Schuman, section editor for Peds v2.0, is clinical assistant professor of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, and editorial advisory board member of Contemporary Pediatrics.
Combating the novel coronavirus will motivate pediatricians to make novel changes to their practices.
Four months ago, we all were aware there was a novel coronavirus causing an epidemic in the Wuhan region of China, but many experts expected it would be limited in scope and spread, not unlike the severe acute respiratory syndrome (SARS) epidemic and Middle East respiratory syndrome (MERS) outbreaks that occurred years ago.
And then COVID-19 began its march around the world, finally arriving on our shores on January 20th.1 We underestimated the tenacity of the virus and were caught without adequate supplies of personal protective equipment (PPE), had no antivirals with which to combat the virus, and had extremely limited testing capability. Clearly, our government and health care system were woefully ill prepared to deal with COVID-19.
Fast forward to mid-March. Advisories to “stay at home” were issued in a cascading fashion by state governors, and nonessential businesses were closed. Now, weeks later, pediatricians still are utilizing telehealth for ill and health-maintenance visits, seeing fewer patients in our offices, and dealing with the financial impact of the pandemic on our practices. As mitigation efforts begin to diminish novel coronavirus infections, we continue our efforts to care for our patients as well as ourselves.
Although we remain optimistic about eventually emerging from seclusion, the reality of the situation is that, at best, local communities will gradually relax restrictions, but some degree of social distancing will last for weeks if not months. During this time, we need to do our best to keep our practices open and accessible. We also need to plan ahead for accommodating patients in our offices once we start the recovery process.
Ultimately, I expect that our response to the novel coronavirus pandemic will be the development of a novel practice model that will allow our practices to survive adversity in the “here and now” and prosper once PPE, toilet paper, and hand sanitizer become plentiful once again.
Your battle plan
1. Holshue ML, Debolt C, Lindquist S, et al; Washington State 2019-nCoV Case Investigation Team. First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020;382(10):929-936.
2. Notario PM, Gentile E, Amidon M, Angst D, Lefaiver C, Webster K. Home-based telemedicine for children with medical complexity. Telemed J E Health. 2019;25(11):1123-1132.
3. McDaniel NL, Novicoff W, Gunnell B, Cattell Gordon D. Comparison of a novel handheld telehealth device with stand-alone examination tools in a clinic setting. Telemed J E Health. 2019;25(12):1225-1230.