COVID-19 Update and Changes to Harper Health Operations

The number of cases of COVID-19 in Chicago and the surrounding areas are increasing. I’m actually in Florida right now with my daughter getting some sun and visiting a few patients down here. There have been two deaths in Florida since I arrived, and the mayor of Miami has been recently diagnosed with the infection. As I intimated the other day, this situation is going to get worse before it gets better.

As a leader, it is incumbent upon me to do my best to ensure that we have policies in place that best support our patients while at the same time work to keep the team healthy. We can’t help YOU if we are too sick to care.

For those of you who know me well, you know I don’t panic. I’m a pretty calm pragmatic dude, so I certainly don’t want to contribute to any sense of panic. That being said, I believe this is a very important issue. Today’s COVID Panel at the UCSF said that we’re moving from containment, where we limit the spread of the infection, to flattening the curve. The experts said that in the next 12-18 months 40-70% of the population will have been infected. We want the numbers in our practice to be significantly lower than this.

So, we at Harper Health, as is our practice, are aiming to be a step or two ahead of the game. For example, it is our belief at this time that all of us—staff and patients alike—should be participating in social distancing. While the CDC, NIH and federal government have not yet made this recommendation, the more we isolate ourselves the more we can reduce the potential spread of infection and ‘flatten the curve” to help ease the burden on the healthcare system. We need to learn from the experience from the 20th century Spanish Flu pandemic and from what our peers in South Korea have done to stem the tide.

So, what we recommend for our patients is this:

1.       Everyone, particularly folks at risk, should practice social distancing. Avoid crowds. Keep over six feet from people. Don’t go to concerts or conferences or large meetings. How large? Hard to say. The more folks gathered, the greater the chance that someone has SARS-CoV-2 virus infection. California and Washington have banned group gatherings of more than 250 people. The Catholic Archdioceses of Chicago and Milwaukee have canceled Mass until the dust settles.

-          Can you go to the grocery? Yes. The contact you have with other folks is minimal. I was recently in Target and just kept my distance from folks. I had my pocket hand sanitizer and used it liberally because there are still fomites. Hand sanitizer! Wash! Don’t touch your face!

-          Can you get on public transportation? If you can avoid it, do. If you can’t, then try and find a nearly empty train car, or a less crowded bus. Try to move around and not be next to the same person for more than five minutes. Abort if someone is coughing. Hand sanitizer! Wash! Don’t touch your face!

2.       We recommend postponing all travel. When you travel through airports you are exposed to innumerable fomites. When you get on a plane you have no control over who is next to you or behind you and no control over the air handling system. Cruise? Just no. In truth, I have to make my way back to Chicago from Florida. My flight is at 6am on Saturday. My hope is that it will be a nearly empty flight. While my daughter and I are fastidious about handwashing, I’m still considering driving.

3.       Educate your children. We all have agency/power and we need to wield it in times like this. Not in a violent way, but with knowledge and strength. If your child interacts with a peer in their class or on the playground that is exhibiting some symptoms, instruct your child to do something. If they’re in school, approach the teacher: “Johnny is coughing and my parents told me to not be around people who are sick. Can you do something?” Or have them tell you about their friend’s illness so you can talk to the child’s parent. While it’s true that children aren’t as affected by SARS-CoV-2, they can be a vector and give it to you.

4.       Consider postponing elective procedures. A few of you have surgeries scheduled, such as knee replacement and eye surgery. There are two reasons to consider delaying these elective procedures. Please contact your provider to discuss your particular situation. One size doesn’t fit all.

- You aren’t practicing social distancing if you are going into the hospital. If you do, you are exposing yourself to an environment with a much higher chance of SARS-CoV-2 infection.

- If there is just a moderate epidemic here in the US, medical supplies may become limited. Items such as sponges, swabs, IVs, hand sanitizer, etc. may need to be rationed, so if we can delay elective procedures until the dust settles, health systems may be better able to support sick folks now. (We, ourselves, are challenged by stocking our supplies, particularly Personal Protective Equipment, PPE, and hand sanitizer. Two of our bottles of hand sanitizer even got stolen from our office, so we now need to lock it up with our medications.)

The team at Harper Health is committed to fully supporting you in this time of uncertainty. We are temporarily changing some of our protocols to mitigate risk of bringing SARS-CoV-2 into the clinics and putting key team members at risk. This is what Harper Health will be doing to prepare itself to support you:

1.       All non-essential visits at the Harper Health Streeterville and Harper Health Hinsdale locations will be postponed on a rolling two week basis. This includes routine annual physicals, routine follow up visits, vaccine visits, etc. Why? When you’re in our clinic, we spend a lot of face to face time with you. If a patient later is diagnosed with COVID-19 we will need to quarantine the practitioner. We need to guard ourselves against that AND we need to reduce the chance of one of us getting infected. While a mild illness is more likely for our team members, a severe illness of a Harper Health practitioner would be devastating to our ability to care for you.

2.       Telemedicine visits will be leveraged. If you have a scheduled routine follow-up visit and it lends itself to a telemedicine visit, we will aim to do that. We have two platforms for telemedicine visits, Spruce and Doxy. As much as possible we will use one of these platforms to care for you. We love your presence in our practices! But we know there is risk for you as travel to get here, and for us when you arrive. If you have not already signed up for the Spruce App, we will send the invite under separate copy.

If you are not comfortable with telemedicine, we will still support you!

3.       We will curtail visits for respiratory illnesses. If you are worried about a cold or flu-like illness please call and we can ask the standard screening questions for possible COVID-19. If the risk is high enough, we’ll send you to a local hospital triage location to be considered for SARS-CoV-2 testing. Testing is important because it would change what is recommended with regard to monitoring and contact with others. I wish there were a better testing system at this point in the process. Unfortunately we’re still a week or two away.

4.       All of the Harper Health team members are now being asked to perform social distancing when not at work. The team will work from home as much as possible and will rotate presence in the practice locations so we vary and limit our individual exposure.

Thank you for your understanding as we navigate this unique and challenging time. We are here for you as you work to navigate it, yourself. Please contact us with any questions you have.

More to come.

Dr. Will