As of early August, only two of the more than 300 patients at Mount Sinai South Nassau hospital had Covid-19, a far cry from when nearly 400 patients were diagnosed with it in April. With a re-turn to more normal services, administrators have slowly been permitting more visitors into the hospital, as long as they practice recommended protocols, such as wearing a mask and social distancing.
“For the most part, we are trying to increase visitation and maintain safety at the same time,” MSSN Chief Medical Officer Dr. Adhi Sharma said. “We’re trying to find that balance.”
At the height of the pandemic, no visitors were permitted at the hospital. In June, as coronavirus cases declined, the facility began permitting one visitor per patient each day for four hours, but did not allow visitors in certain areas, including the emergency room.
Recently, the hospital began letting visitors in the emergency room. They can stay with patients until a staff member informs them what course of action is being taken, and then they are asked to leave or told they can stay. On July 30, Sharma said, about 64 visitors came to the emergency room.
Because New York was the hardest-hit state in the U.S. in the early stages of the coronavirus pandemic, Sharman said, many people learned to adapt to wearing a mask and social distancing, which, he added, has helped prevent a second surge so far. He noted, however, that there have been some instances of residents becoming lax with wearing masks, which he cautioned against.
“The community is the only thing that can keep the spread down,” Sharma said. “The hospital can’t do that. Because we were hit first, people took it seriously here, and the numbers have stayed down. It’s not time to give up. It’s time to keep fighting the good fight. The mask is a minor inconvenience compared to being on a ventilator.”
The return of visitors is part of administrators’ attempts to return to normal operations. To continue that theme, they created a “Don’t Put Your Health on Hold” campaign to encourage the community not to be afraid to come to the hospital because of the virus.
“We don’t want people to put their health on hold in fear of Covid,” said Joe Calderone, MSSN’s senior vice president of corporate communications and development, “and we’ve taken the steps needed to ensure their safety when they come here. Our overall message is simply that it is safe to come here.”
When the virus peaked, doctors and staff at MSSN began adapting in different ways. One example was telemedicine, through which doctors meet remotely with patients. During the height of the pandemic, telemedicine was used to help curb the risk of patients contracting the virus in the hospital.
Sharma said MSSN held about 1,400 telemedicine appointments in April and May as the pandemic surged. He said, however, that most people prefer in-person appointments to telemedicine treatment. Sharma referred to MSSN’s latest Truth in Medicine poll, released in June, which found that 75 percent of respondents said they were not interested in telemedicine and would prefer in-person care. He predicted that as time goes by and it becomes a new normal, telemedicine will continue to grow and more people will accept being treated that way, but for now, he prefers in-person care.
“It’s much easier for us to provide comprehensive care in the in-person setting,” Sharma said. “Telemedicine has its limitations, but it has its value nonetheless for a subset of medical care.”
Sharma said telemedicine is most effective for behavioral health, dermatology and follow-up visits. He said if behavioral health patients are stable, telemedicine is good for follow-up check-ins with doctors and will not require patients to travel and risk exposure to the virus. He also said dermatology works unless the patient needs a biopsy, which cannot be done remotely. For routine follow-ups, Sharma said, telemedicine works best for post-operative and primary care visits.
When patients have virtual appointments, they should be in an area where they have privacy and minimal background noise, Sharma said, and they should be prepared with whatever medications they were previously prescribed in case the physician has questions about them. They should also have a pen and paper to jot down notes.
Many times in-person care is required, though. If a patient hurts a shoulder, for example, the in-person doctor can physically touch the injury and go through a range of motion with the patient at the office, which would be easier than it would be to try and diagnose the issue through video. He added that many issues require routine lab or electrocardiography tests, which have to be done in person.
Sharma said he does not envision a day when telemedicine takes over in-person care. He added that as millennials age, telemedicine should grow, as younger people are more likely to be more comfortable with technology.
“It’s growing, and it will be able to do more tomorrow than it can today, and it’s already doing more today than it did yesterday,” he said. “It’s here to stay. There is a significant role for it, and as technology grows, that role will grow, too.”