Dear Readers:

By now, everyone is aware of the novel Coronavirus disease (COVID-19) pandemic. It certainly is a very serious situation that should not be taken lightly. Each of us has the opportunity and responsibility to limit the spread of the virus by reducing contact with others and using good personal hygiene (ie, hand washing). Obviously, as health care providers we should be practicing hand washing and protective measures daily. It is interesting to hear the response of people when these measures are mentioned; it is as if they had never heard them. Of course, these measures are reiterated and stressed every year during flu season, which proves how little attention people pay to preventative health issues. The same can be said about staying away from crowds and protecting those at greatest risk of having major complications if they should contract the disease. 

During our limited time seeing patients this past week, 2 of the new patients I saw were 94 years old! Both came in due to swollen legs without ulcers and both had ultrasounds to prove they did not have deep venous thrombosis. Both only need compression therapy, which they received. I cannot imagine exposing a 94-year-old family member to the possibility of contracting COVID-19. There was no question each of these patients could have waited a few more weeks to be seen. 

The reality of how this disease is affecting all of us is a major issue. I do not know how your practice is being changed, but our wound center is having to make some major adjustments in how we are seeing our patients. Unlike some medical practices, patients with wounds have to be seen on a regular basis. Closing the doors to the wound center and telling everyone to come back in 2 to 3 weeks when everything is back to normal is not a reasonable solution. One obvious approach is to work with home health agencies to have the visiting nurses see and do dressing changes on as many patients as possible. This eliminates patients being exposed to potentially sick people. Arranging supplies for those who could change their own dressings is being done, but that still leaves a number people who need to be seen. 

After discussing the issue of a full waiting room, my wife came up with an interesting solution. She suggested that since everyone has a cell phone these days, the patients can park in the parking lot then call the office to tell the staff they are at the wound center. The patient then waits in the car until we are ready to take them to an examination room. The patient is called on their cell phone to come into the center where just inside the front door, nurses screen each patient for symptoms or signs of COVID-19. If the patient has any symptoms or signs, they are sent directly to the COVID-19 screening center provided by the hospital. If the patient has a negative screening test, they are returned to the wound center to be seen. If they have no symptoms or signs, they are taken to the exam room where I and the staff do a routine visit and whatever treatment the patient needs, while abiding by the recommended infection precautions. This way we can still see those who need to be seen but are avoiding the packed waiting room. So far, this has worked very well and the patients like the system — a few have encouraged us to continue it after the pandemic is over! 

There is no question that we are facing interesting times regarding how we can prevent an infectious disease, while still providing care to those in need. We must be ingenious in our approach to managing these problems and minimizing the effect on our patients, our staff, and ourselves. Remember, if we or our staff get sick, there may not be anyone to step in and take our places, which does no one any good. Stay safe and remember the old Persian adage: “This, too, shall pass.”