An update from our Chief Medical Officer:
I hope everyone had a good weekend and is starting to see some light at the end of the tunnel. While we are nowhere close to a return to normal, our responsible actions as a society over the last 6 weeks is definitely ‘flattening the curve’. There will be a prolonged backside to the pandemic, but at least we seem to have prevented a devastating surge in most areas. I include here recent data from each of our QDP primary markets showing this beneficial impact on COVID-19 cases and deaths. Undoubtedly our measures are making a big difference and we need to keep sustaining them while starting to responsibly resume some business activity, including non-urgent medical care in our offices. It also seems that there are competing opinions in the scientific community about the true prevalence rates of C-19 infections. Studies last week have shown that 14% of asymptomatic NYC pregnant women tested positive for coronavirus and in Santa Clara County (San Jose, CA) serologic testing showed prevalence rates of 2.5 to 4.1%, indicating a rate 50-85 times higher than confirmed case counts. Herd immunity requires 60-70% infection rates to essentially derail a pandemic and we are clearly nowhere close. But it now appears that asymptomatic transmission has likely resulted in much higher rates of infection, compounded by inadequate testing, which implies that mortality rates may be significantly lower. Debate rages on among the brightest scientific minds and the answers to all these questions won’t likely be confirmed until much later. I mention this, however, to encourage everyone to remain optimistic that we may be further along, we will get through this together, and hopefully sooner than later.
Regardless of our status in the crisis, the world will continue to look very different for a while. The use of cloth face coverings is already apparent as we take our walks and trips to the grocery store. I have included a recent JAMA Patient Page about Face Masks. One important point to remember is not to touch the outer surface when putting on, wearing, or taking it off as this could contaminate one’s hands. I also remind any QDP employees with time or interest to consider making cloth masks for any patients who present to clinic without one. QDP will reimburse you for the fabric and supplies.
The White House, CDC and CMS have developed unified guidance to “Opening Up America Again” with specific criteria that need to be met in order to move from our current restrictions to phased resumption of clinical, social and economic activity. Our entire management team has been laser focused on our strategy and plans for “Reopening QualDerm Again”. The Quality Council and management team have collaborated on a comprehensive checklist (attached) that considers clinical factors for patients and staff, screening and triage, communications, IT and telehealth, and facility (administrative and engineering) controls that promote high quality care under the safest possible conditions. We are following every available guidance issued by federal and state government and health care agencies. The local Joint Operations Committee for each state market will determine precisely when and how to move into Phase 1 of Reopening, understanding that provider, geographic and population differences will impact timing and the extent of services offered at each practice. This checklist will continuously be refined and updated, and we encourage you to offer suggestions.
I continue to think about the mental health of all our QDP team members. These are incredibly challenging times with much uncertainty, but there are also some benefits like more family time, a slower paced life, cleaner air and less crime and congestion. I would urge anyone struggling with anxiety, depression or just overall stress to reach out to a friend, co-worker, family member, pastor, any of our practice leaders or use the HealthJoy app to speak with a counselor. Also be aware of these symptoms in your children. I read a study today showing that 20% of kids in Wuhan reported depression or anxiety during the lockdown, a significantly higher rate than outlying regions. Please take care of yourselves and each other so we can ultimately take great care of our patients and families.
John Albertini, MD