Heroes of Healthcare
Heroes of Healthcare

Episode · 1 year ago

Cycle of Patient Care During a COVID Surge (Part 2)

ABOUT THIS EPISODE

COVID causes tremendous downstream impact within a healthcare system. 

It means that healthcare professionals are working 24/7 to care for all the patients who come in. It means that treatment of other patients — for example, those who are chronically ill or who need to get a CT scan — gets pushed back so that COVID patients can be treated.

In short, the effects of the COVID pandemic go way beyond COVID-infected patients.

In part 2 of this 2-part series, we continue our panel discussion with six distinguished physicians from Memorial Healthcare System. 

Our panel includes:

We discuss:

  • The delta variant
  • Whether FDA approval will improve vaccination rates
  • How to protect unvaccinated children

To hear this interview and more like it, subscribe to Heroes of Healthcare on Apple Podcasts, Spotify , or wherever you listen to podcasts.

Listening on a desktop & can’t see the links? Just search for Heroes of Healthcare in your favorite podcast player.

There has to be a concerted if by society, and I know it sounds a little bit Corny, but that's what it's going to take. It's going to take stopping the nonsense and social media. It's going to take stopping using the vaccine of covid and people's lives as a political agenda. You're listening to heroes of healthcare, the podcast that highlights bold, selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's get into the show. Welcome to part two of this special two part edition of the heroes of healthcare podcast. Cycle of patient care during a covid surge. I'm your host, Ted Wayne, as you may call in part one of this episode, we were discussing the cycle of care delivered by the team of dedicated medical professionals at memorial health system in Hollywood, Florida. and Are you hit very hard by the recent Delta surge of covid nineteen. Let's pick up the show where we left off and delve into better understanding the Delta variant and the ongoing challenge is being experienced by our heroes in the medical industry. Thanks for joining us. Thank you for continuing to share on that. But I'd like to shift, if we could, back to Dr Eckert and if you could share with us a little bit more about the Delta variant. We talked a little bit about the level of transfer, that this is much more transferable, it's more infectious. One of the questions that we had was would it be fair to say that dempt the variant causes a more severe case of Covid? Well, I don't. I don't really think that I will cause them more severe type of Covid I think it's more contagious and, like Dr knabs said, patients tend to have a very, very but high viral load, so more a replication of the virus in their system, which makes it more contagious and and likely cause more inflammation in the patient. So the treatment really is the same that...

...we are been using from the last search. It hasn't changed much. It was a little bit stressful at the beginning of the pandemic when we didn't know how to treat the patients and there was like really no guidelines and every day there was a new recommendation coming out, and right now we have a more set of guidelines that we can follow, but I think we're still missing more of treatment for covid patients. I think that we still need to know more about the disease and how it's really going to be treated. Probably in the future will know more. Will basically what we're doing now is doing supportive care and given some of the medications that in some of the studies have shown that it improves the patient's outcomes, but for some reason some patients don't improve and they end up in the ICU, like doctor Sir Ellie was explaining to you guys eyes. So you know when we start, you know, several weeks ago when I realize this was different, as was when I was started seeing patients in my office again getting infected and calling because of having symptoms and having some of the staff in the hospital get infected again from transmission maybe outside of the hospital, and so I felt it was different. I felt it was more contagious even before, you know, we knew that it was more contagious because of the way it was coming out so fast and the amount of people that were getting infected around me that was more than in the past. Other things that I wanted to just point out is that infectious thecas is usually seen us, you know, the doctor that reased infections, but the infectious DC is doctor has a bigger role and a healthcare organization as such as this one, and it's been stressful since the beginning because we did not know how contagious was this virus at the beginning, and so all the recommendations about personal protective...

...equipment and things that people need to use to go and see the patients have evolved during this time and and I'm for example, now we know that we have to, for short, change our gowns every time we go see the patients. At the beginning, the CDC had recommended to probably use the same gown between page and and patient just for conservation, because there was not enough PPE at some point. And it was very, very stressful. And the number of multi drug resistant infections has increased because of covid around the United States. So one of the things that as infectious dcase doctors, we have to do is to make sure that there's infection control practices that are followed, and we usually follow the CDC, but I'm telling you that the CDC has changed the recommendations multiple times and we just had to keep on our toes trying to figure out what is the newest recommendation. The other part that is very important is that, after all the patients are in the hospital, we give them like the appropriate therapies that we know about, you know, the ones for covid. Some of them don't get out of the ICU for months, so we end up seeing multiple infections that come with being hospitalized for such a long time. And some of the treatments that we're giving for covid cause your immune system to go low, meaning you get immune suppress or more susceptible to other infections, and so so that's why sometimes we have to get involved at, you know, later on during the course of the patients hospitalization. And we also help the healthcare system with their employee health tracing, for example. Sometimes, you know, there's still some, you know, healthcare workers are not vaccinated and then they get infected, they come to the hospital without knowing they're infected, and then the tracing of where that person has been as also part of what we do in the infectiously seas of work. So all of that...

...has multiplied a hundred times with covid. Like we used to do all this work, but now it's like exponentially more, and so we are working seven, what you know, multiple questions, trying to come up with strategies to avoid, you know, infections inside the hospital, because it happens that people can get infected in the hospital too, because it's so contagious. So I just wanted to make sure that we point out that there's so many aspects that have exponentially explode the work of everybody in the hospital. And the other part that I want to make sure that people understand is the more covid patients we have in our system, in and the hospital, the less we can take care of the chronically ill patient, the patient that needs a Mamogram, the patient that needs a city scan might be rescheduled because we cannot take care of them because we are taking care of those patients. So I think that people don't see the effect of the COVID pandemic, that it goes beyond just the covid infected patients. Yeah, though, I think that it's important for the public to know that the far reaching implications are beyond just covid right. That's that's your point is that there's there's just so much more going on within a help system but has been derailed by by this virus. If I can just stay on with you and and I'll open this up some of these questions that I have now to the also to the group. But, Dr Ecker, the FDA obviously this week approved the fiser vaccine. Any sense from you in the team whether we think that will move the vaccine levels numbers up? Is that going to be the piece that will give the people who haven't been vaccinated the comfort they were looking for? What I feel? I think it's important that it was FDA approved. You know, the the people are reluctant and are always not going to take a vaccine will say, for example, it...

...was proved too fast by the FDA, but the reality is that I personally seen more people asking about the vaccine and getting vaccinated in my office that were reluctant to take the vaccine since the Delta bury in search came up because they are seeing people around them getting sick and dying from the DSEAS. So I think that the FDA approval of the vaccine is going to help the ones that are changing their minds because they're seeing other people or their community getting very well affected by this disease. Okay, DCR Sarelli, yeah, hi, thanks to it. I just wanted to opine on that. I do think if da full approval helps, but I want to stress that this is not going to be the magic bullet to enable mass vaccination. There are so many barriers out there. I think that there has to be a concerted effort by society, and I know it sounds a little bit Corny, but that's what it's going to take. It's going to take stopping the nonsense and social media. It's going to take stopping using the vaccine and covid and people's lives as a political agenda, and everyone needs to come on the same page. No one fought about vaccinations for polio. Was it? Because we saw crippled people walking in the street, so it was real for everyone. It's a rhetorical question, but it really needs to be a massive change across the board. The FDA EUA was just one in a long litany of excuses for people not to get vaccinated and to be manipulated by other leaders with the genders in mind. And I think that all of us, every single one of us, and that's why, to say society, we really have a responsibility to take care of this, of this angle, of this information. The FDA full approval is not going to make the difference between where it is now and where we need to get it. I think also, and I have stressed this to...

...for starring committing in the past, like when we speak system wide, I think that it is important that healthcare providers, doctors and nurse pectitioners that take care of patients are vulnerable but population, recommend the vaccine on a personal basis because by experience, like I said before, I take care of some wellnerable patients and they were not back getting vaccinated because I was not telling them to get vaccinated. So if they trust their healthcare provider, they get the vaccine available near them, some of them will get vaccinated if you have a conversation from a provider to to the patient. So I think that that's something that also could be implemented more frequently around the society, because patients to trust or healthcare professionals more than politicians and people that are just talking on the TV about getting your vaccine. If you say so, Dr Ecker, I'm going to get it. That's what I what they tell me, and a lot of my patients have gotten vaccinated were very reluctant to get it because I was able to provide it here at my office and I was able to give them the counseling myself. Thank you and Dr Napp, I'll go back to you on that. So what are some of the things memorial might be doing as part of the community to continue to to, you know, push that out? Obviously you guys are in an ad agency and certainly don't have funding. So something that I mentioned early in the podcast was that we were a public health system. What that means is we are what we're not for profit like many other many other healthcare providers. We are actually owned by our community and we feel very strongly about meeting the mission of improving the health of the community and really being a steward of their of their health and their healthcare resources. And and I've worked at a number of different health systems over the course of my forty year career and have seen places that that say they do this. This is the most impressive organization that I've seen. So we have a very strong...

...community outreach program even during peacetime, not just during pandemics, for improving the health of let's say the under the under privilege, with the socioeconomically challenged. In this circumstance, we've really had a very robust program in fact, we were one of the first five hospitals in the state to get the vaccine, and the first thing we did was identify other healthcare providers that should probably get some of that vaccine rather than US using it ourselves, and so we started to disseminate to other healthcare systems. We opened up when the when testing first became available, on our own, we opened up a testing center in one of the large parks in the region and had a drive through testing facility when nobody else was doing testing. Again, this is going back early in the pandemic. We then, when the vaccine was available, and wildly available, we then opened up our own vaccination center where people could make appointments and come in and get the vaccination, and we staff that with people who really have day jobs. I mean we pulled nursing staff and physicians and other leaders off the line in order to make sure that we could give vaccinations to our community. So these are things that we've been doing all along. We've had a very strong public announcement process for all of the things that are very pro pro basically pot you know, good care for this pandemic, about masking, about social distancing, about hand hygiene, about vaccination. It's something that we that we feel very strongly about. Now, I'm not saying that others aren't doing that as well. We have a regular call every week with all the CEOS in the state and other call with all the CEOS and in the region, and all of us are sharing our ideas about how we're doing this and how we're trying to promote this work. This is truly a village, but it's a village that's the size of the southeast right. Well, yeah, it's Gott. It starts grassroots and we got to just all be continued to say the same thing and be consistent with our message. As we're coming up on time and I want to be respectful of your guys time, I'm just humbled by the fact that you guys would give indulge just the time and we'll continue to get this message out. What are the thoughts on you guys have talked...

...about the youth, the children, who are the unvaccinated, who are who are now seeing a heightened exposure to this thing. What are you hearing in the market? What's the time frame or any information that you're hearing in terms of well a, what can we do to continue to protect them? I guess masking and the normal distancing things that we can do, but is there any word that you're hearing in terms of when will the vaccine be able to be or what are some of the things we can do today to help protect the younger generation who are don't have availability to this? Well, I have not heard exactly when day vaccine will be available for a children below the age of twelve. I think right now they're you know, I have a lot of friends that are are MOMS that are have young kids and everybody's very stressed because of their back in school and and some of those schools are not requiring masking. You know, kids as young as two years old, you know, have to use a mask all day long. Is Very hard. So right now the my recommendation always is, you know, try to get them with a mask when they're were in there in school. Make sure that they know that they have to clean their hands with either a hand sanitizer or wash it. You know, try to stay in the outdoors as much as they can, but you know, they have to follow the rules of the schools and down here are some of the schools are not using a mask. So it's challenging and we're going to see what happens. Hopefully nothing happens, but I think a lot of kids are going to get covid, likely because the Delta bearing. It's very, very contagious and teds. Something to point out with that is it's natural for parents to be worried about their kids, but in fact their kids are not really the ones that are the concern. Even now, even with Delta, we're still not seeing huge numbers of children being admitted to the hospital. We're seeing children getting infected, we're not seeing huge numbers of children being admitted to a hospital. But those children live with parents...

...and many of those parents, as we know, have not been vaccinated. So it's interesting the parents who've chosen not to be vaccinated, who are also sending their children to school and not requiring their children to wear masks, because those two behaviors tend to go hand in hand. Or actually, it's significantly increased risk now for getting covid because of the Delta variant and it's going to be very interesting, or what we see over the next month, now that's schools have started it up again in Florida, to see what happens to the population that's basically the parents of these children, and we may see another surge. Yeah, yeah, the analogy that I heard, which I like, is, you know, if I'm not wearing my seat belt, I can get pulled over and get a citation and a ticket. And why do they give me a ticket if I don't wear my seat belt in my car? But because of my safety and that their risk to the statistics show and my chance to be hurt in an accident go up significantly. More so it's interesting to understand why we wouldn't say we're a mask because we know significantly it'll decrease your chance of getting covid. But I don't want to get political on here and all that sort of stuff, but it there does be. There is some logic that gets defied in this and this pandemic age that we're in. I guess the last thing I'll just kind of maybe throw out are as you guys are with patients, and we may have touched on this a little bit, but I just was in my notes and I just thought what it would throw it out. What do you hear? Is the head scratcher? Biggest misconceptions that you're hearing? So we're talked about all the bad data out there and social media and the things like that. I'd love to just kind of go around real quick last thing and just ask what surprises you. Is the biggest misconceptions? Drs Relli yeah, so, you know, I think it's a tough one because I think is healthcare providers. You know, we've heard it all. You can go out onto the Internet and go to one of the public messages that Dr Napp has spoken about, where we are trying to...

...educate the community of being on public messages that I'm trying to give and you can find all those excuses and all those misinformations. They're ranging from we're robbing people of their freedoms. This is the biggest experiments with humankind. People don't want to do it because I want to make their own choices, I think. You know, we hear the gamut of all these things. You know, I've certainly heard them. People. People really feel that they are thinking for themselves, they making informed choices and it's based on bad information. It's unfortunate that so much information is seen on the Internet and directly translated as fact when it isn't. Thank you. Yeah, I mean, I heard it from Dr Eckert and hear from you. Trust your healthcare professional. If you're not sure what you're reading or what you're hearing or what you're seeing, talk to your healthcare professional and ask them for some some straight advice. I love that. Dr Eckert, you said you know your healthcare professional is trusted far more than your local politician is or should be. So thank you again all for your time and indulging us this. This has been really insightful, really helpful. The message has to get out and we will make sure that we do that here. Dr Nap, thank you for you and your team for helping coordinate this. It's been our pleasure. Normally we end our episodes asking our guests who they are, hero is or was, but I'm taking liberty as the host to just say I actually see all of you as my hero and as our heroes. We want to just thank you so much for the work you're doing. I don't know how to portray the sincerity, but you guys are our heroes and that was the the genesis of creating this podcast was you guys are on the front lines, fighting it out, putting your lives at your putting your families at risk in order to help other people, and I don't think that there's a better way to show a servant led a attitude. And we just thank you and you guys are our heroes and thank you...

...for all you do us on. Thank you, Tayor. Thank you for having us on. Thank you, thank you. You've been listening the heroes of healthcare. For more, subscribe to the show in your favorite podcast player or visit us at heroes of healthcare podcastcom.

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