When physicians have their "COVID-19 blinders" on — that is, when preventing exposure to the new coronavirus supersedes other medical treatment — the effects on other patients who need care can be devastating, an internal medicine physician wrote in an opinion piece for STAT News.
In the article, Reshma Gupta, MD, medical director for value and population care at University of California Health in Sacramento, described the experience of her friend who had a stroke while at home. The friend called her neurologist after she fell twice and her left leg became weak, but she was advised to stay at home and monitor her symptoms. The friend's hospital had reported new cases of COVID-19. A few days later, the friend's symptoms worsened, and when she was finally brought to the hospital, an MRI revealed she had experienced a stroke.
This story "reveals an overwhelming unpreparedness of our nation's outpatient centers to care for high-risk patients during this pandemic," wrote Dr. Gupta.
There has been little guidance for physicians on treating patients with severe and complex conditions unrelated to COVID-19 during the pandemic. There are also no standardized guidelines for using telemedicine or delivering care at home, which can result in delayed diagnoses and treatment, Dr. Gupta said.
Though many hospitals do not have the infrastructure to support virtual care efficiently, some patients will require in-person evaluation anyway, she wrote.
Patient and caregiver fears make matters worse, as both parties are afraid of contracting and spreading the new virus.
"We urgently need strategies for the complex scenarios that doctors now face to balance care for non-Covid-19 conditions with the desire to protect their patients from being exposed to the virus that causes it," she wrote.