How the Covid-19 Crisis is Revealing Who We Really Are

This pandemic is the most serious challenge we’ve faced in a long time. Like most physicians, my inbox is swamped with requests from concerned moms, those caring for the elderly and loved ones, part and full-time workers who haven’t been able to stay home because their work is deemed essential and those who’ve lost wages because their work isn’t. People are often scared, confused and overwhelmed. They need more than just clear answers–they need support.

My heart goes out to those who have lost people near and dear to them in this crisis, and we all must send a strong message of support to the frontline–our true heroes. And that’s not just the physicians and nurses…it’s others who work in support services in hospitals, nursing homes or emergency rooms. Another often forgotten group is our nation’s caregivers–both the professionals and those who do so because their loved ones have no other choice. The frontline also includes people who are putting themselves at risk every day in food and other delivery, grocery store workers and others who support our nation’s infrastructure. These folks don’t have the luxury of staying home–these are the workers who make staying at home possible for others. And since two-thirds of Americans have at least one chronic condition, many of these workers are at even higher risk of complications from the virus.

And chronic conditions absolutely raise the risk of death and serious complications from covid-19. In a study of almost 800 people in Wuhan China, deaths were more likely to occur in males, those over 40 and those with chronic conditions. (In that study, nearly half of those who died had a history of high blood pressure!). A larger study of over 44,000 people with confirmed covid-19 in China confirmed that finding. In that study, the case fatality rate for diabetes was 7.3% which was even higher than the rate for chronic respiratory illness. In the U.S. we see the same trends–of 780 covid-19 related deaths in New York, as of today, 80% had a confirmed underlying chronic condition, 18% were still pending confirmation and only 1.5% were confirmed to have no chronic condition such as diabetes, heart disease, hypertension, pulmonary disease and some others. (accessed on 3/30/2020)

If people with chronic conditions are at such extraordinarily higher risk of death from covid-19, and medical facilities are high-risk areas for contracting the illness, where exactly are they supposed to receive care? In the new environment of “social distancing,” our nation is switching rapidly to telecommuting, ordering essentials including groceries online and, yes, telehealth. In fact, telehealth is rightly getting much attention, since those who suspect they are sick should not go to medical centers without first reaching out (except in emergencies, of course). For many who are infected, the recommended guidance they receive after a telehealth visit is often to recover at home.

But the power of care at home can go far beyond the 15 minutes of a telehealth visit. Remote patient monitoring and phone and digital coaching allow round-the-clock access to insights and support. Just as we learned to work from home, and we learned to shop from home, we are learning to manage our chronic conditions from home. And these newer models aren’t just replicating what’s possible face-to-face in a home environment–insights, analytics and support in a digital environment can improve health in ways that episodic visits never could. As we begin to see not just the convenience but the advantages of this type of remote continuous care, it will not simply be a reaction to the current crisis but rather a new normal for how most people here and abroad should receive care for the best value and clinical outcomes.

There is no doubt that this is a crisis. And it’s often been said that crises build character. But crises also reveal character. Helping others is already in our DNA, and the current epidemic has surfaced the very best in us in terms of social responsibility: thinking of others, helping others and really being there for our most vulnerable and most at risk–especially the elderly and those with chronic conditions. If you agree, then join our effort as we work together to give them access to the very best care in the safest, most efficient way possible.

Sincerely,

Omar Manejwala, M.D. Chief Medical Officer