COVID-19 and Your Patients

What they are worried about

The worries most expressed by survey respondents are no surprise: 55% fear hospitals will be overrun; 53% worry about an economic depression, and 43% fear someone they love will die from COVD-19.

Treating patients, especially those with chronic conditions such as diabetes, thyroid, or other endocrine issues, is a challenge at any time, but has become understandably more challenging in the midst of the COVID-19 pandemic.

Beyond shifting from office visits to telemedicine, reminding patients that prescription refills may take longer than usual, and helping them manage stress to keep their diabetes and other health conditions under control, what more can a doctor do?

Understanding and empathizing with how your patients are feeling, what they are worried about, and what they want from their health care provider can make patient care more efficient and keep them as healthy as possible.

To that end, Remedy Health Media, which owns and operates EndocrineWeb, polled more than 4,300 U.S. patients, asking them what was on their minds and their wish list when it came to the pandemic and their health care. Because the survey focused primarily on the estimated 60% of Americans who live with chronic conditions, the findings are especially relevant to endocrinologists, primary care providers, and the patients they care for. In the survey, the chronic conditions cited by respondents included diabetes, respiratory issues, mental health conditions, and autoimmune diseases.

Among the findings from the survey are suggestions about what might be done to care for and understand patients better during this difficult time.

35% of patients do not feel well-informed about their chronic condition when it comes to COVID-19.

Stigma and COVID-19

Asked if they would share the news if they tested positive for COVID-19, 77% said they would not.

While that may sound surprising, the stigma issue has long been recognized by the CDC, which devotes space on its website to reducing COVID-19-related stigma. Among those who may be experiencing stigma, the CDC says, are people of Asian descent (because some blame China for ''causing" the virus), those who have traveled (and may be presumed to be at fault for bringing the virus into the country) as well as emergency responders or healthcare professionals.

The fact that those who are infected must isolate themselves, and that guidance for the population as a whole is to maintain a social distance doesn't help the stigma either, although they are both necessary measures to ''flatten the curve."

Offering support to these stigmatized patients or suggesting a support group or individual therapy can help them build resilience, the CDC and other experts suggest.

Top worries about COVID-19

The worries most expressed by survey respondents are no surprise: 55% fear hospitals will be overrun; 53% worry about an economic depression; and 43% fear someone they love will die from COVID-19.

While personality drives the degree of worry somewhat, it's also natural that older people and those with chronic disease, who are at higher risk for severe illness from COVID-19, may be worrying more than others. So may other health care professionals you may have as patients, first responders, children, and teens, according to the CDC. Those who have mental health conditions, including substance abuse, may find the pandemic as well as the social distancing and isolation especially troubling.

Balance is the key, according to the CDC. Encourage your patients, especially those who are very stressed out, to take a break from watching the news 24/7. It often repeats, so have them set a schedule and stick to it. Exercise is the last outing many people have. Encourage patients to keep up their workout routine if possible, resume one they abandoned, or learn a new one if they can't do their tried-and-true.

Taking care of the community in a safe way, such as sewing masks or donating to pandemic-related causes if possible, may also reduce stress.

Survey respondents said the biggest impact has been emotional and mental changes.

How COVID-19 has impacted patients

Survey respondents said the biggest impact has been emotional and mental changes, with 53% citing those, and friends and family, cited by 47%.

You can't change the social distancing guidelines, but you can encourage patients to think outside of the box. Your patients don't have to take to singing on their balconies Italian-style, but they can re-think rituals. News reports are full of drive-by birthday parties, with guests plastering banners on the sides of their cars and then beeping and singing as they travel in a caravan by the house of the birthday person. Grandparents, even the technologically challenged, have learned to Zoom with their kids and grandchildren or gotten better at FaceTime. A short Google session will bring up tons of ideas for staying in touch. 

Remind patients that it's perfectly healthy to see a therapist, and encourage them to seek mental health help when they can benefit from it.

Anxiety and how people manage it

More than 65% of respondents said they feel anxious, not a surprise. Yet, more than 65% of those polled said they do not see a therapist.

While the economy has triggered financial stress for some, you can still encourage anxious patients to seek help. If a virtual visit with a provider is not possible, you can point them to meditation or mindfulness apps, some of which are free.

What's on patients' health care wish list?

In general, patents are seeking their health care provider's wisdom:

  • 54% want clearer guidelines around quarantine 
  • 36% around treatment 
  • 35% about how the virus impacts life
  • 33% about testing

So much of this is in flux or evolving; simply explaining that may help patients cope. As you keep up with guidelines, you can pass on the information to patients. Treatments are emerging, being tested and discarded, or studied further, and testing is eventually going to get better and become more widespread. 

How patients view the pandemic "rebels"

Being in ''lockdown" isn't easy for anyone. So it's also not surprising that 52% of respondents said they get annoyed when they see people gathering in groups as they stay home whenever possible. They felt everyone should be doing their part.

How do you suggest annoyed patients cope with the rebels? Some mental health experts say calling them out isn't likely to work, while others say the rebels tend to fall into line when they see someone they admire following the rules. If all else fails, you could suggest your patients take a look at Twitter, where #COVIDIDIOTS is good for a laugh.

Continue Reading:
Telemedicine and COVID-19: One Year Later
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