COVID-19: 6 key points physicians should share with patients

Sara Berg, MS , News Editor

As the pandemic continues to evolve, patients might have lingering concerns about their risk. Here are some tips to address those concerns about COVID-19.

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As the number of novel coronavirus disease (COVID-19) cases continue to rise, patients may worry about their risk and safety. To help ease patients’ concerns about COVID-19, JAMA Associate Editor Preeti Malani, MD, shared some important advice for physicians and other health professionals. 

Dr. Malani is the chief health officer and professor of medicine in the Division of Infectious Diseases at the University of Michigan in Ann Arbor. She co-wrote the JAMA Viewpoint, “Translating Science on COVID-19 to Improve Clinical Care and Support the Public Health Response,” with Carlos del Rio, MD, an infectious diseases physician in Atlanta.

“It is an interesting situation in that everyone’s behavior affects everyone else,” she said. “It’s a time where the idea of shared responsibility has to be central—everyone has to do their part because the whole ship will sink otherwise.”

In a recent AMA interview, Dr. Malani offered this advice for physicians and other health professionals to help calm patients who might be worried about COVID-19.

Patients “should call for instructions because what’s happened is testing has become more available and you may or may not even need to be seen, depending on the history and potential exposures and how you’re feeling,” said Dr. Malani. Whether communicating through a patient portal or on-call nurse, patients can often get effective advice before making an in-person visit.

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“It would require some planning to make sure that you’re taken care of right away,” she said. “If patients have issues like shortness of breath or they have a lot of health issues, they certainly should just call for advice and they may even be directed to go to the emergency department.”

If a patient does not need to be seen in person, they can still be seen by a physician through telehealth. Learn more from the AMA about how to establish telehealth and deliver patient care while practicing physical distancing. 

The U.S. State Department and the Centers for Disease Control and Prevention (CDC) have issued warnings and recommend avoiding nonessential travel, Dr. Malani explained.

“It's actually not a good time to visit anywhere. Stay-put unless you absolutely need to travel,” she said, adding that “international travel is very limited for U.S. citizens right now.”

It remains more important than ever for patients—and everyone in general—to follow time-tested preventive habits.

“The basics around prevention are always important, beginning with keeping your hands clean, maintaining physical distance and to not be around people if you have symptoms,” said Dr. Malani, adding that people should also cover their cough and sneeze. 

“One thing that’s become very clear is the amount of transmission that occurs from individuals who are either minimally symptomatic or asymptomatic,” said Dr. Malani. “The CDC has come out since April and made a recommendation around face coverings in any sort of public space.”

“Since then, about half the states have passed mandates in some indoor public spaces, enclosed spaces and many outdoor spaces because it’s difficult to socially distance when you’re outdoors, even though the transmission risk is less when you’re outside,” she said, adding that “masks are part of our uniform now.”

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Everyone should wear “a comfortable cloth face covering that fits well and doesn’t fall down,” said Dr. Malani. “We wear the mask to protect everybody and to allow us to move forward with some type of normalcy.”

CDC Director Robert R. Redfield, MD, explained the protective value of face masks during a recent episode of “Conversations With Dr. Bauchner.”

“Unfortunately, the U.S. is the epicenter,” said Dr. Malani, adding that “certain parts of the U.S. are extremely high risk, especially in the south and the west.”

“The risk varies depending on where you are, but the risk is not zero anywhere,” she said. “We have to all practice prevention whenever we’re outside our homes and to limit how much we’re leaving our homes, particularly those individuals who are at higher risk for complications.”

For those at higher risk, it is important to keep “travel outside your home to essential things, such as doctor appointments and grocery shopping,” said Dr. Malani, adding that “any interaction with people outside your household should be limited to small groups.”

While it is about if someone has visited a hot spot, it’s also “if you’ve just been out and about,” said Dr. Malani. “This is particularly true for younger adults and potentially kids who have a hard time not interacting with other people.”

“This always needs to be balanced with social well-being. It’s important to have social interactions,” she said. “We can’t just not see other people, but some people are going to be at higher risk because they’re engaging in parties and gatherings where physical distancing isn’t happening.”

“We all need to heed the signs because everyone is at risk who is outside their home,” said Dr. Malani.

If physicians have questions, they should call their local or state health department, said Dr. Malani.

“It’s a good idea for physicians in the United States to get to know their public health colleagues,” she added. “We often don’t communicate except when there’s an emergency, but we should be communicating. That’s a message that’s been lost in all this.”

The AMA has developed a COVID-19 resource center as well as a physician’s guide to COVID-19 to give doctors a comprehensive place to find the latest resources and updates from the CDC and the World Health Organization.