The U.S. may follow in Italy’s footsteps and be overwhelmed by the coronavirus unless we take preventive action now. The capacity of the American health-care system is already under strain — even without the COVID-19 pandemic — with emergency room overcrowding, long wait times to schedule an appointment, and a chronic shortage of nurses.
We need to expand capacity and unleash creative flexibility in our health-care systems. We have many options such as expanding telemedicine, creating self-service stations for testing, and rapidly establishing specialized flu clinics. The clinics could be set up as separate spaces in existing facilities or as standalone facilities, or even tents, in various locations, similar to those built in Wuhan to handle the pandemic’s explosive initial outbreak there.
As fears of COVID-19 or the actual spread of the disease increase, we expect more people with flu-like symptoms to seek testing or care. There is simply not going to be sufficient capacity to continue business as usual and doing so could actually harm patients not only due to delayed care but also increased risk of infection.
Patients with flu-like symptoms gathering in tight spaces like waiting rooms with other patients suffering from serious illnesses could fuel COVID-19’s spread, and other patients with unrelated conditions such as injuries or heart disease would be at increased risk of contracting COVID-19. Hygiene measures in every corner of a large facility, especially waiting rooms, is hard to enforce at all times.
We need new health-care delivery practices to ensure social distancing within the healthcare system itself to increase infection control. Some countries already do drive-thru testing, which could be adapted or even further extended to self-service in the U.S. Telehealth services have already been on a gradual rise in the U.S. For example, Blue Cross of North Carolina announced the expansion of virtual access in place of some visits
Dedicated flu clinics could implement targeted hygiene practices, air filtration and more specialized protective equipment beyond masks and gloves for healthcare workers to reduce the spread. They can also establish a more efficient workflow and processes to test and care for patients with flu-like illnesses, reducing wait and care times and thus curtailing spread due to prolonged exposure to others.
Latest pandemic flu modeling research at the Georgia Institute of Technology shows that establishing dedicated clinics could achieve goals being publicly called for: Reduce the total number of people infected during the pandemic, flatten the peak of the curve, and slow hospitalization rates.
New, flexible care delivery practices such as telehealth or flu clinics would raise the scarce capacity for patient care and potentially reduce the overall costs, keeping many patients with flu-like illnesses out of emergency rooms where resources are scarce and expensive.
With a likely surge of people with flu-like illnesses seeking testing and care in the coming weeks, it is imperative to consider all alternatives for increasing the capacity and the flexibility of the U.S. healthcare system to provide timely and quality care to those in need and to save lives. Hospitals and clinics should have the ability to adopt new, flexible protocols for triage, treatment, payment, and reimbursement, including for the uninsured.
In the middle of a public health emergency, it is vital to think outside the box, and not get bogged down by regulatory restrictions meant for normal times.
Keskinocak is a professor and director of the Center for Health and Humanitarian Systems at Georgia Institute of Technology.
