Specialists pivot to virtual, phone care to protect patients at high risk of COVID-19

As the coronavirus continues to spread through South Carolina, doctors at the Medical University of South Carolina who care for people in high-risk categories are adapting their practices.

The Centers for Disease Control and Prevention has said that people over the age of 65 have a greater risk of severe illness from COVID-19, the disease caused by the new coronavirus. People with chronic conditions like diabetes, lung disease and asthma and those who are immunocompromised could also be at higher risk.

Endocrinologist Aundrea Loftley, M.D., said she’s been getting a lot of questions from her patients with diabetes about their risks. She noted that although people with diabetes aren’t more likely to get the disease than other people, they appear to be more likely to have severe complications.

To keep patients from having to leave home during this time and potentially risk being exposed to someone who is sick, she and her colleagues are now seeing patients through virtual visits.

“Most patients have chosen to participate in virtual care and are pleased this is an option MUSC is offering,” she said.

Geriatrician Amanda Overstreet, D.O., treats patients over the age of 70. Three weeks ago, she began giving patients the option of canceling appointments for routine issues. Now, after the technology team quickly built an option into MUSC Health’s electronic medical record for telephone appointments, she’s started offering telephone visits, and all regular in-person visits have been suspended.  

For an emergency, like chest pains or confusion, which could be a sign of a stroke, people shouldn’t hesitate to go to the Emergency Department, she said.

Loftley said she’s also advising patients to make sure they’re taking good basic care of themselves, like staying hydrated, getting adequate sleep and taking a multivitamin, unless there is a health reason not to.

Both doctors are advising their patients to keep a good supply of their medications, to avoid crowds and to wash their hands frequently.

Overstreet has also told her patients to stay home as much as possible.

“For instance, I told my patients that when possible, family members should get groceries for them and bring them to the house, versus them going and walking around the grocery store,” she said.

Although having visitors is discouraged, some of Overstreet’s patients have home health aides to help them with necessary daily tasks. In those cases, Overstreet recommends a thorough cleaning to follow, including frequently touched surfaces like doorknobs and appliances.

“We know that the virus can live on shoes, so I’ve been telling people, ‘Take your shoes off and don’t walk through the house with your shoes. And, lots of good hand washing. And then make sure you’re using some sort of bleach product to clean,’” she explained.

Overstreet said the first telephone visits have been smooth. In one case, she was able to arrange hospice for a patient for an ongoing noncoronavirus illness.

“I felt thankful I was able to get her the help she needed without having to bring her into the health center,” Overstreet said.

Loftley said most patients appear to understand the need for the extraordinary measures that are being taken at the local and state levels.

“People understand this is an unprecedented time in our history and are largely respectful of the precautions being taken to help reduce the transmission of COVID-19,” she said.