Safety of Healthcare in COVID-19

You should call your doctor’s office if you’re experiencing a minor illness or injury, or if you aren’t sure whether you need to come in for a routine appointment.

Depending on your condition, your doctor’s office will provide recommendations for home care, reschedule your appointment, schedule an in-person visit, schedule a Virtual Visit, or direct you to an appropriate facility for further treatment.

If you need to visit the doctor’s office in person, practicing proper hand hygiene, following social distancing recommendations, and wearing a cloth face covering can help you stay safe.

If you have an injury or other medical problem, call your doctor immediately like you would at any other time and they'll determine the next step—whether it's a phone or video appointment, an in-person visit, a trip to urgent care or a visit to the ER.

If you have a minor illness or injury, you should call your doctor’s office to ask what the next steps should be for your care. Examples of minor illnesses are colds, sore throats, gastrointestinal viruses, or sinus infections. Minor injuries include small cuts or burns, sprains, and strains.

You should also call your doctor’s office if you think you may be experiencing COVID-19 symptoms, which may include fever, cough, shortness of breath, or fatigue.

Depending on your condition and symptoms, your doctor’s office will provide recommendations for home care, schedule an in-person appointment, schedule a Virtual Visit, or direct you to an appropriate facility for further treatment.

More serious conditions, such as allergic reactions or broken bones, can be treated at an urgent care facility or the emergency department. If you are experiencing life-threatening symptoms, you should call 911 or go to your hospital’s emergency department.

Some preventive health screenings such as mammograms, colorectal cancer screening, depression screening and vaccinations often need to be set up with an in-person exam—as do wellness exams for older patients, as they often require a visual test. Call your doctor to ask if your preventative health exam can be done virtually or if they will want you to come in to be seen in person.

A Virtual Visit allows you to quickly, safely, and conveniently see your doctor using a mobile device or computer that’s connected to the internet. You and your doctor will be able to see and hear each other through a secure virtual video connection. If you are an existing patient, your doctor will also have access to your electronic medical record.

During your Virtual Visit, your doctor will ask questions about your condition, conduct a visual exam, provide a diagnosis, make recommendations for additional care. If necessary, your doctor can send prescriptions to your pharmacy or order follow-up testing.

Hospitals and medical offices are taking appropriate precautions to reduce the chances of COVID-19 transmission. Precautions may include:

• Wearing personal protective equipment (PPE)
• Cleaning and disinfecting surfaces and frequently touched items
• Practicing healthy hand hygiene
• Asking health, exposure to COVID-19, and travel questions during check-in
• Minimizing physical contact
• Following social distancing guidelines

You can also take steps to reduce your risk of getting COVID-19 when you go to your doctor’s office. Here are a few suggestions to help you stay safe:

• Wear a cloth face covering: The CDC recommends wearing cloth face coverings in public settings to slow the spread of COVID-19. The cloth face coverings recommended are not surgical masks or N95 respirators. These are critical supplies that should be reserved for healthcare workers and other medical first responders. Visit gov/coronavirus for more information about cloth face coverings.
• Follow social distancing recommendations: Avoid sitting within six feet of other patients in the waiting room and do your best to minimize physical contact with your doctor and staff.
• Practice proper hygiene: Wash your hands frequently with soap and warm water for at least 20 seconds at a time. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60 percent alcohol. As much as possible, avoid touching things such as doorknobs, elevator buttons, and credit card machines. Also, avoid touching your face, eyes, nose, and mouth.

The bottom line: If you need non-emergency medical care during the COVID-19 pandemic, you should call your doctor’s office to find out what steps you should take to get the care you need. Instead of an in-person visit, your doctor may recommend rescheduling a routine appointment, setting up a Virtual Visit, or discussing your condition over the phone. If you need to visit the doctor’s office in person, taking simple precautions can help you stay safe.

Phone or video appointments work well for some situations. Doctors can do routine health checks and monitor certain chronic problems, such as well-controlled diabetes, with a virtual appointment. Other illnesses are best handled in the office. Examples include poorly controlled diabetes, high blood pressure, heart or lung disease and mental illness. There's no one-size-fits-all. Call your doctor's office so you can discuss how they can best meet your needs.

Many people are nervous about in-person visits. In most doctor’s offices, clinics and hospitals, patients are screened for COVID-19 symptoms upon arrival. They have their temperature measured and are asked to wear masks, as do any visitors and personnel. Waiting rooms have been laid out for social distancing. Exam rooms are disinfected between patients.

You should go to the ER if you are experiencing symptoms that could be potentially life-threatening or cause harm if they are not addressed immediately. Examples of these symptoms include chest pain, difficulty breathing, face drooping, arm weakness or speech difficulty, or acute injury or trauma. Similarly, if you are in immense pain, you should not hesitate to call 9-1-1 or go to an ER.

Certain health issues will require an in-person visit. Conditions needing a physical examination, a formal assessment before treating or a therapy that is delivered in person—like an infusion or treatment--may need to be done in person.

COVID-19 can result in severe disease, including hospitalization, intensive care unit admission, and death, especially among older adults and people with additional underlying medical conditions (see additional risk factors below). Everyone should take critical actions, such as social distancing, to help slow the spread of COVID-19 and protect vulnerable individuals from these risks.

Your doctor will discuss with you what factors will influence whether your surgery should be done now or delayed. There are many surgical procedures that are not an emergency. Examples may be cataract surgery, knee or hip replacements, or some plastic or reconstructive procedures. Your doctor will determine if your condition will worsen without the surgery and whether other treatments are available. Your doctor will also assess the individual risk to you by coming to the hospital, office, or surgery center for surgery during the pandemic. They will also consider the extent of COVID-19 in your community including the hospital’s capacity.

People with cancer often have compromised immune systems (often referred to as being immunocompromised). This usually happens due to cancer treatment, such as chemotherapy, radiation, or surgery. It’s harder for the body to fight off diseases when the immune system is not strong enough, so it’s extremely important that people with cancer and their family members follow steps to protect themselves.

Cancer patients who receive radiation or chemotherapy have a weakened immune system (immunocompromised). This happens when radiation and chemotherapy treatments kill not only the cancer cells but also some of the immune system cells, especially white blood cells.

Patients who are immunocompromised are more vulnerable to viral and bacterial infections including infection by SARS CoV-2, the virus that causes COVID-19.

After treatments end, the immune system can rebuild itself and fully regain a functional immune system. However, this process takes time. Some research suggests that it can take between 2 to 9 months. Patients are most vulnerable right after they receive their treatments.

Speak with your doctor if you have concerns about your risk for COVID-19 being higher as a result of current or past cancer treatment.

Certain populations are more at risk for severe illness. The coronavirus that causes COVID-19 is new, so we don’t yet understand exactly how it impacts specific groups of high-risk people. But, those who are thought to be most susceptible to serious complications of COVID-19 include people who:

• Are over age 65.
• Have cancer.
• Have obesity.
• Have hypertension.
• Have lung disease.
• Have diabetes.
• Have heart disease.
• Have another condition that compromises the immune system.
• Are taking medications that suppress the immune system.

If you think you developed signs of COVID-19, call your doctor and seek immediate medical attention. Signs and symptoms may include:

• Shortness of breath / Difficulty breathing
• Cough
• Fever
• Diarrhea (digestive problems may be an early sign)
• Chills
• Repeated shaking with chills
• Muscle pain
• Headache
• Sore throat
• New loss of taste or smell

If you develop any of these urgent warning signs, call 911 or head to the nearest emergency room:

• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest
• Bluish lips or skin
• Sudden confusion or inability to wake up

Talk to your doctor about your treatment plan and how it could be modified to reduce your risk of being exposed to COVID19.

• Wash your hands for 20 seconds or more with soapy water or, at a minimum, alcohol-based sanitizer (which may be less effective than soap and water).
• In public places, avoid touching common surfaces (doorknobs, elevator keys handrails, etc.) without protection or means to disinfect them first.
• Avoid close contact with anyone who shows cold or flu-like symptoms.
• Cover coughs and sneezes with a tissue or your inner elbow shirtsleeve.
• Clean and disinfect frequently touched objects and surfaces such as desks, doorknobs, phones, and handrails.
• Get a seasonal flu shot.