Gabriel Perna | May 21, 2020
Reopening concerns from health care leaders are being verbalized all across the country from specific initiatives, from the national #OpenSafely movement to individual state leaders. While states reopening may be evidence to some that the public is moving past the first phase of COVID-19, health care leaders said that without the proper messaging and protocols, it could be a matter of one step forward, two steps backward for a country that’s been rocked by the pandemic.
On May 20, Connecticut became one of the last states to at least partially reopen. Yale New Haven CEO Marna Borgstrom shared some of these concerns in a health care leadership webcast hosted by the Hartford Business Journal. Borgstrom says the public staying at home, wearing masks in public and overall compliance from the public led to the decrease in COVID-19 hospitalizations and deaths—allowing for the partial reopening to occur. But she said the reopening plans could go awry very quickly.
“We’ve had discussions that if we see areas with hotspots and areas of concerns, the state is going to pull back because we don’t want a new surge of COVID-positive patients coming back in the system,” says Borgstrom, who is on the taskforce to re-open the State of Connecticut.
She says the phased reopening that Connecticut, and many other states, has taken should help prevent “the floodgates from opening up.” However, she says, it’s also important for health care leaders to communicate to the public the importance of maintaining social distancing and other safety protocols.
The reopening concerns go beyond the state of Connecticut and are being addressed nationally. David Brailer, MD, Health Evolution Chairman, Andy Slavitt, former CMS administrator and Chairman of United States of Care, and Mark McClellan, MD, director of the Robert J. Margolis Center for Health Policy at Duke University, along with 19 other health care leaders, wrote an op-ed on this issue in the USA Today promoting #OpenSafely.
#OpenSafely is a public-facing campaign that asks different stakeholders (politicians, health care leaders, the public, etc.) to consider opening up at a deliberate pace that puts safety first. “It won’t help the economy if we end up having to pull back hard or close again because the virus starts spreading toward the point where it threatens our health care systems and further disrupts our health,” the health care leaders wrote in USA Today.
The health care leaders laid out several measures that would help communities open up safely including:
Like Borgstrom suggested with Connecticut, the health care leaders say that if states see a rise in cases that threatens ICU capacity, they need to slow or even pause reopening efforts. They also included a list of areas within the community, such as medical clinics and doctor offices, that can open up with proper social distancing and risk mitigation steps.
Mara Borgstrom, Yale New Haven Health
Bringing other patients back in
Yale New Haven, Connecticut’s largest health system with 2400-plus beds and $4.6 billion in revenue, went from a peak of 126 COVID-19 patients hospitalized and a need for increased ICU capacity to 38 patients currently. The system delayed nearly 3,000 surgeries and countless appointments and services for two months from mid-March to mid-May.
The financial result of this, Borgstrom estimates, will end up costing Yale New Haven more than $350 million at the end of the year. In her 41 years at Yale New Haven, she says the system has never lost money before this event.
But what’s more pertinent is that with the health system slowly resuming those services, there is increased importance in public-facing communications about returning to the proverbial doctor’s office. Many patients delayed services that are only “elective” by name but are necessary for their health and wellbeing.
Borgstrom said hospitals and clinics will need to be transparent to patients and create COVID-free zones and clinics that are safe from the virus. They will need sufficient testing capabilities for both patients and providers. People who need these health care services need to know that providers are compliant with CDC guidelines.
“It’s being smart about how we use health care services and how we optimize a reintroduction plan that supports people feeling safe,” Borgstrom said. Moreover, she says health systems like hers need to leverage the increased interest in telehealth and virtual health visits. “Those kinds of technologies can reduce the foot traffic going in [to providers].”