Should I keep up with routine doctor appointments?

Yes. “There's a substantial risk to not getting routine care,” said Gerald Harmon, president of the American Medical Association. Data collected since the beginning of the pandemic and anecdotal reports from doctors paint a concerning picture of the possible consequences of delaying care. In 2020, adolescents and adults potentially missed an estimated 26 million doses of recommended vaccinations, not including the coronavirus vaccines, compared to 2019 figures, according to the AMA, citing an analysis by the health care consulting firm Avalere Health . An estimated total 725,000 screenings for breast, cervical and colon cancers were also missed during the first year of the pandemic. Annual physicals and scheduled checkups are also crucial appointments for people with chronic health conditions that need to be monitored. “We’ve seen both locally and nationally that patients are presenting later than usual with symptoms of diabetes, of poorly controlled hypertension and other chronic illnesses that, if not taken care of, can shorten people’s lives, careers and result in mortality,” said Russell Phillips, director of the Center for Primary Care at Harvard Medical School. “It’s really important to try to keep up with your ongoing medical issues as well as your ongoing planned contacts with primary care, even if you’re well and don’t have chronic illness.” Before making decisions about medical care, first talk with your health-care provider, Knight said. Your provider can help you prioritize which visits to keep or come up with alternative ways to access care, such as telehealth appointments , if you don’t feel comfortable going in person. But even though it’s understandable to feel wary about going to a doctor’s office during a pandemic, experts emphasized that the risk of coronavirus transmission is relatively low given the effective safety measures that have been widely adopted in medical settings, including mandatory mask-wearing and the use of other personal protective equipment, symptom and exposure screenings, and sanitation practices. “When you go to the doctor’s office, don’t think you’re walking into an infection center,” Knight said.

What should I do about a non-urgent health issue?

Experts recommend contacting your primary care physician to determine the severity of any health issue and the best way to assess and treat it. But for true non-urgent matters, you may be able to schedule a virtual appointment. In some cases, you could even do some monitoring and testing at home or go to a nearby laboratory or outpatient facility where there may be less potential exposure to the coronavirus. Patients being treated for hypertension, for instance, can monitor their own blood pressure and, when appropriate, their doctor can make adjustments to their medications based on the readings, Phillips said. With doctor referrals, routine imaging tests such as mammograms, ultrasounds, MRI exams, CT scans and X-rays can be done at outpatient locations that are less crowded than the major medical centers. And although screening for colon cancer, which typically requires a colonoscopy, is often done in hospital settings, there are alternative forms of testing that allow low-risk patients to start the screening process at home, Phillips said. Still, there are non-urgent issues for which a trip to the doctor’s office may be needed, but patients can ask about their provider’s coronavirus protocol, said William Schaffner, medical director of the National Foundation for Infectious Diseases. “I think it’s important to be very frank about that,” he said. “ ‘Is everybody vaccinated?’ ‘Are you all wearing masks?’ ” Some people might be more comfortable going at nonpeak times, such as getting the first appointment of the day to be “in and out before anybody else is around,” he added.

What about a problem that is more time-sensitive?

Patients experiencing a medical emergency should go to the nearest emergency department. But ERs “should not be substitutes for urgent-care clinics or for routine visits because they tend to be very crowded almost all the time,” which could increase your risk of exposure to the coronavirus and other illnesses, Schaffner said. If you have a non-emergency medical issue that cannot wait for a primary care appointment, urgent-care centers or satellite clinics affiliated with major medical centers may be a good option. Those clinics should follow the same protocols as primary care offices, such as screening patients before visits for the coronavirus or coronavirus-like symptoms, Phillips said. Inside the clinic, patients with suspected coronavirus symptoms should be kept separated as much as possible, though you should still wear a mask and stay distanced, he said. Experts said you will have to make a judgment call about where to go for care, but a primary care doctor can help you make that determination.

If I have an emergency, is it safe to go to the ER during the pandemic?

Yes, but you should take precautions. If you are not experiencing a “911 life or death emergency” but still need immediate care, Harmon, the AMA president, recommended calling the emergency department to let them know you’re coming, so they’re expecting you and you can find out if there’s an extended wait. If possible, try to bring pertinent health documents, such as a medical history and medication list, which can help ER staff expedite your care. Once you’re there, make sure you’re wearing a well-made, form-fitting face covering, Harmon said. Nearly all hospitals in the United States require people to wear masks. But this is particularly important for people in emergency room waiting areas “where a lot of folks are of an uncertain covid status and, therefore, you’ve got a slightly higher risk of being exposed to it,” said Keith Hemmert, medical director of the emergency department at the Hospital of the University of Pennsylvania. “Simply wearing a mask can dramatically lower your risk of contracting covid in that environment,” Hemmert said. Experts recommend a surgical mask, which most ERs should provide for patients who do not have one, or a well-fitted two-layer cloth mask. Higher-quality masks such as N95s can provide greater protection if worn properly, however, they are not necessary for most people and may be less comfortable, Hemmert said. “If you decide to wear an N95 mask but you wind up leaving it off half the time because it’s so uncomfortable, you’re better off just wearing a standard medical-grade mask,” he said. “In terms of your own personal safety and the safety of the folks around you, leaving that mask on is most important.” Experts cautioned against wearing surgical gloves since most people are not trained on how to properly use them and can inadvertently spread disease with the gloves. But all agree hand hygiene is vital. Bring your own hand sanitizer or wipes, or use the hand-sanitizing stations throughout hospitals and emergency departments. “Every time you see one, pump the button and sanitize your hands,” Hemmert said. Aside from that, experts encouraged people waiting to be seen to try to keep their distance, though it may be difficult since ERs are often crowded. In some hospitals, after patients have been triaged, they may be allowed to wait outside or in their cars until a room is available — assuming the ER staff tells them it is safe to do so. Hemmert urged patients to inquire about the hospital’s policy before deciding on their own to wait outside the ER because “your medical condition may worsen and then nobody knows where to find you.” Above all, do not avoid the emergency department during a potential emergency. Call 911 if you have significant chest pain, extreme shortness of breath, a head injury, or if you lost consciousness or are actively bleeding from a trauma, Harmon said. Other symptoms that should not be ignored include an abnormal heart rate or a fluttering sensation in the chest, rapid changes or losses in vision or hearing, or signs of a stroke, such as weakness in one side of your body, Knight said. The risk of suffering long-term harm from not getting diagnosed and treated for a severe medical condition “is far greater than your risk of contracting covid in an emergency department,” Hemmert said. “We really do urge folks — if you think you’re having an emergency, go to the emergency department.”

What if I’m trying to help a child or loved one?

Don’t put off routine medical appointments for your children unless you’re following guidance from your child’s doctor, said Jennifer Shu, a pediatrician in Atlanta and a fellow of the American Academy of Pediatrics. If possible, she said, parents and guardians should adhere to the AAP’s recommended schedule of appointments . Pediatricians have also adapted to the pandemic by prioritizing certain in-person appointments and increasing access to virtual appointments, Shu said. But if your child develops a fever or starts to experience respiratory issues such as a cough or labored breathing, you should seek in-person care, she said. She added that any concerns with children under the age of 2 should also be assessed in person because kids that young can’t always clearly articulate what’s wrong. For after-hours or more-immediate help, Shu recommended going to a pediatric urgent care because such facilities will be better equipped for treating children. If you have to go to a normal urgent care or the emergency department, check in with your child’s pediatrician the following day because there are “nuances to medicines and treatments that an adult-oriented facility might not be as familiar with,” she said. During in-person visits, children need to be wearing masks, experts said. Keep children who are too young to wear masks away from other people in waiting rooms or ask if it would be possible to wait in the car until it’s your turn, Shu said. But, she noted, if your child is really sick, places such as emergency departments will prioritize their care. And, if possible, people with multiple children should only bring the one who is sick, Harmon said. If you’re taking a child, adult family member or friend to a doctor’s office, urgent care or emergency department, experts said to familiarize yourself with the facility’s rules because there may, for instance, be limits on the number of people allowed to accompany the patient. You should also follow safety guidance, such as wearing a mask, maintaining distance from others and sanitizing your hands. But in terms of safety in any environment, Hemmert said, “getting vaccinated is the single most important thing you can do to keep yourself and your family members safe.”

clockThis article was published more than 2 years ago

Well+Being

How to seek care for non-covid health issues during the pandemic, and why you shouldn’t delay

By Lindsey Bever

and

Allyson Chiu

September 16, 2021 at 7:00 a.m. EDT

Throughout the pandemic, fears about the coronavirus have driven many people to skip doctors’ appointments and avoid hospitals. Now, with the highly contagious delta variant surging across the United States, those worries may be resurfacing. But doctors say that risk can be managed with vaccinations and other safety measures, and there are potentially greater consequences to delaying medical care.

“There are individuals who, with rising rates of covid-19 infection, have been hesitant about coming to the doctor’s office, and that has allowed for missed opportunities to identify a disease early on or to achieve optimal control over chronic diseases,” said Michael Knight, a primary care physician and the associate chief quality and population health officer with the George Washington University Medical Faculty Associates.

Whether it’s time for a routine visit with your primary care physician or you have a medical emergency that needs immediate attention, here are tips for deciding when to see a doctor, where to go for treatment and how to try to stay safe.

How to make the most of your first doctor’s appointment in a while