As virus spreads, VA gets set to back up taxed US hospitals

President Donald Trump departs after a press briefing with the coronavirus task force, at the White House, Wednesday, March 18, 2020, in Washington, with Veterans Affairs Secretary Robert Wilkie, Administrator of the Centers for Medicare and Medicaid Services Seema Verma and Dr. Deborah Birx, White House coronavirus response coordinator.

Following recommendations announced by Centers for Medicare and Medicaid Services during the White House Task Force press briefing Wednesday, non-emergency health care providers across the United States are suspending all elective surgeries and non-essential medical, surgical and dental procedures during the outbreak of the novel coronavirus disease, or COVID-19.

CMS oversees multiple federal healthcare programs.

Accordingly, providers across Tribland are limiting their hours of operation and services provided in hopes of limiting the spread of the virus, which had infected a confirmed 33 Nebraskans as of Friday afternoon.

In Hastings, dentists, chiropractors and other non-primary care providers remained busy Friday treating patients on a priority basis, with only those requiring immediate services being seen.

At Hastings Family Dental, Dr. Charles Bauer has remained plenty busy providing root canal procedures and other emergency care, though not busy enough to avoid cutting regular office hours by half.

Bauer said area dentists are heeding guidelines handed down Monday by the Nebraska Dental Association to shut down for all but necessary procedures through at least April 1.

Bauer identified what is categorized as essential procedures during a recent telephone conversation with Dr. Dennis Anderson, president of the Nebraska Board of Dentistry. The list includes: facial swelling or pain, trauma to the face, broken teeth, abscesses, dislodged filling or crowns, and ill-fitting denture sores.

Bauer said he and fellow dentists across Hastings are implementing procedures to limit patient exposure to the virus. Examples include restricting office usage to a few rooms and vigorously disinfecting them between patients; requiring patients to sanitize their hands before coming into the office; and placing restrictions on waiting room protocol, such as not having patients arrive early and not allowing guests to be with them.

Just how long the virus will continue to impact Bauer’s and other practices across Hastings is unclear, he said. The situation is unlike any he has encountered before.

“I’ve been working for 42 years, and I’ve never seen anything like this in my career,” he said. “It’s pretty much unprecedented. But we will get through it.

“When you’re used to going 60 miles an hour and then have to put on the brakes and do 10, that’s kind of how it feels. But that’s what needs to be done. Everybody is in the same boat, and we all have to look out for each other.

“Obviously, all the dentists in town are using standard protocol for infection control. We have been in contact with each other and have closed our offices except for those emergencies. We need to get through these two weeks and it will be re-evaluated. It may go longer.”

Bauer encouraged area residents to follow CMS recommended safety procedures and to remain level-headed during the crisis. To date, he said, patients have been gracious during the transition process when notified of cancellations of their appointments.

“Typically when we call they say, ‘We were kind of expecting this,’ “ he said. “Personally, I’m not anxious about it. We all need to keep our heads about this thing here.”

At Hastings Vision Clinic, routine eye care was suspended beginning Thursday, following recommendations from the U.S. Centers for Disease Control and Prevention and guidelines put forth by national and state optometry associations.

Dr. Richard Arneson, optometrist with Hastings Vision Clinic, said the front door is locked, but staff members still are working and patients can pick up glasses or contacts and needed. Staff will meet patients at the door

“We do a lot of the adjustments ahead of time, so they don’t necessarily need to come in,” he said. “We’re trying to minimize staff exposure.”

The clinic is mailing eye care products to patients as possible.

“If they have something we need to see, more of an emergency-type thing, we can see them,” Arneson said.

Arneson and his son, Eric, who also practices at Hastings Vision Clinic, have been talking to other optometrists elsewhere in the country to see how they are handling the current situation. Hastings Vision Clinic doctors also are talking to other local eye clinics and to other types of physicians, as well.

Arneson said during normal operations the lobby of his clinic can become congested.

Hastings Vision Clinic staff members have been even more diligent than normal cleaning surfaces.

“There’s part of our exam where we’re fairly close to a patient and just with contacts there’s that fluid if you’re touching around their eye with a contact,” he said. “We just want to be careful that if something did happen that we were vigilant in trying to not spread it.”

At the Murray Natural Health & Chiropractic clinic, Christopher Murray and his staff have remained busy providing services he said will help keep emergency rooms less taxed during the crisis. The clinic offers patients a less crowded location to seek various kinds of health care treatment and testing, enabling emergency providers to see more patients who may be in need of services while limiting potential patient exposure to the virus.

“What are non-essential health care services?” Murray said. “I would argue that some of the services that chiropractors offer are elective, but some are essential. I would say that taking care of somebody’s overall health is definitely important.”

The impact of the COVID-19 virus hit home last week with Murray and some 500 other chiropractors from across Nebraska when their state conference in Omaha was canceled partway through on March 13. Several attendees now will need to make up the conference to meet their continuing education requirements.

“A week ago, we were still holding it (conference) with a little trepidation, sitting around with about 500 chiropractors and saying, ‘Maybe we shouldn’t be here, ‘” Murray said. “Our board said we needed to close down, so at 3 p.m. Friday we closed down the conference. It was supposed to go through Sunday.”

Although he agrees with recommendations made by the CDC pertaining to the virus, Murray said that list omits some important steps that could be taken to help limit the spread of the disease. He is sharing those steps with patients who continue to seek treatment, both through social media, phone or in person.

“I did four phone consultations today for more than three hours,” he said Friday. “That reduces the risk of exposure for people coming to our office. We’ve also asked patients to stay in their cars and call us to let us know they are here. We call them when we’re ready. That’s worked out fine so far.

“We want to talk about prevention. How about making sure people are getting plenty of sleep and exercise? And practicing proper nutrition habits (by) staying away from excessive alcohol and fine sugars and stimulants?

“We’ve had a huge spike of people wanting nutrition supplements, like vitamin D or iron. Nobody is really talking about these things, but these are things you can do that will give patients a real feeling of control over what’s going on.”


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