Getting Treated for a Medical Problem That's Not Coronavirus
With COVID-19 spreading, many people are thinking twice about medical visits. But some conditions shouldn't be ignored.
The health problem on everyone’s mind—and the one filling up emergency rooms and hospital beds around the country—may be COVID-19, but that doesn’t mean that other medical needs have disappeared.
With the health system strained and social distancing guidelines in place, many doctors' groups have already recommended that patients postpone routine visits and elective procedures. But people still get sick and injured, develop dental problems, and—especially for people with chronic conditions—need regular treatment to maintain their health. Some of these problems can be resolved remotely, but others still require in-person treatment.
To understand when you need to be seen in person, when a remote visit is a better option, and when you should stay home, CR reviewed guidance from medical and dental organizations and spoke with several physicians still working to see patients when possible.
Is It an Emergency?
Emergency situations still clearly need to be addressed, but many hospital emergency departments are treating or getting ready to treat a surge of coronavirus patients. This means that patients should try to gauge whether their situation is urgent enough to need immediate attention, because wait times may be longer than usual and there’s a significant risk of being exposed to the coronavirus in an ER.
But “it’s difficult to know from a patient’s point of view when something is an emergency and when it is not. It’s our job to sort through the complaints,” says Avir Mitra, M.D., an emergency medicine physician at Mt. Sinai Hospital in New York City and a spokesperson for the American College of Emergency Physicians.
Not all emergencies are painful, but there are certain signs that you may be suffering a medical emergency that needs treatment, says Mitra. These include signs of stroke (slurred speech, weakness on one side of the body, or facial droop); chest pain or severe shortness of breath that could indicate a cardiac or lung problem; uncontrollable vomiting; an anaphylactic allergic reaction; or severe trauma, like from a car accident. Such symptoms generally require immediate attention.
Otherwise, however, it’s become more common for hospitals to offer a 24-hour telehealth service for the initial evaluation of a potential emergency, says Mitra. If this is an option, make use of it. It could help you determine whether you need to expose yourself to what’s in an ER, and it may help ensure you get any treatment you need.
If you do need to call 911 or go to an ER, hospital staff are doing what they can to keep COVID-19 patients away from other patients, Mitra says. People with respiratory infections are being triaged into isolation rooms when possible. If you're having respiratory problems and have a mask, wear it to help protect the people treating you (and other patients).
In general, if you can’t tell for sure whether something is an emergency and you can’t get in touch with your regular doctor or someone at a hospital to guide you, err on the side of getting treatment. “Just come and we’ll help you,” Mitra says.
What Other Times Should I See My Doctor?
To avoid having too many people in the same place at the same time, especially around sick people, telehealth has become an important tool. It's a preferred option for many nonemergency visits where people still require a consultation with a doctor, according to medical groups including the American Academy of Family Physicians and the American College of Physicians. In other cases, it’s been recommended that routine visits simply be postponed.
For pediatric practices, the American Academy of Pediatrics has recommended keeping kids out of healthcare offices when an in-person visit isn't necessary. Pediatricians in areas with significant outbreaks should also consider doing only routine visits with newborns and younger children who need vaccines, the AAP says, or having routine visits and sick visits take place at different times of day.
Pregnant women should continue to receive prenatal care, according to the American College of Obstetricians and Gynecologists, but should expect some potential changes to their schedule, including visits that are more spaced out and fewer in-person visits, with some visits done via telemedicine.
In general though, people are still getting lots of medical care, but it’s largely being done remotely, says McLean of Yale New Haven Hospital. “The phones are just as busy as they’ve ever been, if not busier,” he says. But he says that at this point, he’ll have people come in only when there’s something that needs to be done or seen in person, like a steroid injection, draining an abscess, or following up to get a closer look at a bump first examined via video.
In the office, many practices are trying to ensure that people can follow social distancing practices, which means limiting the number of interactions and people in waiting rooms, according to McLean.
And depending on where you are, doctors might take other precautions to protect their patients and themselves. McLean says that in Connecticut, his practice isn’t seeing patients who have had respiratory symptoms. They are being asked to wait for symptoms to resolve at home or to seek emergency care if needed. Doctors in his practice are also generally keeping more of a distance from patients when possible. Officials in some places have recommended that everyone wear a cloth mask when possible, including to a doctor's visit.
You can expect your doctor to be taking additional steps as well, such as wearing protective equipment like a mask and eye protection. In New York City, for example, where Mitra sometimes works in an urgent care facility along with his ER shifts, he says he’s wearing more protective gear than usual to avoid potential coronavirus transmission. He gets geared up in full protective equipment even if someone comes in asking for a pregnancy test or with stomach pain, he says, because we don’t yet know just how many people are carrying the coronavirus.
When you call your doctor to make an appointment, ask about the precautions he or she has put in place. And keep in mind that urgent care may also be an option, though those facilities also pose the risk of potential exposure to COVID-19.
What About a Dental Emergency?
The American Dental Association (ADA) has asked dentists around the country to postpone nonurgent dental procedures through at least April 30 to slow the spread of COVID-19. That means now is not the time to get a cleaning, X-rays, whitening, or treatment of a nonpainful cavity. But if you're in pain or if you’ve recently had dental surgery that needs follow-up treatment, the ADA says that it should be looked at.
An ADA website has guidance for patients outlining the sorts of issues that should be treated: gum infections, broken teeth, bleeding that doesn’t stop, abnormal tissue, and anything painful. Some dental problems can even be life-threatening, for example, if you have bleeding that doesn’t stop, an infection that’s swelling your airway, or bone damage that could compromise your ability to breathe.
If you need to go in for a procedure, you can expect your dentist to be wearing a surgical mask along with eye protection or a face shield, which he or she may have done even before the current health crisis. Offices will also be taking other precautions to help people maintain social distancing, like limiting the number of those in a waiting room. (Call ahead to make sure your dentist’s office is taking these sorts of precautions.)
In all of these cases, what you should expect will change as the coronavirus becomes more or less common in your area. Guidance from professional organizations on what requires treatment—and how it’s accomplished—will continue to be updated.