Giving Patients Hope on Their Journey Back to Health
Some patients who recover from COVID-19 have persistent symptoms. In a Community Conversation on October 27, Steven Sheris, MD, discussed what we've learned about COVID-19 and how the Atlantic COVID Recovery Center is meeting the individual needs of those patients.
Dr. Sheris is the senior vice president, physician enterprise at Atlantic Health System, and president of Atlantic Medical Group.
How are you helping patients with lasting complications from COVID-19?
Lingering symptoms of COVID-19 experienced by some patients can affect multiple areas of the body - including the lungs, heart, nervous system and joints - and present themselves in highly individualized and personalized ways. There are also lasting impacts on behavioral health.
The Atlantic COVID Recovery Center was established to effectively manage the health and recovery needs of patients experiencing lasting complications. Patients are connected to a health coordinator and a navigator to unify the specialty areas needed to provide comprehensive and personalized care. Patients can access the Atlantic COVID Recovery Center through both in-person and remote visits.
Do all COVID-19 patients experience post-recovery symptoms?
Dr. Sheris explained that every patient is different and therefore may experience some or multiple symptoms post-recovery. The variation is highly individualized. Symptoms can be mild or intense, intermittent or constant. That's why the coordination of care is so important. Doctors are learning more about COVID-19 recovery from each new case and can begin to recognize the patterns that emerge. The treatment options they offer are developed with the input and collaboration of multiple specialty areas.
How have patients responded to this process?
"From a clinical standpoint, it's too early to give a broad answer of how patients are doing. But… they've all expressed gratitude for this having been made available to them,” Dr. Sheris said.
Many patients felt hopeless when their symptoms didn't fit into one conventional diagnosis, and now there is a place for them to turn, he said.
As some patients get relief from chronic symptoms, our team can give them hope that there may be improvement over time.
What is unique about the approach of the COVID-19 Recovery Center at Atlantic Health System?
"Everything that made Atlantic Health System successful in the years leading up to this particular challenge really enabled us to comprehensively deal with COVID-19 as an acute illness, and now COVID-19 as a chronic illness,” Dr. Sheris said.
“We have always been a proponent of patient-centered care,” he said, adding that Atlantic Health System aims to simplify access, create care where the patient needs it, where it's appropriate, and do it all at the highest level of expertise.
“Our experts in all different specialties really stepped up to the challenge of constructing this recovery program in short order."
How is COVID-19 affecting those with heart conditions?
COVID-19 can cause chronic conditions in the cardiovascular system and can directly affect the heart muscle, resulting in poor pumping function. Dr. Sheris explained that one of the evaluations that patients receive is an echocardiogram, an ultrasound of the heart that evaluates both the pumping function and the integrity of the heart. Tachycardia, or a rapid heartbeat, is another symptom that would warrant evaluation.
These problems may be due to COVID-19, or may exist in isolation. They can occur in those in prime health, such as athletes, or those in average or compromised health. The Atlantic COVID Recovery Center tailors an evaluation and therapy to the needs and situation of each patient.
Have there been changes to the way people are responding and reacting to the virus?
Dr. Sheris said, "The virus really has not changed. There have been small genetic changes that have been detected in the virus [RNA], but those have not translated into changes in how the virus infects people. As COVID-19 washes through vulnerable and susceptible populations, we're seeing those with pre-existing conditions, associated conditions and the elderly disproportionately affected."
Is COVID-19 more or less lethal than it was in the spring?
Dr. Sheris responded, "Now we're seeing the rest of the country and those at a younger age being infected. We're seeing the disease play out a little differently, with less severity in some instances. Nonetheless, the illness can be debilitating even to young people. It can take them out of action for quite a while.”
He stressed that young people can transmit the virus to the elderly or to vulnerable people with other associated conditions, so the level of vigilance that we need is no different now in the fall than it was in the spring.
Have the strategies to control the spread of the virus changed?
According to Dr. Sheris, the most effective ways to control the virus remain the same:
- maintain physical distancing of at least six feet
- wear a mask that covers your nose and mouth
- avoid indoor gatherings of more than 10 people
- wash your hands frequently, especially after you contact high-touch surfaces like doorknobs.
- Learn more >
The best course of action is to remain vigilant. Avoid pandemic fatigue and compliance fatigue, he said.
What is pandemic and compliance fatigue?
Dr. Sheris explained that this type of fatigue occurs when people become complacent about wearing masks, social distancing, handwashing and avoiding indoor gatherings.
It is important to stay home from work when you're not feeling well, whether or not you have tested positive for COVID-19, he said. The goal is to protect the most vulnerable, protect the capacity of the health care system to care for patients and suppress the illness.
Without a vaccine and without development of broad immunity, there won't be a total eradication of the illness, he said, but people should not get discouraged or think things are not working as cases rise and fall in New Jersey.
Discipline in our interactions and behavior will help fight the virus, Dr. Sheris urged.
Based on what we've learned about COVID-19, how has visiting a physician's office changed?
The physician practices, medical centers and emergency departments of Atlantic Health System enacted both environmental and process measures to prioritize the safety of patients and visitors during the pandemic. We have learned a lot about COVID-19, including strategies to mitigate the spread and ways to treat patients who are infected.
Our physicians continue to learn every day, and we put that knowledge into action to refine our care, Dr. Sheris said.
How do virus hotspots occur?
A hotspot occurs when there is an increase of cases in a particular geographic area and the virus spreads. Dr. Sheris explained that communities respond to hotspots with contact tracing, isolation testing and quarantines. To prevent hotspots, communities and individuals must remain vigilant. The threat of COVID-19 will not end and life will not return to normal until there is a vaccine.
Is a second surge of COVID-19 inevitable?
“The future will be written by today's actions,” Dr. Sheris said.
He repeated that the key to protecting ourselves and our communities is wearing a mask, social distancing, avoiding indoor gatherings and washing your hands.
"We will get through this. And it will happen more quickly and with less devastating effect if we are diligent with public health pronouncements.”
Atlantic Health System is ready to weather this storm, Dr. Sheris said. And because of the actions of the citizens of New Jersey, he is still optimistic that we won't see a surge to the extent that we saw in the springtime.
“Brighter days are ahead," he said.