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.
“It’s important to understand that smoking is a very, very difficult habit to break,” Dr. Fiel said. It’s particularly tough because of all the behavioral reasons behind why a person began to smoke in the first place. That's why replacement therapies by themselves don’t always work, he cautioned.
“Nobody should feel bad that they’re smoking. Many people do want to try and stop smoking. Where there's a will, there’s a way,”
What resources and services are available through Atlantic Health System to help people quit smoking?
To help those struggling with addiction to cigarettes, Atlantic Health System offers a free smoking cessation program. There are several drugs available that have proven to be successful in helping people quit smoking. In addition, there are nicotine replacement therapies including patches, inhalers, nasal sprays and gum, where nicotine can be consumed without the smoke and additives associated with cigarettes.
Have these technologies and therapies made it easier to quit?
While many medications and nicotine replacement therapies on the market have performed well in studies, statistics indicate that none of them are guaranteed to help smokers quit. Dr. Fiel noted that many people who attempt to quit smoking may be unsuccessful at their first attempt. The process or method may need to be repeated several times to achieve success.
How does a smoking cessation program work?
A smoking cessation program is designed by caregivers who are specifically trained and educated to help people quit smoking. Patients meet in a group setting for an eight-week period to engage in behavioral therapy and use various nicotine replacements, including gum and patches, to address cravings. Dr. Fiel noted that the program requires a commitment from patients to be successful.
Are electronic cigarettes safe to use to transition away from traditional cigarettes?
An electronic cigarette is a very potent and efficient way to deliver nicotine, Dr. Fiel said. The delivery system is heat and vapor and doesn't include the tar and additives present in cigarettes. There is no evidence that they cause cancer. However, that does not mean electronic cigarettes are safe. They are addictive and can cause lung damage. Flavored versions are especially harmful. While there is some data to suggest that electronic cigarettes can effectively help people transition away from traditional cigarettes, he said it is important to consult a doctor or a smoking cessation specialist to determine the best course of action.
How long does it take for nicotine cravings to pass once a person quits smoking?
The idea behind nicotine replacement therapy is to address those cravings. If you quit cold turkey, nicotine in your blood is gone within a day, but your cravings may last up to a week. The idea is to replace the nicotine from smoking and wean yourself off slowly, Dr. Fiel said.
Can people using nicotine replacement therapies still smoke on occasion?
People should not smoke cigarettes while actively using nicotine gum, patches or inhalers. In addition to the increased additive effect, a person can become ill from too much nicotine. Consequences can include increased heart rate and the potential for a heart attack.
What is the best way to convince a loved one to quit smoking?
“There's no easy answer to that. There are a lot of reasons why people began smoking in the first place…It’s a delicate balance and dance.” Dr. Fiel explained.
Rather than focusing on feelings of guilt, he advised talking with your loved one about the ways quitting smoking will improve their health and why it's important for them and for you. Be supportive and focus on potential problems that could be reduced in the future, he said.
Are smokers at higher risk for COVID-19?
The pandemic gives smokers another important reason to quit, Dr. Fiel said. Smokers are more vulnerable to complications related to COVID-19 and are at higher risk because lung damage decreases their ability to clear viruses, bacteria and infections. Those with chronic obstructive lung disease or COPD have significant risk factors. A simple breathing test by a doctor can determine if you have COPD.
Where can I find more information about the Great American Smokeout and smoking cessation programs at Atlantic Health System?
Learn more about the Great American Smokeout >
Learn more about the comprehensive smoking cessation programs offered by Atlantic Health System >
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.