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Health officials in Georgia are scrambling to treat patients afraid to leave their homes amid the coronavirus outbreak — as some nurses are now making house calls.
“If you compare to what we’re seeing on the news, we’ve been very much spared” by the coronavirus, said Damien Scott, the CEO of Emanuel Medical Center in Swainsboro. And yet, Scott said by the end of March, his emergency room was “almost a ghost town” despite a population rife with long-term conditions.
According to the Centers for Disease Control and Prevention (CDC), approximately 90 percent of patients hospitalized for COVID-19 had underlying conditions including hypertension, obesity and diabetes, along with lung and heart diseases.
“Right now, these chronic issues are greater risks to these individuals than the virus is,” Scott said.
Earlier this month, Emanuel’s ER staff released a YouTube video imploring people living in the area to return to the medical center.
“We are a safe place to come for health care,” ER manager Brooke Marsh said in the video. “There’s a lot of fears and anxieties associated with COVID-19, but at this time we just wanted to reach out and let you know that we are safe, that we are providing an environment that is careful and cautious. We’re doing everything we can at this time to ensure your safety as well as the safety of our staff.”
“I think what people have in their mind is, you know, the stories out of New York or even the stories out of Albany, Georgia,” Scott said. “I’ve had citizens tell me they felt like we were utilizing every ventilator in this hospital and people were dying left and right in our ER.”
“We’ve had a few patients that if they were afraid, we say, ‘Well, what if we meet on the front porch, what if we meet out in the driveway or in the front yard? You may be seeing someone in a lawn chair in the front yard.”
ER and doctor visits plummeted by 80 percent for the medical center, according to Scott, before leveling off to a 60-percent decline. “If you’re having a medical emergency, don’t wait at home and be fearful of coming to be seen.”
The Albany metro area has seen the country’s second-highest number of deaths per capita from COVID-19. A community health center, Albany Area Primary Health Care (AAPHC), started an in-home care program complementing the clinic’s telemedicine options. A team of two nurses would drive out to rural stretches along dirt roads to Internet-enable patients in seven counties.
“Here in South Georgia, some of the patients live on clay roads. It’s easy to get stuck and then you get scared because you feel like you’re going to slide in a ditch. But I made it through and I made it to my patient’s house.”
“We’ve been a little nervous with the state opening back up,” said Betsy Powell, the director of nursing at AAPHC. “We’re just praying that our numbers don’t resurge back up.”
To meet the needs of a large and apprehensive community, AAPHC selected staff members Monica Childs and Sheronda Byron to meet with patients at their homes.
“I love trying to make sure I meet my patients’ needs just like we do in the clinic,” Byron said. “To me, it’s just like I’m still in the clinic. I’m just doing it at home.”
Though the program is barely a month old, both Byron and Childs recalled trips down dirt roads to meet patients living throughout the surrounding seven counties they service.
Their routes have varied and sometimes could take hours. On an especially rainy day, Byron almost got stuck.
“I said, ‘I think somebody’s going to need to come get me out,’” she said. “Here in South Georgia, some of the patients live on clay roads. It’s easy to get stuck and then you get scared because you feel like you’re going to slide in a ditch. But I made it through and I made it to my patient’s house.
“I leave my phone in the car because I don’t know if I’m going to be running from a dog like I did Monday, so I don’t know what my day is going to consist of,” Childs said.
The nurses divided and conquered scheduling their patients based on location. In one day, they might see six or seven patients each. The next day, if another patient lived hours away, they’d see only one.
“When you talk about not overwhelming an already overwhelmed emergency room or hospital in your rural setting, imagine the number of patients that would have flooded into those, that one hospital in our area, if we had not tried to figure out ways to keep seeing our patients.”
Armed with thermometers, blood pressure cuffs and oxygen saturation monitors, Byron and Childs have covered a lot of ground to ensure patients have the proper equipment to track their health.
Having medical equipment would provice a baseline of health data that patients could share later with health providers via telemedicine. That information would help doctors provide better care for their patients. The nurses also assessed patients for COVID-19.
“We know that everyone is scared to go in the clinic and for us it’s the opportunity, especially for them, to do the telemedicine. So, many patients and family members are so happy that we’re offering that here, so they can do that and their needs are being met inside the home, so they won’t have to go out as much as possible,” Byron said.
Despite all the safety measures, some patients have remained wary of anyone entering their homes.
“We’ve had a few patients that if they were afraid, we say, ‘Well, what if we meet on the front porch, what if we meet out in the driveway or in the front yard? Would you feel more comfortable?’ You may be seeing someone in a lawn chair in the front yard,” Powell said.
“It continues to evolve and we continue to learn. It’s been an opportunity as much as it’s been scary. We never closed,” she added. “We can’t. We’re a community health center. If you think about the disparity of our patients, some of our patient population and the chronic diseases, I mean, when you talk about not overwhelming an already overwhelmed emergency room or hospital in your rural setting imagine the number of patients that would have flooded into those, that one hospital in our area if we had not tried to figure out ways to keep seeing our patients.”