GREENFIELD — More than six months into the novel coronavirus pandemic, pediatrician Dr. P.J. Halter is still waiting for things to settle into a “new normal.”
“It feels like March was years ago, and at the same time it feels like it still is March,” Halter said.
A doctor at Hancock Pediatrics, Halter is one of many health-care professionals who has seen his work radically change, and continue to change, since COVID-19 became a public health issue. He’s gone from putting most of his appointments on hold to helping kids get back to school.
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Procedures for doctors are different than they were before COVID-19, but it also hasn’t remained stable during the period since the pandemic began, said Dr. Julia Compton, the director of the Hancock Physicians’ Network.
“It has very much evolved with the CDC guidelines,” Compton said.
In the early months of the pandemic, doctors were contending with not knowing exactly how the virus operated — some questions about that are still unanswered — as well as not knowing how bad things would get in the community. They worried about how severe the need in Hancock County would be, Compton said, and hoped preventive measures could keep the hospital system from being overwhelmed.
“The medical world was learning,” Compton said. “It was very, very hard at the beginning.”
During that period, most patients weren’t allowed to visit the hospital or doctor’s offices for procedures and appointments considered non-essential.
Now that experts are more certain about what helps prevent transmission and of best practices for health care providers, Compton said, patients are being encouraged to return to their doctors for preventive care.
“Patients are coming back,” she said, “but we’re just not seeing the same numbers. That’s a little bit worrisome. (Regular appointments) are how we find things earlier so we can make an impact and make a difference.”
Other health concerns aren’t put on pause because of COVID-19, Compton said, and it becomes concerning when children aren’t getting vaccines or women aren’t getting mammograms.
Halter focused on his youngest patients at the beginning of the pandemic, ensuring infants received care and young children were getting their regular vaccinations while encouraging other patients to stay at home. He felt lucky, he said, that he likely wouldn’t be called upon to work with severe cases to the same extent as his counterparts with adult patients.
As the state began to reopen and the biggest conversation around COVID-19 became what school would look like in the fall, Halter’s interactions with parents also changed.
“Probably the biggest question we got was, ‘Is it the right thing to send my kids back to school?’” Halter said. “…We really tried to encourage parents to send their kids to school, because it is an environment where kids will thrive.”
Halter said parents are starting to resume bringing their children in for “well-child” checkups, a trend he hopes will continue. He said it’s important to make sure kids continue to get their vaccinations to prevent the possibility of secondary outbreaks of childhood diseases like whooping cough.
Dr. Molly Strong with Hancock Ob/Gyn never stopped seeing her pregnant patients.
“In pregnancy care, those visits are basically essential,” Strong said.
The care Hancock obstetricians and gynecologists provide hasn’t changed, Strong said, but procedures have. When pregnant women are visiting for an ultrasound or are in labor, they are allowed to have one visitor with them.
“I think that has been hard for patients, not having the whole family there to celebrate,” she said.
Strong said her office strives to provide the most up-to-date responses to the many women who have questions about how COVID-19 might affect their pregnancies.
“When we take care of pregnant women, they in general are very concerned about their health,” she said.
Patients also have the option to connect digitally or in the office with a maternity care companion who can offer support.
Telemedicine has been one way doctors have been able to continue meeting their patients’ needs while remaining socially distant. It’s frequently used for visits with patients who are experiencing COVID-19 symptoms; who are confined to their homes; or who can’t get transportation. Hancock Counseling and Psychiatric Services is currently conducting all appointments virtually.
“It also allows you to learn more about a patient than maybe you knew, because you’re seeing them in their home environment,” Strong said.
Doctors aren’t the only ones at the hospital making new use of technology for communications. Lead chaplain Russel Jarvis is doing the same, frequently using iPads to connect patients with their families or pastors outside the hospital.
“We had to find a way to connect with people and make sure we’re taking care of their faith and spiritual needs,” Jarvis said.
Providing comfort to patients is different in the age of COVID-19. Jarvis said he’s always there to listen to patients’ concerns about being away from family, and is willing to be in the room with a patient who needs it even if they are COVID-19 positive.
It’s difficult, he said, not to be able to offer a hand on the shoulder or a hug to people in distress.
“If a person wants to reach out and hug me, I won’t stop them,” Jarvis said.
Jarvis has been there for dying patients during the pandemic, including those suffering from COVID-19. He makes sure their family members and faith leaders can, to the greatest extent possible, be there for them, too.
“It’s always sad at end-of-life, but it’s especially challenging with this obstacle,” he said. “…What’s important to them is important to us.”
The hospital’s chaplains also took on the task of providing emotional and spiritual support to workers, especially during the stressful and uncertain early months of the pandemic. At one point, they would meet and pray with nurses at the start of every shift.
“There was a lot of mutual support going on and a lot of support from the outside, in the early days especially,” Jarvis said. “We’ve weathered part of the storm, the waters stayed at flood stage, but we got through that and there’s more hopefulness that we’re not going to see that stage again.”
Ongoing concerns
One thing the Hancock Health system has struggled with throughout the pandemic is the availability of personal protective equipment and testing. Compton said many hospital personnel have recently been using powered air purifying respirators, designed for dealing with toxic chemicals or fumes, because they are more accessible than N-95 medical masks.
Testing also remains an issue. Standard tests, which usually take two to four days to return results from a lab, are fairly available, but there is an ongoing shortage of rapid tests, which can provide a result in 15 minutes.
“We have tried really, really, really hard to hold on to those rapid tests for people who need them,” Compton said.
The highest priorities for those tests are people in immediate medical crises, as well as school personnel and children attending school in person.
Compton said doctors still deal with the difficulty of communicating with patients who believe the virus is a conspiracy or an exaggerated issue for political reasons. They encourage those patients to wear masks and observe other safety measures as a courtesy to those more vulnerable than themselves.
“You never know the impact of what will happen if you have the virus,” Compton said.
Halter said he’s found it is relatively easy to convince children, even young ones, to wear masks. They are often eager to follow the behavior if it is modeled for them by their parents or siblings.
Sometimes it’s harder to stress the importance of mask-wearing to parents, which he said is understandable when they’ve received conflicting and sometimes inaccurate messages from politicians and the media. As doctors, he said, it’s part of the job to dispel those misunderstandings.
“There’s many things we do in our society that are uncomfortable or seem unnecessary, like wearing a seat belt,” Halter said.