by Tanvi Desai, MD
Accreditation Advisor

The COVID-19 pandemic has wreaked havoc on the world and the impact it has had on the health care industry is nothing short of devastating. In addition to hospitals, emergency departments (EDs), and intensive care units (ICUs), preventative medicine has been hard hit by the pandemic. Data shows that people are avoiding their doctors’ offices for routine care because they are concerned about acquiring the virus there. This includes parents not bringing their children in for regular check-ups and vaccines and therefore, they are not receiving routine vaccines in a timely manner and increasing their risk for preventable diseases.

This risk is exponentially higher given the growth in the number of parents who forgo vaccines and instead rely on herd immunity to protect their children. As more and more parents opt out of vaccinating their children, this concept stops being effective. Case in point, the measles outbreak that affected 1,282 people across 31 states in 2019. Of these cases, 128 were hospitalized and 61 reported complications, including pneumonia and encephalitis. Measles had been eliminated in the United States in 2000 according to the Centers for Disease Control and Prevention (CDC). However, unvaccinated travelers who get measles then spread it to communities with unvaccinated or inadequately vaccinated people creating outbreaks of the virus. 

Parents must be assured that doctors’ offices are taking appropriate precautions to reduce the likelihood of patients and family members contracting the virus when they come for routine care. Here are some steps primary care providers can take to reassure parents and patients they can safely receive care in their offices.

  1. Inform patients and their families of current COVID screening processes, changes related to exam room utilization and cleaning protocols. Let them know that everyone is screened prior to entering the building including staff, patients, family, visitors, etc. to reduce exposure to COVID-19. Explain that the screening process could include questions related to symptoms, exposure, and travel as well as performing temperature checks. Advise them that masks must always be worn unless staff asks them to remove them to provide care. Have masks available as needed for patients and their family members. To minimize contact with other patients, have patients wait in their cars after screening until they are ready to be seen. 

Have separate areas for well visits and sick visits and schedule them for different times of days. Practice social distancing in waiting room and in hallways. Ensure patients that waiting areas, restrooms, and exam rooms are cleaned thoroughly and frequently and with the recommended cleaning products. When patients and their families become aware of these processes, this should help reduce their anxiety about scheduling an appointment and updating vaccinations.

  1. Use appropriate personal protective equipment (PPE). Have physicians and staff use face masks, N95 respirators, gowns, gloves, etc. as necessary to demonstrate to patients and their families that coming to the office will not increase their risk for contracting COVID-19. Make sure all staff are donning, doffing, decontaminating, and disposing of the PPE as recommended by CDC to further reduce the risk of spreading the virus.
  2. Encourage the use of both telehealth and in-person visits as appropriate and stress the importance of vaccination during the pandemic. Reach out to the families to let them know their children are due or overdue for their vaccines, why these vaccines are necessary and to schedule an appointment. Explain all the precautions that are being taken to decrease the risk of spreading COVID-19 to their children. The American Academy of Pediatrics (AAP) offers resources for providers such as Guidance on Providing Pediatric Well-Care During COVID-19” and “Guidance on the Necessary Use of Telehealth During the COVID-19 Pandemic.” These resources can guide pediatricians on when to offer parents the option of telehealth and in-person visits as appropriate, which may alleviate their anxiety due to COVID-19. Spending less time in the doctor’s office waiting area may entice some parents to bring in their children for the in-person visit for vaccinations.

The COVID-19 pandemic is still surging in most of the country. While there is not yet a vaccine available for COVID-19, there are vaccines available for several other contagious and preventable diseases. Every effort should be made to close the gap of unvaccinated and inadequately vaccinated children during the pandemic. Doing so will reduce, if not eliminate, the outbreaks of vaccine-preventable diseases during and after the COVID-19 pandemic.

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About the author.  In her role as accreditation advisor, Dr. Tanvi Desai is responsible for delivering accreditation and regulatory services to Vizient members encompassing hospital, ambulatory and critical access organizations through onsite assessments and various education programs and blogs. Prior to joining Vizient, Dr. Desai was a TJC surveyor of the Comprehensive Accreditation Manual for Hospitals conducting triennial surveys, extension surveys and Medicare Deficiency surveys.   Dr. Desai is certified by the American Board of Pediatrics and is licensed to practice medicine in North Carolina.  

Published: September 17, 2020