Office Visits Decimated, No ‘Vaccine Nationalism’

What your doctor is reading on Medscape.com:

APRIL 26, 2020 — Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today: 

Outpatient Visits Decimated

A massive decline in outpatient office visits — 60% in mid-March and at least 50% since early February — suggests patients are deferring needed care, according to data compiled by Harvard University and healthcare technology company Phreesia. The analysis was reported online April 23 by The Commonwealth Fund.

New England and Mid-Atlantic states saw the steepest drops with declines as high as 66%, whereas visits by patients living in mountain states were down by 45% as of April 16. Not surprisingly, the declines have had the most impact on procedure-oriented specialties, and the youngest and oldest age groups were most likely to skip visits.

Despite a major push to reach patients via telemedicine, which accounted for about 30% of visits as of mid-April vs zero in February, virtual visits have made up for only a tiny portion of the decline in office visits.

Vaccine Access and Equity

Equitable access to a successful vaccine will be the key to tackling the COVID-19 pandemic, especially as the disease spreads in less developed countries, according to an expert panel convened by the National Academies of Sciences, Engineering, and Medicine (NAS).

“Vaccine is really going to be the answer,” said Susan R. Weiss, professor of microbiology, University of Pennsylvania School of Medicine, Philadelphia. She, along with other NAS panelists, including Anthony Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases (NIAID), agreed there is no room for what Richard J. Hatchett, CEO of the Coalition for Epidemic Preparedness Innovations, called “vaccine nationalism.”

The agency’s first obligation is to the US, Fauci said, adding, however, that NAS is “very sensitive to the fact that, as a country that has a big research and development operation, we do have a global responsibility,” and that it will be crucial to ensure that any successful vaccine be distributed equitably around the world.

Tele-hospitalization?

“Hospital at home” is not a new concept, but it is getting more attention as hospitals seek ways to manage COVID-19 surges while continuing to provide quality care to other patients in need.