State of COVID-19 in NYC

Spotlight on the physician perspective: Conversation with Dr. Ariel Pablos-Méndez

On Monday, March 30, Rabin Martin, as the Secretariat for the Private Sector Roundtable for Global Health Security (PSRT), hosted a sixth call in a series on the latest health impacts of COVID-19. Dr. Ariel Pablos-Méndez has had a distinguished career in global public health, with roles at the World Health Organization, Rockfeller Foundation, USAID and Columbia University Irving Medical Center, where he is now professor of medicine and internist. Dr. Pablos- Méndez provided his insights on the current situation in New York City – the new global epicenter. Dr. Pablos-Méndez emphasized that this is a hyperacute epidemic and that we’re only seeing the “tip of the iceberg.” He expects ICUs in NYC to be overwhelmed for another couple of months.

Notably, he urged greater attention to testing to understand fully the extent of the epidemic and its trajectory – and argued that serology is more important now than vaccines because, in most places, the virus will be gone before a vaccine is developed. Testing is also important because he estimates that a high proportion of health care workers may already be positive and, if they were tested, they would be relieved to know they were immune and could continue working. Finally, Dr. Pablos-Méndez recommended an age-bifurcated approach to the response, calling for “obsessively isolating the elderly and the sick” given that 90% of deaths have been among those over 65 and those who have other illnesses. He added that the situation is quite different from the H1N1 virus, for example, which led to the deaths of many children.

Spotlight on the patient perspective: Q&A with The Mighty

Rabin Martin spoke with Mike Porath, Founder and CEO of The Mighty – an online patient community of more than two million registered users facing health challenges around the world. On March 26, The Mighty published findings from a survey on the healthcare impact of COVID-19 amongst its users. 72 percent of respondents reported that their healthcare has changed because of the on-going crisis; 35 percent have gone without doctor visits; and 23 percent have gone without medications or treatments. Our discussion focused on exploring these findings and how decision makers can help mitigate the crisis.

What are the most surprising trends you’re seeing among patients and their reaction to COVID-19?
Fear and anxiety over this pandemic have really skyrocketed over the last couple weeks, though that’s not surprising. What’s most striking to me is the impact to people’s healthcare. More than a third of our community members are reporting they aren’t able to see their doctors. Nearly a quarter aren’t getting their medications or treatments.

How do you think these patients’ views compare with those of the overall population given general heightened anxiety?
Our community is made up of patients, caregivers and healthcare providers. We have a lot of high-risk people who are taking more actionable steps to avoid contracting the virus than the average population. They are also more concerned about the long-term effects of this outbreak – the inability to get the healthcare they need. I’m not surprised that their anxiety levels are through the roof right now.

What differences are you seeing based on disease or condition? Are patients with certain conditions responding differently than others?
The clearest difference is that people who are at high risk for contracting coronavirus – people who are immuno-compromised – are more anxious and fearful and have really changed their behaviors to limit their exposure. For people managing mental health issues, this is a very difficult time. It can be paralyzing.

Given the findings, what would you like to see from health care leaders – government, health care companies, health care providers, hospitals – do to support patients during this crisis?
I would like to see the focus return to the patient. Let’s put the “care” back in healthcare. This pandemic is causing people to lose access to their healthcare. We asked them what they needed right now. 38% said telehealth  services. 31% said a delivery service from pharmacies. If every organization in healthcare focused on delivering for patients, we’d do a better job of helping them. And that’s what healthcare is all about.