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During Coronavirus Outbreak, Virtual Doctor Visits Are Encouraged


So what are you supposed to do if you are showing the symptoms of coronavirus? The advice from health care providers is to call first - don't just show up at a hospital or your doctor's clinic. And because of that, we're seeing more virtual evaluations. Instead of sitting on an exam table, patients download an app and turn on the webcam. Here's NPR's Allison Aubrey.

ALLISON AUBREY, BYLINE: Last month, Sara Dehbashi (ph) traveled to Europe. She returned home to the Philadelphia area on February 23.

SARA DEHBASHI: Two days after, on February 25, I started feeling, like, sore throat, I had mild cough, nasal congestion.

AUBREY: She was concerned about coronavirus, so she called the emergency department at Jefferson Health. And one of the attending doctors recommended an online evaluation using the system's telemedicine program JeffConnect.

DEHBASHI: Basically, it's a simple app that we can download. And it asks some basic information.

AUBREY: Within an hour, she was face-to-face with a physician using an online platform. It's like being on FaceTime. There's video and audio.

DEHBASHI: So basically, he started asking questions about my symptoms and also where did I travel.

AUBREY: It may not seem as if a doctor could do much virtually, but emergency medicine physician Judd Hollander, who leads Jefferson Health's telemedicine efforts, says you'd be surprised.

JUDD HOLLANDER: So if I need to look in your throat, I get the phone positioned so I can look in your throat. I can clearly see that you're breathing well or not breathing well. I could see your respiratory rate. I could see whether you look to be well or look to be sick.

AUBREY: In the case of Sara Dehbashi, she was able to take her temperature and talk about her symptoms. They were able to rule out coronavirus, but doctors continued to monitor her symptoms and check in with her remotely for several days. Hollander says this is a success story for the patient and for the welfare of the community at large because, he says, telemedicine may help keep people out of emergency rooms and urgent care during this epidemic.

HOLLANDER: We want to keep people out 'cause we want to limit spread. That's the main goal.

AUBREY: He says, of course, when people need to be seen - say, if they're having trouble breathing and coronavirus is suspected - they'll be directed to come into the emergency department.

HOLLANDER: Because if we know you're coming at Jefferson, we bring you in through the back door into a biocontainment unit, put a mask on you and bring you back into your room with the least contact possible.

AUBREY: Hollander says more and more people are using the telemedicine program.

HOLLANDER: I mean, our telemedicine volume yesterday alone was double what it was a month ago.

AUBREY: Health care providers around the country are taking steps to improve access to telemedicine. For instance, Blue Cross Blue Shield companies say they'll encourage the use of virtual care and try to facilitate access. Sean O'Leary is an infectious disease expert at the University of Colorado. He says many health care systems have rolled out telemedicine programs.

SEAN O'LEARY: I think this pandemic is the perfect opportunity to really scale those up because the less we can keep people going in to the doctor, the less we're going to overburden the health care system and the less we're going to spread this virus.

MARTIN: That report by NPR's Allison Aubrey. Allison, that was so interesting. She's now in our studio to talk more about what we can all do to help stop the spread.

AUBREY: Good morning.

MARTIN: So let's talk more broadly about recent developments.


MARTIN: The CDC has made this new recommendation about public gatherings. Fill us in.

AUBREY: Yes. The CDC says at gatherings of 50 or more people should be canceled or postponed for the next eight weeks, so that's through mid-May. And in addition to all the announcements from states and cities on restaurant closings, we're likely to hear more advice from the administration about social distancing. Anthony Fauci, the nation's top infectious disease adviser, said over the weekend, everyone needs to hunker down. And we expect to hear more details today.

MARTIN: Right. The White House is going to release this guidance.

AUBREY: That's right. Mmm hmm.

MARTIN: So lots of people have been asking how to protect the older members...

AUBREY: Right.

MARTIN: ...Of their family. What do you tell them? What's your advice?

AUBREY: You know, a lot of people don't like to hear this. My own mom didn't want to hear it at first either because it seemed so draconian. But given all the evidence that older people are more vulnerable, can die from this virus, it is prudent to keep young children away. So now is a good time, if you have children, to say to the grandparents or elderly family members, we don't come to your home; you don't come to ours temporarily.

Children who get the virus are only likely to have mild symptoms or none at all, but they could pass it on to an older person. I spoke to Shawn Morrison. He's a geriatrician at Mount Sinai Health System.

SHAWN MORRISON: This really is a public health crisis that is of a magnitude we haven't seen before. And if we all act as we know we should, we will get through this.

AUBREY: So think about FaceTime, maybe a drive-by visit. You know, remember this isn't forever.

MARTIN: Right. So as of today, there are going to be a whole lot of kids off from school at home, my kids included...

AUBREY: That's right.

MARTIN: I know Steve's, too. I mean, all of us.

AUBREY: Mine, as well.

MARTIN: So how does social isolation apply? I mean, can we do playdates, Allison? - she says desperately.

AUBREY: Well, social distancing may not mean complete isolation, but it does mean we have to take this seriously and be smart. So you may have heard this six feet rule - keeping six feet away from others. And at a playdate, think about that. Do you think it's possible to keep young kids six feet apart? I mean, that's a challenge. Older kids may be different.

There's no official guidance on playdates. No one is telling you, you must cancel a playdate. But I spoke to a pediatrician, Lindsay Thompson at the University of Florida. And she says, from her perspective, you'd rather be safe than sorry.

LINDSAY THOMPSON: I personally am taking a really strict line. I would say that playdates inherently have a risk. I don't know how big or small. But if we can put off for a few weeks and replace it with a little family time, it would all be better.

MARTIN: All right. So what do we do? Especially because you said we should keep kids away from older people - I mean, a lot of families rely on grandparents...

AUBREY: Right. That's right. Grandma cannot...

MARTIN: ...To help care for their kids.

AUBREY: ...Come in to take care as easily now, right?

MARTIN: So what do we do?

AUBREY: Well, you know, this is really hard. And obviously, it's going to differ situation by situation. But you know, if you're home with your kids and you're trying to work, encourage your kids to read, you know, the old-fashioned way. A pediatrician told me lots of parents will likely loosen screen time rules. I mean, that's just the reality here. I know I will have to. There's lots of instructional videos and games online. And kids need to move around and be active. So you know, go outside, ride bikes, go to the park. If you do, take that hand sanitizer. Wipe down afterwards.

MARTIN: All right. NPR's Allison Aubrey with some very useful guidance and tips. Allison, we appreciate this. I'm sure we'll be hearing from you.

AUBREY: OK. Thank you very much.

(SOUNDBITE OF JINSANG'S "INTROSPECT") Transcript provided by NPR, Copyright NPR.

Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.