The Second Wave
Tuesday, May 5, 2020
Submitted By: Marc J. Levine, MD – President of Medical Society of New Jersey
The best part of my job is that I get to talk to physicians every day. Most people only speak with a physician when they are personally sick or a family member is ill. However, I talk to doctors daily – about the problems they face caring for patients, as administrative burdens mount and insurance companies deny or delay care for their patients.
As you can imagine, during this time of pandemic, those conversations focus on issues that are very different than the challenges we encounter in “normal” times. We speak of childcare for physicians that must work extra hours while their kids are home and schools are closed. Or the lack of personal protective equipment they need to stay safe from coronavirus. Or the crushing waves of very sick patients they are seeing one after the other in hospitals around the state.
Recently, I’ve witnessed another common theme in these conversations – preparation of a “second wave.” It is not a second wave of coronavirus they fear. Indeed, we have a huge investment in research around the world seeking a vaccine or a treatment. COVID-19, unlike influenza, has proven quite stable. No antigenic shifts have been documented, like we see in the case of the flu. COVID-19 has not needed to mutate, as it is doing quite well spreading in the community in its current state. Therefore, coronavirus will be with us until researchers develop effective treatments or a vaccine.
The “second wave” my physicians are talking about is the result of the ban on so called “elective” procedures. Those not in the healthcare world interchange the word “elective” for “optional.” In fact, most “elective” procedures are not optional, but very much necessary. Doctors in hospitals are shocked about the lack of cardiac procedures being performed. There are no bowel obstructions, no rotator cuff surgeries, no early stage cancer procedures, no urologic or ophthalmology procedures – even though they may seem necessary to most, these procedures are considered “elective” and are not being scheduled at this time.
As social distancing restrictions remain in place, people must stay at home – some in pain and unable to schedule necessary procedures while their chronic conditions get worse. According to state authorities, so far we have lost an estimated 4,500 lives to coronavirus in a bit more than a month. We do not know what the coronavirus will do in regard to the total number of lives lost. However, we do know about 18,000 lives are lost to heart disease every year in NJ.
If we have learned anything about COVID-19, it is that it feasts on those with underlying chronic conditions. We must not create a population of vulnerable individuals by leaving their chronic conditions unmanaged.
As the coronavirus’ burden on our healthcare system lessen, we must begin to carefully open elective procedures in sterile facilities around the state, with abundant infection controls in place. Hospitals, free-standing Ambulatory Care Facilities, Ambulatory Surgical Centers and other surgical practices should be the first to begin operations and procedures when cases lower, infection rates drop and testing capacities allow for it. To do this responsibly, physicians, nurses and other members of the care team must be protected – working in safe facilities with all the appropriate protections in place.
Our healthcare system has met the surge – now, we must prepare, both hospitals and physician practices, for the next wave of demand that is sure to come.
Marc J. Levine, MD currently serves as the 227th president of the Medical Society of New Jersey. Dr. Levine is a board-certified spinal surgeon with more than 20 years of experience and currently practices in Mercer County. As a part of Rothman Orthopaedic Institute, Dr. Levine specializes in reconstructive spinal surgery, using both traditional open surgery as well as state-of-the-art minimally invasive surgical techniques. In addition to his clinical practice of medicine, Dr. Levine serves as a clinical assistant professor at Rutgers New Jersey Medical School, Department of Orthopaedic Surgery and is the director of the spine surgery program at Robert Wood Johnson University Hospital Hamilton. Additionally, Dr. Levine serves as president of the Eastern Orthopaedic Association.