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COVID-19

News >  Health

Routine visits being postponed for now as care providers focus on pandemic

Dr. Gretchen LaSalle talks with Terri Hewey about the latest versions of the shingles vaccine on Nov. 26 at MultiCare Rockwood Quail Run Clinic on the South Hill in Spokane. Primary care providers such as MultiCare have adapted their services amid the coronavirus pandemic. (Jesse Tinsley / The Spokesman-Review)
Dr. Gretchen LaSalle talks with Terri Hewey about the latest versions of the shingles vaccine on Nov. 26 at MultiCare Rockwood Quail Run Clinic on the South Hill in Spokane. Primary care providers such as MultiCare have adapted their services amid the coronavirus pandemic. (Jesse Tinsley / The Spokesman-Review)

For medical appointments that can wait, they’re likely postponed until May or as long as three months.

That timing is a best guess, health professionals say, because of the COVID-19 pandemic. It’s better odds to get a virtual visit. Primary and specialty health providers have made temporary adjustments here and statewide for seeing patients while postponing routine visits as the virus spreads.

Examples include MultiCare Rockwood pediatric clinics postponing well-child appointments for children older than 18 months.

For adults, there are postponed routine procedures along with more options for telehealth. Three Rockwood clinics now set up for respiratory illnesses offer a choice for patients to stay in the car until a call or text informs them to go directly to a cleaned exam room and bypass the waiting area.

Local pediatric care changes for older well-child visits align with advisory updates from the American Academy of Pediatrics, said Dr. Sarah d’Hulst, a MultiCare Rockwood pediatrician.

“The recommendations loosely are to keep kids out of the health care system unless it’s totally necessary,” said d’Hulst regarding AAP’s COVID-19 response.

“Pediatricians can chose to conduct visits for infants, newborns and younger kids up to 18 months who require immunizations and to reschedule those who can wait.

“We’re continuing to see the kids who need to be seen for routine well-child care through 18 months because we feel it’s so important for them developmentally and to receive their routine vaccinations.”

Regionally, health care adjustments also are linked to a March 19 proclamation from Gov. Jay Inslee to protect the state’s personal protective equipment supply chain.

With the spread of COVID-19, Inslee ordered a delay of certain medical and dental services, procedures and surgeries that require PPE if that postponement isn’t anticipated to cause harm to the patient within the next three months.

The order applies to all hospitals, ambulatory surgery centers and dental, orthodontic and endodontic offices in Washington state. It doesn’t include outpatient visits delivered in hospital-based clinics or for emergency and urgent care needs.

Providence and MultiCare now have designated clinics to see patients with fever and respiratory symptoms. If you suspect possible COVID-19 symptoms, however, both advise first to schedule a virtual visit or set up a call.

Rockwood’s Moran Prairie clinic at 3016 E. 57th Ave. can provide pediatric care to children with urgent needs who have respiratory symptoms, d’Hulst said. That building also has a separate entrance and clinic areas for adults with respiratory symptoms.

Also, Rockwood’s Cheney and Liberty Lake clinics will see patients regardless of age at respiratory-symptom clinics under screening and other COVID-19 protocols.

Providence’s respiratory-symptom sites for adults are at 421 S. Division and 551 E. Hawthorne, while its pediatric designated site for children with fever and respiratory symptoms is at 1919 S. Grand. Parents or guardians will need to check in for appointments from their cars in the parking lot.

Additionally, Providence Health & Services has made a number of other changes to reduce COVID-19 exposure. It includes postponing non-life-threatening and non-urgent inpatient and outpatient surgeries. A list of changes are outlined at providence.org/ewaupdate.

Under pediatric care adjustments, certain Rockwood clinics have separate areas for well-child visits distanced from patient areas for children who are sick, d’Hulst said.

Three Rockwood clinics – at Fifth Avenue, NorthPoint and Spokane Valley – have designated areas for well-child visits or other urgent visits for well children such as a need for a medication adjustment.

Pediatricians do see a number of kids who are on regular medications for chronic conditions, such as ADHD, asthma or anxiety and depression, for routine care about every three months. Most of those visits are postponed, d’Hulst said, but with an option for virtual or telehealth calls.

By 18 months, most children have had their early required vaccinations, and the next ones are scheduled at age 4, then 11.

“We will see kids for the 4-year-old and 11-year-old visits if those come up and can’t be pushed out,” she said. “Some child care centers require the 4-year-old vaccinations, for example.”

The hope is that older children will miss no more than one appointment during the pandemic response, she added.

“As pediatricians, we absolutely feel it’s important for children to have well-care and have immunizations on time,” she said.

“We very much look forward to the day when we can resume normal operations, but until we feel it is safe to do so, we will continue to follow the guidance of our regional and national organizations.”

Virtual visits and telemedicine options were in place but have broadened significantly under current responses so that providers can talk to people sheltering in place, said Kevin Maloney, a MultiCare spokesman.

He echoed that primary care situations are “just a little different right now for all of us.”

Another consideration is keeping vulnerable pediatric patients safe, including those with chronic lung and cardiac conditions along with diabetes, d’Hulst said. Although children have been relatively unaffected by COVID-19, there is risk, she said.

Under stay-home orders, d’Hulst said pediatricians are advising parents to ensure that children are getting fresh air and exercise while distancing from others. They’re also encouraging fun family time to ease kids’ stress during current changes.

“If their child is ill, certainly they should call their primary care provider because the pediatricians and the primary care offices are ready and waiting to talk to the patients to guide them to the most appropriate method of care during this pandemic time,” she said.

“Honestly, I’d like to thank the patients and families for being so understanding. They’ve been very supportive. We know everyone is very nervous, and we want to continue to provide the best possible care during this time.”

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