Why It Matters
"With communities in different stages of response, mapping out the next phase of addressing the coronavirus may be as complicated as preparing for its surge."
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COVID-19: Why Humility, Caution, and Hope Should Guide What’s Next

By IHI Multimedia Team | Tuesday, May 19, 2020

COVID-19: Why

Photo by K. Mitch Hodge | Unsplash

Government officials are gradually lifting the restrictions imposed in the last few months in response to the coronavirus. Health care providers are waiting and watching with one key question in mind:

What comes next?

To answer that question, IHI invited US health care public policy experts, Andy Slavitt, MBA, and Kavita Patel, MD, to be special guests on the May 15 Virtual Learning Hour COVID-19: The Other Side of the Curve). Both Patel, a practicing primary care physician and nonresident fellow at the Brookings Institution, and Slavitt, a former acting administrator for the Center for Medicare and Medicaid Services, were humble about predicting the future of a virus the world is still struggling to understand.

Slavitt cautioned against listening to anyone willing to describe the future course of the pandemic with any certainty. “We don’t really know how this is going to play out,” he warned.

Slavitt noted that there are opportunities to learn from a range of countries as they gradually open schools, businesses, parks, and other aspects of daily living. He said that countries including the Czech Republic, Germany, Greece, New Zealand, and Vietnam have made progress in learning to live with the virus by employing a variety of strategies, including widespread testing and using color-coded systems for communicating about threats and behaviors.

With communities in different stages of response, mapping out the next phase of addressing the coronavirus may be as complicated as preparing for its surge. Patel, a physician who practices in a federally qualified health clinic in Washington, DC, expressed concern about the number of cases still rising in her area. “We’re nervous about re-openings surrounding us,” she said, “because we know that states and cities are not hermetically sealed.”

Patel had four recommendations for how health care providers can address this next phase of the pandemic:

  • Better integrate hospital care with primary care. Many hospitals have a COVID-19 committee. Patel recommended this group collaborate with local primary care providers to develop a robust primary care prevention task force. “Flattening the curve is going to depend on primary care,” she said.
  • Develop what is being learned from providing telemedicine. Many organizations shifted much of their care to virtual visits. “What proportion of our care should continue in a virtual manner?” Patel asked. She recommended that organizations risk stratify care for those most vulnerable, analyze which kinds of visits can safely and effectively continue virtually, and determine what needs to be done in person.
  • Learn how you can assist with contact tracing. With no vaccine and standard treatment yet available, developing some basic contact tracing skills will complement the increase in testing needed to deal with the coronavirus.
  • Promote more effective communication with patients and their communities. Calling health literacy “a critical, functional piece” of dealing with the coronavirus, Patel recommended the COVID-19 Health Literacy Project fact sheets that offer clear information in 30+ languages to help patients know when and how to seek care. She also recounted a candid conversation with an African American mother of three sons who worries that a shop owner, for example, might see them wearing masks in their store and assume they’re being robbed. “We have to realize,” Patel said, “that some of the things we recommend don’t translate well [in every community].”

While acknowledging that the relentlessness of the crisis can be overwhelming, Patel observed that, before the pandemic, many people may not have been aware of public health. Now, many are understanding more about its importance and relevance to people’s daily lives. “We’ve got the world listening to scientists," she remarked. Slavitt agreed. “We have for the first time in decades, captured the public’s imagination on one topic,” he said. “We have an opportunity to share [examples of] goodness, joy, support, sacrifice, and courage, but sustaining that will require effort and patience.”

To learn about other recommendations for getting to the “other side” of the curve, watch and listen to the full Virtual Learning Hour. Learn more about IHI’s special series of weekly COVID-19 Virtual Learning Hours.

(Having difficulty hearing this excerpt? Watch on YouTube.)

You may also be interested in:

Don Berwick JAMA Viewpoint: Choices for the "New Normal"

Recommendations for Designing High-Quality Telehealth

 More COVID-19 Guidance and Resource

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