To go or not to go? So many questions on navigating the health system during COVID-19


Published: May 12, 2020

By Sally Crocker

Drs Office Waiting

The gradual rollback of COVID-19 social distancing guidelines in Texas and across the U.S. has many vulnerable populations, including adults 65 and over and those with underlying health conditions, asking questions.

This is an especially scary time for our aging population and those dealing with chronic medical conditions, says Kayla Fair, DrPH, MPH, BSN, RN, HSC Assistant Professor of Public Health Education.

K Fair

Dr. Kayla Fair

Prior to joining the HSC School of Public Health, Dr. Fair has done “a little bit of everything” as a nurse caring for patients in settings that include critical care, pediatrics and transplant, as well as working to improve the health of communities as both a researcher and practitioner.

“Older adults and those managing chronic medical conditions may experience challenges navigating the many recent changes in our healthcare system in response to COVID-19, including transitions to telehealth visits,” Dr. Fair said. “This can be further complicated if they are not comfortable with technology and/or online health platforms, or have limited access to computer or internet service.”

“As a nurse, I have had several conversations with family members and friends about whether they should go to previously scheduled appointments now or wait it out. Ultimately, this is a conversation that patients should be having with their providers, as every situation is unique. Your provider’s office can supply additional information about the best course of action.”

Sometimes a phone call can take care of prescription refills and other needs between office appointments.

Patients should also utilize the expertise of other healthcare team members, including local pharmacists, Dr. Fair said.

“Your pharmacist is another good resource for medication questions and the specifics on your insurance plan’s approved refill schedules. The pharmacy may also have information on discounts or prescription coupons to help with out-of-pocket costs.”

Providers are continuing to give updated guidance, especially now as communities move into the summer months, on how appointments are being managed, what to do on arrival, whether patients should wait in the car until they are called, how companions and special assistance accommodations are being addressed, whether masks and gloves should be worn to the office, if temperature checks are required at the door, and what to do if you have any cold, flu, COVID-19 or other potentially infectious symptoms before or on the day of an appointment.

“It’s an important time to communicate with your provider, especially for those who may be immunocompromised, recovering from surgery or undergoing chemotherapy, radiation or other cancer treatment, and any patient with questions,” Dr. Fair said.

“I am concerned about recent reports that many patients are delaying or avoiding emergency medical care due to fears about being exposed to COVID 19.  If at any time you feel that you or a loved one is experiencing a life threatening or rapidly deteriorating health status, please seek care immediately. Do not delay,” Dr. Fair advised.

Signs and symptoms that you or someone you know may be in need of immediate medical care can include shortness of breath or difficulty breathing, chest or abdominal pain, facial drooping or uncontrolled bleeding.

Any concerning change in health status should be addressed immediately. Call 911 for any life-threatening emergency.

Resources for high-risk groups, including those older than 65 and those managing chronic health conditions during COVID-19, include:

CDC Recommendations for High Risk Groups, for adults over 65, people with asthma or chronic medical conditions, and HIV patients.

When to Seek Emergency Care – never avoid emergency rooms or wait to see doctors if you feel your symptoms are truly serious

American Heart Association: What Heart Patients Should Know About Coronavirus, for patients with heart disease.

American Cancer Society: Coronavirus, COVID 19 and Cancer website for cancer survivors.

American Diabetes Association: Coronavirus and Diabetes for individuals with diabetes.

US Department of Health and Human Services: Interim Guidance for COVID 19 and Persons with HIV.

Stay Safe and Informed about Coronavirus Disease, offering resources and weekly webinars/information sessions for patients with chronic lung conditions.

Asthma and Allergy Foundation of America: Coronavirus: What People with Asthma Need to Know, for those with asthma and allergies.

The University of North Texas Health Science Center at Fort Worth Center for Geriatrics, an interdisciplinary Center guided by values and committed – through education, research and patient care – to improving the quality of life and promoting optimal aging for older adults.

Caregiver Action Network: COVID 19 and Family Caregiving, a resource for caregivers, including guidance on communicating with medical providers.

Alzheimer’s Association: Coronavirus: Tips for Dementia Caregivers, offering coronavirus resources for caregivers of dementia patients.