Healthcare in the age of COVID-19

By Lois Ann Dort    
May 6 2020

Last week The Journal printed a letter to the editor from Dr. Gary Ernest, of Liverpool, N.S, current president of Doctors Nova Scotia which asked Nova Scotians not to put their health on the back burner. The letter stated, “Patients are not seeing their doctors for routine appointments. You might think we’re not providing routine healthcare during the pandemic, but we are.”

This information, while welcome, failed to mention the many aspects of our healthcare system that are no longer in operation at this time due to precautions taken to prevent the spread of COVID-19. While primary care offices and Emergency Departments are open, some specialist, clinics and diagnostic tests have been put on hold until the immediate crisis subsides.

On the same day that Dr. Ernest’s letter was released, Moni Duersch of Whitehead, Guysborough County issued a cry of frustration on social media. Medical appointments which she had been waiting for -- some for over a year -- had been cancelled, with no rescheduled date or alternative in place. She spoke to The Journal about her situation last week.

“In March they called and told me everything was cancelled because of the coronavirus,” said Duersch, adding that she had been hanging all her hope on those appointments. “That was very disappointing, but I could understand that.”

Since 2006 Duersch has been struggling with pain and inflammation in her joints; it started in her fingers and over time has progressed to affect her elbow, shoulders and back. “Right now, I can’t really lift anything…and I’m in a lot, a lot of pain. Normally I get cortisone shots, which I can’t get; they’re in New Glasgow.” She explained that the clinic where she had previously received the shots, now only had an answering machine that informed callers that the office was closed due to the COVID-19 pandemic.

Over the years, Duersch has had several surgeries to relieve the calcification on her joints but the appointments she’s missing out on now were meant to help diagnose the underlying cause of these issues. Without any indication of when she might learn more about her condition, the stress of waiting is weighing on her.

The Journal spoke to Dr. Ernest last week in regard to his letter and the problems some Nova Scotians are having in heeding his advice to take care of their health. “The question is a common one and when you’re on the receiving end of it in terms of the person looking for care; it’s very frustrating," he said.

“I’m a family doctor in Liverpool. I’ve been in practice for 38 years and so this sort of situation…is one I deal with all the time with my patients and they are waiting to get into a specialty clinic and they have waited a long time and along comes a pandemic and all of a sudden, all bets are off. I am fielding the same sort of questions; what do I do now type of questions." Ernest said cancelled appointments don’t mean the patient starts from the bottom of the waiting list once service resumes; they will maintain their place on the list.

“Once the pandemic is over enough that the clinics are allowed to resume, they pick up where they left off,” he said. “My hope is we’ll start to see some of these clinics start to reopen in the summer time, if things settle down like we hope they will, so that people who were due to be seen at the start of the pandemic will be top of the list once things open up again.”

Speaking to his letter to the editor, Ernest said it was to encourage people to see their doctor for, “care of an ongoing condition or if they have a new condition they need to have assessed.

“Most family doctors are still in the office…and a lot of family doctors around the province have noticed that people aren’t calling them for regular follow-up appointments that they should be because of their chronic diseases or they are not coming to their offices and they’re either not going anywhere, not getting seen when they should get seen, or they are waiting for hours and hours in an Emergency Department for something that doesn’t have to be assessed in an Emergency Department,” said Ernest.

Statistics gathered by the Nova Scotia Health Authority suggest many people are putting off healthcare. Provincial numbers for ED visits provided by NSHA show evidence of this trend: March 9: 1854 visits, April 5: 752 visits, and April 23: 973 visits.

“We have certainly seen a decrease in all rural emergency departments in the area and across the province. Overall visits are down by about 50 per cent,” said Angela MacArthur, director integrated health rural hospitals for NSHA in an email response to questions asked by The Journal about current outpatient usage rates in rural hospitals.

Family doctors continue to deliver primary care and people are encouraged to seek help when needed. Unfortunately for those who need diagnostic tests and specialist assessments, the wait will continue, but when regular service resumes, they should be in the same position for an appointment as before the COVID-19 pandemic changed the healthcare landscape.