COVID-19: What we’ve learned, how we’re helping
By Pam Coffey, RN, CHCQM, Executive Vice President, Chief Clinical Officer
When the world first became aware of a new virus with a potential global impact, little did we realize how much it would change our personal and work lives. From the outset, we knew our focus needed to be on helping our clients navigate COVID-19 with information and resources. We also knew we needed to focus on the safety of our staff to ensure we would be able to continue to operate to meet our clients’ needs. An outbreak on our team would hurt our ability to help clients and members during this frightening time. And since just like our clients, HealthSmart is a self-insured organization, we knew that managing our staff’s health and safety needs would have potential impacts on our benefit costs as well as our operations.
Like many of our clients, HealthSmart transitioned to a work-at-home organization
Almost immediately, as the importance of social-distancing and mask wearing became apparent, coupled with the recognition the virus was transmitted through the air, HealthSmart pivoted to a remote workforce. We also created a COVID-19 Executive Taskforce that has overseen the creation and implementation of our company-wide pandemic policy that encompasses a comprehensive approach to business continuity and eventual return to work strategies. Following the science, the taskforce’s work is guided by the Centers for Disease Control (CDC) guidelines and evidence-based protocols.
I’m proud to say that we managed to shift from office-based work to remote work quite smoothly while maintaining a high level of service and support to our clients across the country. To maintain productivity and a sense of company culture, we have implemented a proactive and sustained internal communications program with strong executive leadership team participation.
Today, like many of our clients, 95 percent of our employees work at home. The latest business continuity plan calls for our employees to begin returning to the office in stages in September 2021. The plan is flexible, enabling us to change the return timeline based on the current status of the pandemic in the markets where we have operations. Our multi-pronged return to office roadmap outlines protocols to ensure personal hygiene, social distancing, mask-wearing and facility redesign including personal space barriers, touch-free sinks and ice machines and strategically located sanitizing stations.
HealthSmart’s evidence-based approach to intervention and management
In March 2020, HealthSmart activated a Clinical COVID-19 Unit within our Specialty Case Management team to help our organization and our clients proactively manage employees who contract the virus. Nurse case managers, many with expertise in infectious disease and critical care, are assigned to individuals who are exposed or test positive for the virus. Understanding that these patients have changing real-time needs based on the course of their illness, the COVID-19 Unit nurses conduct contact tracing and provide one-on-one support for patients and their family members.
To date, this unit has handled over 695 cases, including client members and HealthSmart employees or their families. As we do with all of our Specialty Case Management programs, our COVID-19 unit approaches cases using data analytics and clinical judgement to make sure that members are getting the right care and that unnecessary costs are avoided.
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Many clients are accessing telemedicine for non-emergency care through our partnership with Teladoc.
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Behavioral health visits are increasing due to the stress of isolation, economic uncertainty and grief. Many of these visits are taking place through virtual visits, which appears to be a highly effective approach to care.
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Our anecdotal evidence is that having a case manager gives members a sense of confidence and relieves the anxiety that comes with a positive test of a potentially deadly disease.
One of our employees had a daughter away for school who tested positive. She wrote me an email saying,
“Jennifer* said her Case Manager helped tremendously and now she has this ‘plan’ on who she calls when. The funny thing too is that now Jennifer is the GO-TO person for all the girls just now getting diagnosed. They are of course freaking out and many are VERY SICK and there’s no more quarantine apartments left. There was so much gossip and bad info spreading around, but since Jennifer has experience and a real nurse to talk to, she is now the expert helping the other girls. Isn’t that beautiful how case management can help in an epidemic far beyond the patient? I work here and I’m in awe!”
*name changed to protect the patient’s privacy
Thoughts and Observations About COVID-19
The COVID-19 situation continues to evolve, so I want to share some important information about things to consider over the next few months as COVID-19 vaccinations are being administered across the country.
First, I encourage everyone to receive the vaccine when it is your turn. Getting vaccinated is key to achieving herd immunity, which means that enough people in a community are protected from getting a disease because they’ve already had the disease, or they’ve been vaccinated.[1]
A common question I am asked is if the vaccine is safe and effective. Per the Center for Disease control, the answer is yes. What you may not know is that decades of basic research enabled the quick development of today’s two approved COVID-19 vaccines, but more importantly, both have been shown to be safe and effective as determined by data from the manufacturers and findings from large clinical trials with thousands of participants.[2]
Other questions I’m asked:
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Can you get COVID-19 from vaccine? The answer is no because there is no live virus in these vaccines.
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Do the vaccines have eggs or other ingredients to worry about? The two COVID-19 vaccines currently available do not contain eggs, preservatives, or latex. You can visit the FDA website for a full list of ingredients. Pfizer | Moderna
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Can I stop wearing a mask after getting my 2nd dose of vaccine? No! There is not enough information to stop recommending that people wear masks and avoid close contact with others. There are also new variants of the virus and there is not enough information to understand the protection vaccines will provide against these variants. It is critical to slow the spread of the virus because a virus cannot mutate if it cannot replicate.
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Are there side effects? Side effects are minimal. You may have pain and swelling on the arm where you got the shot. You may also experience fever, chills, tiredness and headache. These are normal signs that your body is building protection and should go away in a few days. Learn more here.
A few other thoughts about the vaccines. It is important to get your second shot for the vaccine to work. There is strong scientific data to support that the booster shot increases the number of antibodies dramatically. Also, if you make an appointment to receive your vaccine but cannot make it, let the vaccination provider know so they can use your dose for another person.
Together, COVID-19 vaccination and following CDC’s recommendations for how to protect yourself and others will offer the best protection from getting and spreading COVID-19.
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Wear a mask over your mouth AND nose
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Stay at least 6 feet away from others (but still wear a mask)
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Avoid crowds
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Avoid poorly ventilated spaces
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Wash your hands often
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Avoid travel
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Have a routine to perform daily health assessments
We are in this together
As the pandemic continues to evolve, we are steadfastly committed to honoring all our stakeholders with dignity and respect by maintaining the safety and health of our employees and our clients. Our resources and expertise are available to help all of us get through this, together.