The chief medical officer at Carle BroMenn and Carle Eureka hospitals says he doesn't see COVID-19 ever going away. But Dr. Jim Nevin said effective treatments will hopefully make if more manageable over time.
“There is still going to be disease, but herd immunity doesn’t necessarily get rid of everything,” Nevin said. “It just makes it a nuisance more than a predator as such.”
In this edition of Sound Health, Nevin said COVID will likely be treated as a more contagious, more deadly version of the flu, but it's not clear if COVID vaccines will ever gain the same cultural acceptance as vaccines for influenza and other infectious diseases.
“From the get-go the politicization of the COVID virus was very, very unfortunate. It caused a real chasm in the social media world and the scientific world early on back in March of 2020,” said Nevin, adding he told staff to listen to the medical scientists. “You should not be listening to the politicians. This is not a political disease,” he told them.
Nevin said reducing vaccine hesitancy will reduce the likelihood of the coronavirus mutating.
Business model
Nevin said as hospitals shift to care for COVID patients, costs are going up, while routine exams are being delayed. That leads to more health problems as illnesses and cancers are detected at more advanced stages. Nevin said a drop in elective surgeries during the pandemic has limited reimbursements hospitals get from insurance companies. He said that would necessitate a re-examination of the health care business model.
“They’ve got more sick people than healthy people and that’s a losing proposition, unless (insurers) raise their rates to compensate for that, or if they say they aren’t going to pay as much, the rest of health care suffers the consequences of that, too,” he said.
“From the get-go the politicization of the COVID virus was very, very unfortunate."Dr. Jim Nevin
Nevin said hospitals also are having to pay more for staffing by hiring travel nurses to cover some shifts.
“They go where they can make two to three times as much per hour, sometimes five times as much per hour basically as paid mercenaries,” Nevin said. “That causes a lot of strain on the system.”
Carle BroMenn and Carle Eureka hospitals said travel nurses have made up less than 3% of their nursing staff during the pandemic. Bloomington-Normal hospitals continue to operate at nearly full capacity. Nevin said that remains a challenge as Carle has had to refuse patient transfers from other hospitals, even some in other states. He said expanding surge capacity seems unlikely, given health care’s move toward more patient privacy. That limits available space for more beds.
“How can we go backwards in some ways and say how can this private room be adapted to a semi-private room,” Nevin explained. “How can we look and say this area of the hospital be opened up and expanded to a 10-bed clinic?” Nevin added hospitals have adapted by adding more beds when possible, but the challenge is having sufficient staff to care for the patients.
Telemedicine
Nevin also said the pandemic has accelerated health care’s push toward telemedicine, saying it has “exploded” since the pandemic began and even some older patients have embraced the technology as a way to improve access to their doctor.
Nevin said telemedicine may be especially helpful for rural hospitals to provide care for patients, but he cautioned the absence of human contact with patients could have negative consequences, too.
He suggested doctors could shift a majority of its patients to telemedicine to focus more attention on patients with more serious health concerns, especially as new technologies emerge that will make various health screenings less invasive.
