In just seven weeks, the number of Texas COVID-19 cases has grown from zero to more than 19,000 – killing 495 Texans, changing the way some physicians practice medicine, and causing serious financial difficulties for many more.
But there is some recent good news about the pandemic, Wendy M. Chung, MD, chair of the Texas Medical Association’s COVID-19 Task Force, told more than 2,000 physicians who tuned in to TMA’s COVID-19 telephone town hall meeting Monday evening.
“We have been encouraged to see a decrease in the rate of newly diagnosed cases [in Texas] over the last week or so due in part to the shelter-in-place orders that were established across the state,” said Dr. Chung, who is also chief epidemiologist at Dallas County Health and Human Services and chair of the TMA Council on Science and Public Health.
The town hall gave physicians a chance to question TMA experts on both clinical and practice management issues tied to COVID-19. Like TMA’s first town hall, physicians also answered poll questions about the pandemic.
One of the questions showed the dramatic change COVID-19 has forced on many physician practices. Twenty-four percent said they have lost three-quarters to all of their practice’s revenue since the start of the pandemic. Another 36% have lost between half and three-quarters of their revenue; 23% have lost between one-quarter and half; 10% have lost up to one-quarter; and 7% have seen no drop or were unsure.
Gov. Greg Abbott last week announced a plan to begin reopening businesses around the state, including loosening restrictions on surgeries and procedures.
Physicians concerned about economic difficulties caused by the pandemic should look over TMA’s Practice Viability Toolkit as well as TMA’s COVID-19 resources page, says Joseph S. Valenti, MD, a member of TMA’s Board of Trustees who addressed economic issues at the town hall.
Several participants asked about COVID-19’s impact on patients. For instance, anesthesiologist Scott Leighty, MD, of Austin wanted to know if patients obtain immunity after recovery.
“It’s the million-dollar question right now,” said Trish Perl, MD, chief of the division of infectious diseases at UT Southwestern Medical Center in Dallas and a member of the COVID-19 Task Force. Some people may achieve limited immunity, but the evidence so far is inconclusive, she says.
In another poll question, a plurality of physicians – 41% – said they needed more information on testing for the disease and different testing options.
Dr. Chung warned physicians about some potential testing pitfalls. For instance, several COVID-19 tests marketed to physicians have not been granted a Food and Drug Administration (FDA) emergency use authorization (EUA) or been reviewed for accuracy, she says. These tests are attractive to physicians because they are inexpensive and accessible, but they also are unreliable, she says. She recommended that all physicians check the FDA’s EUA web page before using any tests.
Also, physicians should not use serological tests to make an active diagnosis of COVID-19 infection, Dr. Chung says. That is because antibody production is not present until several days after the first onset of symptoms.
In yet another poll of physicians during the town hall, 74% said they began using telemedicine for the first time only after March 1.
Physicians should check out TMA’s telemedicine resources page to learn more about using telemedicine and the loosened restrictions during the pandemic, says Ezequiel “Zeke” Silva III, MD, a San Antonio radiologist and member of TMA’s Council on Socioeconomics.
“Once we’re in the post-COVID period, we’re going to look back on this as one of the largest pilot experiments in the history of mankind as it applies to telemedicine,” Dr. Silva said. “And we’re going to look at what worked and what didn’t work, and what we want to keep and what to evolve and what to get rid of. And that will be based on the quality of what we do currently.”
You also can find the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center regularly.