Doctors urge: Don’t neglect other issues during pandemic

Local physicians’ panel focuses on whole-body health

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While COVID-19 continues to sweep Colorado, now with the added threat of the omicron variant, Douglas County doctors urged the importance of balancing COVID prevention and vaccination with overall health and wellness during a virtual panel hosted by the Castle Pines Chamber of Commerce on Dec. 8.

"Your Health and You in 2022," a panel discussion held in conjunction with Centura Health’s Castle Rock Adventist Hospital, marks the second annual health-centric panel hosted by the chamber, with the first held in November 2020 as the number of COVID-19 cases experienced its most dramatic ramp-up since the pandemic began.

This year, with the proliferation of vaccines and the emergence of new variants playing tug-of-war over the state’s case count, the panel focused on the intersection of COVID-19 and the general well-being of the population.

According to Colorado Department of Public Health and Environment data presented during the panel, 1,419 people were hospitalized with COVID-19 in Colorado. Of those, 84% were unvaccinated.

Daily hospital admission rates are lower than they were around this time last year, but Colorado hospitals have been busy, said Dr. Devin Bateman, chief medical officer for Castle Rock Adventist and Parker Adventists hospitals and the panel’s moderator. Rather than a sharp spike in new cases, the data reflect a more sustained rate of hospitalizations.

“Patients are really consistently being admitted with this wave that began several months ago,” Bateman said.

And COVID patients stack up day after day, the rest of the hospital feels the impact, he said.

But COVID-19 is only part of the picture for health care providers and patients alike, with more than 20 months of strain on health systems and postponed preventative and maintenance care coalescing to reach even those who have remained physically untouched by COVID, according to the panelists.

Beginning in the spring of 2020 with the first wave of COVID, many people put off regular medical care like screenings that can detect cancer, high blood pressure or diabetes, and vaccinations against things like influenza, shingles and tetanus, said Dr. Widian Jubair, a primary care physician at Castle Rock Internal Medicine.

In the very early days of the pandemic, non-emergent medical facilities were closed in most cases, which meant that patients had to postpone these kinds of procedures, but even after these clinics were allowed to reopen and patients could visit relatively safely with precautions, patients hesitated, Jubair said.

More than a year later, this trend has resulted in an increase in the number of preventative and manageable conditions Jubair and her partners see in their practice.

The tertiary impacts of COVID-19 aren’t limited to primary care clinics.

Dr. Jesse Loar, an emergency room physician at Castle Rock Adventist, sees the effects as well.

In the two weeks preceding the panel, Loar estimated that COVID patients made up 15 to 20% of daily volumes in the emergency department at his facility. Some come in at the beginning of their illness, experiencing symptoms and needing a test to confirm their suspicions. Others have been sick for seven to 10 days and seek more serious treatment. And still a third group come into the emergency department for another reason, like an injury, and happen to have COVID as well.

Regardless of what brings these patients to the hospital, Loar said, the supportive care they require, including intravenous fluids, medications, and breathing therapies, creates a trickle-down effect for the rest of the emergency department.

“There are indirect effects on our ability to take care of the community the way we’d like to because of the severity of this disease,” Loar said.

The pandemic’s impact on mental health is another indirect, if better documented, effect, as people across the world deal with increased levels of anxiety, depression and attention disorders stemming from isolation, uncertainty, life changes and even sickness and death of a loved one.

“Mental health is a huge, huge concern for our population,” said Anna Jones, an obstetrician and gynecologist at Centura Health Physician Group and Castle Rock Adventist.

Pregnancy always adds a layer of wariness about the world, and carrying a baby through a pandemic is particularly stressful, Jones said. At first, uncertainty swirled about the safety of COVID vaccines for pregnant women, as they are not generally included in clinical testing groups. Some women chose to be inoculated, while others resisted.

“The pregnant population continues to be the least-vaccinated group of people in our nation,” Jones said.

But in the months since the vaccine rollout began in the U.S., respected groups such as the American College of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine have recommended the vaccine for pregnant women, with studies demonstrating its safety and effectiveness for mother and child alike, Jones said.

But mental health struggles aren’t limited to pregnant women, Jones said. Overall, she has seen increasing rates of depressions or anxiety, which in turn can lead to substance abuse.

She noted one silver lining, however. Many patients in her practice have taken the opportunity presented by the pandemic to reinvent themselves in ways they otherwise wouldn’t have. Whether that means taking steps to improve their health, leaving bad relationships or making a career change that better aligns with their values, some women are making significant changes for the better, according to Jones.

But while this is hopeful news for some women, the pandemic continues to generate uncertainty and fear for children, some of whom are so young that they don’t remember life before the pandemic.

Children are struggling with emotional balance, socialization, keeping up in school and an array of other challenges as the pandemic drags on, said Dr. Ann Engel, a physician at Centura’s Healthfit Family Medicine.

“You could go on and on about the effects this pandemic has had on our kids,” Engel said. But she hopes that broadening vaccine-eligible populations will help reign in the virus, easing these effects.

“The more people we can vaccinate and protect, the less disease we’ll see in the community at large” Engel said.

Both Engel and Jones encouraged the use of things like therapy and counseling when possible, even if that means virtual visits or other online resources. Primary-care doctors can sometimes offer services that their patients may not have known about.

Jubair pressed the importance of keeping up with regular health care tasks, including physicals, screenings and vaccinations, including an annual flu vaccine.

Colorado’s flu season was incredibly mild last winter, according to Loar, the result of COVID-related masking, sanitizing and isolation, but the medical community in Colorado does not expect a repeat this winter.

The doctors agreed: It will be as important as ever to take care of oneself this cold and flu season and beyond.

“Preventative medicine and primary care are not elective, they’re essential. To fight any infection, we have to have a healthy immune system,” Jubair said. “Getting your shots, getting your screenings, they’re the first steps toward staying healthy.”

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