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COVID -19 Concept Map
8
COVID-19 IMPACTS
IT'S PROBABLY WORSE THAN YOU THINK!
Stepwise Treatment
Physical/Social Environment
By Lauren Dotterer and Molly Flanigan
Healthcare
Health Care
What has been affected:
- Missed Primary care appointments (missed yearly physicals)
- missed preventative care (pap smears/mammograms)
- Chronic illness management
- Missed diagnoses
- Increased need for ventilators and ICU beds
- healthcare workers
- increased need for Telehealth
Health Care Workers
Healthcare workers
- Feeling of dread and doom
- PTSD
- Lack of resources
- Coping mechanisms (healthy vs non-healthy)
- Increased incentives to work in cities/areas hit the hardest
- Dis-trust of govt agencies and hospital administration
Public health- healthcare systems developing pages for both employees and general public educating on disease process and how policies/procedures are changing daily to support care
Public Health
Hospital Visitations
Hospitals with restricted visitor policies, patients left without emotional/social support of family, push for more responsibility of nurses to use communication services such as ipads/face time for families. Increased demand of physicians/advanced practice providers to communicate with families about treatment options/goals of care via phone.
Finances
- Job loss
- Bankruptcy
- J-Crew, Brio Italian, True Religion, and many more
- Inability of families to pay bills including rent
- Landlords losing income
- Using retirement savings early
- Working at home and decreased consumer spending
- Stimulus checks to business and individuals
Finances
Education
Education
- Universities closing to prevent spread & classes shifted online
- 0% interest on student loans
-Clinical placements being stopped to preserve PPE/decrease exposure
-Health promotion- education on symptoms (60-80% cough, 45% fever, 20-40% with shortness of breath, 15% upper respiratory symptoms, 10% GI symptoms N/V/D)
- States closing school systems still Fall 2020
Media
MEDIA
-Community based- mass media coverage often misleading and different facts, social media being consumed by covid related posts
-Motivational interviewing- understanding how people have been exposed, and their barriers to seeking treatment sooner, screening tools for assessment when seeking care (allowing people to use open communication to be forthcoming about symptoms and exposure without judgment)
-Social media outlets such as Tik-tok, instagram, Zoom,and facebook keeping individuals and families connected.
-Anxiety of public at a high due to continuous media coverage and being unsure of which sources to believe
Health Habits
Health Habits
-Those with cancer or immuno compromised higher risk of being affected. How are they taking healthy precautions?
-Increased incidence of substance abuse (alcohol and drugs) due to being quarantined at home, using these as methods of coping
-Possible weight gain due to closure of gyms/access to fitness equipment
-Increased spread of virus from more people getting outside to exercise (crowded trails/sidewalks)
- Patients afraid to seek care/follow up for chronic conditions like diabetes and hypertension
-Coping mechanisms due to stressors could be healthy or unhealthy. Increased alchol intake, exercise, etc.
Consider
?
Are normal resources available for those in need such as food banks/pantries?
How will those people get access to what they need?
Reduced capacity at grocery stores, limited shopping hours, food delivery services overwhelmed?
WHERE IS ALL THE TOILET PAPER?!
Government involvement
-National and state local initiatives- Virginia order number fifty-five temporary stat at home order due to novel coronavirus (COVID 19) in effect March 23-June 10th 2020. No national concordance on rules of stay at home order, state by state rules in place with different rules/regulations about what is acceptable.
-Leading indicators (access to health)- testing not initially available in beginning of pandemic, US behind other countries in testing sites/facilities = ineffective diagnosis and treatment in early phases
Government Response
Families
- School canceled= online learning which may be difficult for some children
-Daycare closed= parents having to take time off work to be at home kids
-normal growth/development timelines altered without structure/routine
-Families forced to find others to care for their children (friends/extended family)
-Increased adverse childhood experiences
-Increased use of electronics and less outdoor play = less socialization for children
-Stimulus checks to families
Families
Transtheoretical Model of Change About Virus
Phases of Thought
Pre contemplation- is this virus real? Do I really need to stay at home and is it possible for me to do so?
Contemplation- Will doing this actually prevent the spread of the virus?
Preparation- buying masks/supplies like soap/hand sanitizer to help prepare for period ahead.
Action- Being responsible and only leaving home for necessities, understanding that the virus is real and these safety measures are important Maintenance- continuing with these behaviors after the peak has occurred. Will people continue to comply once things start to reopen? Will they go back to beginning of cycle or stay in action phase?
Stepwise Approach
Early treatment algorithm- STEPWISE approach- isolate and send PCR test, early goals of care discussions, notify department of health/ CDC, intubate early and under controlled conditions, avoid aerosolizing procedures, investigational therapies- clinical trials