Health system experts: Don't expect return to pre-COVID-19 business before vaccine, herd immunity

While hospitals around the country are carefully moving forward offering elective surgeries again, don't expect them to get back to pre-COVID-19 volumes anytime soon.

In fact, healthcare leaders from health systems such as Kettering Health Network as well as Vituity Healthcare and Medical Staffing Services said they don't expect hospitals to get close to normal business until a vaccine is developed.

"It will vary from community to community but I think chances are good we won’t see normal again until after a vaccine or sufficient herd immunity," said Gregg Miller, M.D., Vituity's chief medical officer, during a webinar hosted by FierceHealthcare. 

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That will almost certainly be the case in Ohio, said Jodie Cremeans, who manages Kettering Health Network's Operations Command Center there.

"For us and our community, it’s probably going to be 12 to 18 months before we’re even that close to what our baseline was just because [there is] a lot of hesitation," Cremeans said during the Coronavirus Virtual Roundtable series.

"With flu season—especially in Ohio, we see a huge flu surge in flu season because of where we are geographically and everyone being inside and touching each other all the time—we really do think it’s going to be quite a while before we’re back to that new norm," she said. "It’s going to take a long time and probably not until we have a vaccine, or a mixture of a vaccine and herd immunity."

Miller pointed to the precipitous drops in non-COVID-related care for patients in hospitals around the country as the pandemic raised fears among patients of catching the virus in a healthcare setting.

Health systems have a communications battle to fight in convincing them about their safety, he said, even as they prepare for a surge in the fall that could require a redoubling of shelter in place efforts. Health systems in markets around the country, including Los Angeles, are banding together to put out public announcements to remind patients they are still open for business.

That's the case at Cedars-Sinai as the hospital begins reaching out to patients about scheduling their procedures. "We’re starting with what we’ve postponed first," said Bryan Croft, senior vice president of operations for Cedars-Sinai.

Simultaneously, they are doing a campaign about the importance of community members feeling comfortable seeking necessary medical care as they consider the best way to open up access more broadly through its health system.

"We haven’t yet established a firm timeline on the reopening of our clinics," Croft said. "We see about 800,000 visits a year within the whole system and we recognize that, in order to do that, we have to be aware of the issues associated with the stay-at-home guidance that still exists in this state until the 15 of May." That includes understanding the potential impact on personal protective equipment, the impact of social distancing and how the health system may need to physically reorient spaces such as parking garages or waiting rooms to assure patients they are safe, he said.

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"There are still so many unknown elements," Croft said. "If we’re planning the way everyone else is, and everyone else should be, about the fact this could surge with the easing of certain social distancing or stay at home orders that are going on across the country, we need to be aware of what’s going on around us so we can quickly flex back to be able to think in terms of surge again."

Bottom line: All eyes will be on the health systems, and they need to get this right, Melanie Morris, senior director of the Roanoke, Virginia-based Carilion Clinic's transfer and communications center. 

"It’s huge how we do it when we first start to open back up because people are going to be watching closely and we can still lose the trust and faith of the community if we backtrack," Morris said. Health systems will have to focus on variables they can control such as how well they are screening patients and get quick turnaround results.

"I think we need to be very careful about how we open back up and gain that trust back with the public," Morris said. "We can’t predict how quickly it will happen. It will be a phased approach. But all eyes upon us and we have to do it quickly and correctly."