Health care workers treating Coronavirus disease 2019 (COVID-19) patients face significant stressors such as caring for critically ill and dying patients, physically demanding care requiring new degrees of personal protective equipment use, risk of contracting the disease, and putting loved ones at risk. This study investigates the stress impact from COVID-19 exposure and how nurses and medical providers (eg, physicians, nurse practitioners, physician assistants) experience these challenges differently.

An electronic, self-administered questionnaire was sent to all hospital staff over 6 weeks surveying exposure to COVID-19 patients and degree of stress caused by this exposure. Responses from medical providers and nurses were analyzed for significant contributors to stress levels, as well as comparing responses from medical providers versus nurses.

Stress levels from increased risk of disease contraction while on the job, fear of transmitting it to family or friends, and the resulting social stigma were highest in medical staff during the COVID-19 pandemic. Compared with medical providers, nurses had nearly 4 times the odds of considering job resignation due to COVID-19. However, most health care workers (77.4% of medical providers and 52.9% of nurses) strongly agreed or agreed with the statements indicating high levels of altruism in their desire to treat COVID-19 patients.

The significant stress burden placed on nurses likely contributes to increased thoughts of job resignation. However, health care providers displayed high levels of altruism during this time of extreme crisis, despite their personal risks of caring for COVID-19 patients.

The significant stress burden placed on nurses likely contributes to increased thoughts of job resignation. However, health care providers displayed high levels of altruism during this time of extreme crisis, despite their personal risks of caring for COVID-19 patients.

Severe acute respiratory syndrome coronavirus (SARS-CoV-2) and the associated coronavirus disease of 2019 (COVID-19) have presented immense challenges for health care systems. Many regions have struggled to adapt to disruptions to health care practice and use systems that effectively manage the demand for services.

This was a cohort study using electronic health records at a health care system in northeast Ohio that examined the effectiveness of the first 5 weeks of a 24/7 physician-staffed COVID-19 hotline including social care referrals for patients required to self-isolate. We describe clinical diagnosis, patient characteristics (age, sex race/ethnicity, smoking status, insurance status), and visit disposition. We use logistic regression to evaluate associations between patient characteristics, visit disposition and subsequent emergency department use, hospitalization, and SARS-Cov-2 PCR testing.

In 5 weeks, 10,112 patients called the hotline (callers). Of these, 4213 (42%) were referred for a physic receiving help were offered services to meet their needs including food deliveries (n = 92), behavioral health telephone visits (n = 49), and faith-based comfort calls from pastoral care personnel (n = 37).

Robust, physician-directed telehealth services can meet a wide range of clinical and social needs during the acute phase of a pandemic, conserving scarce resources such as personal protective equipment and testing supplies and preventing the spread of infections to patients and health care workers.

Robust, physician-directed telehealth services can meet a wide range of clinical and social needs during the acute phase of a pandemic, conserving scarce resources such as personal protective equipment and testing supplies and preventing the spread of infections to patients and health care workers.

The coronavirus disease 2019 (COVID-19) outbreak poses serious health risks, particularly for older adults and persons with underlying chronic medical conditions. Community health centers (CHCs) serve as the patient medical home for populations that are disproportionately more susceptible to COVID-19; yet, there is a lack of understanding of current efforts in place by CHCs to prepare for and respond to the pandemic.

We used a comprehensive cross-sectional survey and focus groups with health care personnel to understand the needs and current efforts in place by CHCs, and we derived themes from the focus group data.

Survey respondents (n = 234; 19% response rate) identified COVID-19 infection prevention and control (76%), safety precautions (72%), and screening, diagnostic testing, and management of patients (66%) as major educational needs. Focus group findings (n = 39) highlighted 5 key themes relevant to readiness leadership, resources, workforce capacity, communication, and formal policies and procedures.

The COVID-19 pandemic has exacerbated long-standing CHC capacity issues making it challenging for them to adequately respond to the outbreak. Policies promoting greater investment in CHCs may strengthen them to better meet the needs of the most vulnerable members of society, and thereby help flatten the curve.

The COVID-19 pandemic has exacerbated long-standing CHC capacity issues making it challenging for them to adequately respond to the outbreak. Policies promoting greater investment in CHCs may strengthen them to better meet the needs of the most vulnerable members of society, and thereby help flatten the curve.

This study was conducted to determine if limited access to health care during the COVID-19 pandemic impacted utilization of recommended nonpharmacological treatments, nonsteroidal anti-inflammatory drugs, and opioids by patients with chronic low back pain and affected clinical outcomes relating to pain intensity and disability.

Participants within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation were eligible if they provided encounter data in the 3 months immediately before and after the national emergency proclamation date (NEPD).

The mean age of the 528 study participants was 53.9 years and 74.1% were women. Utilization of exercise therapy, massage therapy, and spinal manipulation decreased during the pandemic. Increasing age was associated with decreased utilization of all nonpharmacological treatments except exercise therapy, and with increased opioid use during the pandemic. African American participants reported decreased utilization of yoga and spinal mave treatments.

The 2019 novel coronavirus (COVID-19) caused a global pandemic that forced medical providers to rapidly alter methods of health care delivery. One month into this pandemic, we surveyed providers and patients to assess satisfaction or concerns with the change from in-person visits.

We surveyed internal medicine (IM) and family medicine (FM) faculty and residents to ascertain satisfaction or concerns with the change to telehealth from in-person visits.

Of patients surveyed (129 IM, 94 FM), 84.4% of IM patients and 94% of FM patients agreed or strongly agreed that they enjoyed the televisits, and 82.9% of IM providers (47 surveyed) and 64% of FM providers (25 surveyed) felt the same. For continued televisits, 76.74% of IM patients and 84.1% of FM patients agreed or strongly agreed that they would not mind having virtual visits after the pandemic, compared with 89.44% of IM providers and 88% of FM providers, and 91% of IM providers and 88% of FM providers felt comfortable managing visits virtually.

Patients are open to the expanded use of telemedicine, and providers and hospital systems should be prepared to embrace it for the benefit of patient care.

Patients are open to the expanded use of telemedicine, and providers and hospital systems should be prepared to embrace it for the benefit of patient care.

Primary care practices rapidly adopted telemedicine visits because of the COVID-19 pandemic, but information on physician perspectives about these visits is lacking.

Fifteen semistructured interviews with practicing primary care physicians and physicians-in-training from a Southern California academic health system and group-model health maintenance organization were conducted to assess physician perspectives regarding the benefits and challenges of telemedicine.

Physicians indicated that telemedicine improved patient access to care by providing greater convenience, although some expressed concern that certain groups of vulnerable patients were unable to navigate or did not possess the technology required to participate in telemedicine visits. Physicians noted that telemedicine visits offered more time for patient counseling, opportunities for better medication reconciliations, and the ability to see and evaluate patient home environments and connect with patient families. Challenges existed when visitsit remains to be seen whether others such as lack of physical examination and loss of physical presence and touch adversely influence provider-patient communication, patient willingness to disclose concerns that may affect their care, and, ultimately, patient health outcomes.

The COVID-19 (C-19) pandemic required swift response from health care organizations to mitigate spread and impact. A large integrated health network rapidly deployed and operationalized multiple access channels to the community, allowing assessment and triage to occur virtually. These channels were characterized by swift implementation of virtual models, including asynchronous e-visits and video visits for C-19 screening.

(1) Evaluate implementation characteristics of C-19 screening e-visits and video visits. (2) Identify volume of C-19 screening and other care provided via e-visits and video visits. (3) Discuss future implications of expanded virtual access models.

Retrospective analysis of implementation data for C-19 screening e-visits and video visits, including operational characteristics and visit/screening volumes conducted.

Virtual channels were implemented and rapidly expanded during the first week C-19 testing was made available. During the study period, primary care clinicians conducted 10,673 e-visits and 31,226 video visits with 9,126 and 26,009 patients, respectively. Within these 2 virtual modalities, 4,267 C-19 tests were ordered (10% of visits). Four hundred forty-eight clinicians supported 24/7 access to these virtual modalities.

Given ongoing patient interest and opportunity, virtual health care services will continue to be available for an expanded number of symptoms and diagnoses.

Given ongoing patient interest and opportunity, virtual health care services will continue to be available for an expanded number of symptoms and diagnoses.

Because of the Coronavirus disease 2019 (COVID 19) pandemic, many primary care practices have transitioned to telehealth visits to keep patients at home and decrease the transmission of the disease. Yet, little is known about the nationwide capacity for delivering primary care services via telehealth.

Using the 2016 National Ambulatory Medical Survey we estimated the number and proportion of reported visits and services that could be provided via telehealth. We also performed cross-tabulations to calculate the number and proportion of physicians providing telephone visits and e-mail/internet encounters.

Of the total visits (nearly 400 million) to primary care physicians, 42% were amenable to telehealth and 73% of the total services rendered could be delivered through telehealth modalities. Of the primary care physicians, 44% provided telephone consults and 19% provided e-consults.

This study underscores how and where primary care services could be delivered. It provides the first estimates of the capacity of primary care to provide telehealth services for COVID-19 related illness, and for several other acute and chronic medical conditions.