BLOG: ODs should close offices during COVID-19 pandemic
These are unprecedented times for all of us. The last pandemic was the H1H1 flu virus of 2009. Although that outbreak resulted in over 60 million cases in the U.S. and unfolded over the course of a year, the mortality rate was only 0.02%.
Optometry’s role in this event was minimal. We saw our patients without disruption, took no unusual precautions and gave the event little thought.
The public health service, however, learned a lot from this experience. The loss of 12,500 lives, many of them young people with no immunity, was unacceptable. The CDC developed a host of programs to improve outcomes for the next pandemic. These included: Monitoring and Protection, Risk Assessment, Prevention and Treatment, and International Work.
The areas of prevention and treatment provide the key role for optometrists. Our unique access to patients at the time in their lives when they develop the risk factors that lead to poor outcomes in a pandemic are the same that reduce the quantity and quality of life. These are smoking, obesity, diabetes, dyslipidemia and hypertension. Identifying your patients who are at risk, on the path or struggling with these problems and intervening with health education, wellness programs or referral can lower the risk and improve outcomes. The improvement comes from increasing resistance to the agent of the pandemic and by increasing the odds of survival should your patient become infected.
One of the strategies that I personally employ and have recommended to my patients is intermittent fasting. This not only lowers virtually all the risk factors noted, it strengthens the immune system and improves the immune response to viral infections. In addition to my losing 25 pounds and lowering a number of my personal of risk factors, I did not contract the COVID-19 virus, despite the fact that I was late to close my offices. Say what? Close an office providing essential health care?
That’s correct. As essential as optometry may be for prevention and primary care, a pandemic event requires us to follow the CDC’s guidelines for nonpharmaceutical interventions. These include creating physical distance or “social distancing” and closing locations where people may be tempted to come in close distance to one another. This would include optometric practices. We should be on call to triage medical eye emergencies, use telemedicine and online resources when appropriate and educate patients who call the emergency line to try to pick up new glasses and contact lenses about the nature of the emergency and the CDC guidelines.
I admit that I was late to realize the importance of these guidelines. I thought that optometrists were essential health care providers, and because most of my patients have medical problems and are not routine, I should be out there on the front lines. As I read more and watched the numbers grow, I realized that I was part of the problem and that way too many of us thought that we were essential but actually were just serving as vectors to spread the virus.
After years of asking my optometric colleagues to “step up” to their essential role in the health care system, I am now asking you to stand down and follow the critical public health guidelines to manage the pandemic.
References:
- CDC. 2009 H1H1 Pandemic – Summary of progress since 2009. Updated June 6, 2019. Accessed March 23, 2020. https://www.cdc.gov/flu/pandemic-resources/h1n1-summary.htm.
- CDC. Nonpharmaceutical interventions. Updated June 11, 2019. Accessed March 23, 2020.
- de Cabo R, Mattson MP. N Engl J Med. 2019;doi:10.1056/NEJMra1905136.
- University of Southern California News. Fasting triggers stem cell regeneration of damaged, old immune system. Posted June 14, 2014. https://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/.
- Zenz G, et al. Front Neurosci. 2019;doi:10.3389/fnins.2019.00359.