The COVID-19 Balancing Act: How Data Can Help Cut Through the Chaos
The COVID-19 pandemic has introduced a host of challenges to clinicians on the front lines. Not only are they dealing with the clinical consequences brought about by the novel coronavirus, but they have also been caught up in a precarious balancing act of managing patient care with incomplete and unreliable data, all while patients put important, life-saving non-COVID care on hold.
Take, for example, the dip in preventative screenings and routine procedures early in the pandemic. As elective procedures were canceled, patients became increasingly unwilling to seek care even for pressing health concerns. There was a near evaporation of routine testing in the US compared to the year prior, with the most significant declines ever seen in cervical cytology screening (-68.2%), cholesterol/lipid panels (-66.6%), and hemoglobin A1c tests (-64.7%). These are concrete examples of patients who need regular monitoring but are living with the risk of chronic disease complications rather than face the risk of COVID exposure in health facilities.
Cancer care also plunged. For example, screenings, diagnoses, and surgeries for breast and colorectal cancers plunged sharply in April, and are only now beginning to normalize to the usual volume of care. But the time lost is not easily made up, as cases that could have been diagnosed in Stage 1 may have descended to Stage 2 or 3, resulting in more serious outcomes.
While we have more clarity on those ripple effects now, the latest surge in COVID-19 presents new challenges in how to treat and manage a crushing caseload among diverse patient populations, while also maintaining ongoing healthcare needs and mitigating the follow-on effects of the pandemic. So how are physicians on the front lines of the pandemic using data to better understand comorbidities, identify nuances in treatment outcomes, and target underserved patient populations?
The Need for Data on the Front Lines
I had the privilege of discussing these issues recently with Sreelatha Naik, MD, a medical school colleague of mine who is currently a critical care physician and pulmonologist at Geisinger Health System. We discussed how the pandemic has impacted patient volumes, unlocked new opportunities in digital health, and unleashed new data-driven approaches that have the potential to revolutionize healthcare as we know it.
She described some of the early challenges in the ICU at the beginning of the pandemic, such as a lack of protocol and limited literature on COVID itself. “Because the literature was lacking in the beginning, we wanted to make sure there was a consensus in our treatment protocols and made sure those were continually updated and disseminated throughout the system.” They created systems to deal with what they knew, what they didn’t know, and how to assimilate new information as the science evolved.
As new treatments emerge, her team’s focus has shifted to better understanding why certain treatments are working while others don’t, depending on nuances like comorbidities or socioeconomic factors. Recognizing these nuanced details is highly contingent on access to population data – and these are details that can be crucial in achieving better outcomes for COVID patients. She added: “In the acute setting, we need to see what therapies can change the course of the disease, and that will include replicating data sets that we’ve seen from some early encouraging clinical trials.”
Now, nearly a year into the pandemic, Dr. Naik says that data on the lingering effects of COVID will be instrumental in the country’s overall recovery as we grapple with the heavy burden of this virus. She shared her observations on the phenomenon of “long-hauler syndrome,” as well as post-ICU psychological challenges that many patients face.
“We’re great at measuring and quantifying the physical ailments, but how is the psychiatric impact of this [COVID infection] quantifiable, and do we have the physicians, social workers, and providers available for that?” she asked.
The impact of COVID-19 will undoubtedly be felt for years to come, but how clinicians are able to address it across the entire continuum of care will define just how far the ripple effects spread. The insights we can glean from Dr. Naik’s experiences on the front lines are that data, transparency, and the humility to learn, coordinate, and adapt will be integral in this process and the key to success in what lies ahead.
Watch the video to learn more about Dr. Naik’s perspective from the front lines of COVID-19.