{"id":366,"date":"2020-07-11T03:57:00","date_gmt":"2020-07-11T03:57:00","guid":{"rendered":"https:\/\/covidqanda.org\/?p=366"},"modified":"2020-11-09T03:59:14","modified_gmt":"2020-11-09T03:59:14","slug":"what-is-the-relative-risk-of-going-to-a-doctor-or-clinic-for-health-care-visits","status":"publish","type":"post","link":"https:\/\/covidqanda.org\/?p=366","title":{"rendered":"What is the relative risk of going to a doctor or clinic for health care visits?"},"content":{"rendered":"\n

Question:<\/strong> What is the relative risk of going to a doctor or clinic for health care visits? A kid in our \u201cpod\u201d (two families that have merged our circles of isolation) recently went in to get routine immunizations, and we are wondering if we should un-merge from that family for a couple weeks. Likewise, my doctor asked me to come in and get blood work done, and I wonder (a) if doing that is worth the risk of contracting Covid, and (b) if I should isolate from my family and the other family in our \u201cpod\u201d afterwards. On the one hand, health care workers are highly trained and likely to be very diligent about masks, disinfection protocols, etc. But on the other, these interactions are indoors, typically in small confined rooms with limited air flow, in establishments where lots of people are coming and going, and without social distancing (you can\u2019t socially distance from someone while examining them, giving them a shot, or drawing their blood). Arguably, health-care settings also attract more sick people than, say, bars or restaurants. We are in one of the areas of the country where cases are recently exploding. I\u2019m not suggesting people avoid going in for preventative health care, but more wondering whether a period of self-isolation afterward is appropriate. On a scale from 1=\u201disolate at home\u201d to 10=\u201dattend a huge indoor rally\u201d, how would you rate the risk of going to a clinic for routine health care?<\/p>\n\n\n\n

Answer: <\/strong>We\u2019re all grappling with this issue right now. Another friend wrote a similar question about going to the dentist and then there\u2019s the Q&A from 7\/9<\/a> about risk from being in a hospital waiting room. As with everything COVID-related, we\u2019re still operating with incomplete information and our understanding of risk is limited as a result. When it comes to scaling risk of seeing the doctor or dentist, I suggest the following:<\/p>\n\n\n\n

  1. Read up on safety guidelines. <\/strong>CDC\u2019s suggestions for infection control in dental offices<\/strong> are here<\/a> and suggestions for pediatric healthcare providers<\/strong> is here<\/a>. Additionally, the American Academy of Pediatrics offers practice management tips during COVID here<\/a>.<\/li>
  2. Check whether your provider is following safety guidelines. <\/strong>After you\u2019ve read up on infection control suggestions, reach out to your provider to understand what they are doing to protect themselves and their patients. Compare their practices with what you read. Do they align? Are they weaker\/stronger? If they don\u2019t meet the guidelines, consider finding another provider.<\/li>
  3. Check community transmission levels. <\/strong>You can find community transmission data from your local health department (e.g. Nashville\u2019s is here<\/a>). If the rate of transmission is greater than 1.0, then your community is seeing rapid spread. Other data points you could use are \u2014 1) number of daily hospitalizations and currently hospitalized; 2) number of daily cases and percent of tests that are positive [note: increases in hospitalizations OR in cases + test positivity rate are both worrying signs.]<\/li><\/ol>\n\n\n\n

    So, how would I then use this data? Three scenarios:<\/p>\n\n\n\n

    1. IF the provider is following safety guidelines and community transmission is declining, THEN your risk is quite low. <\/strong>On a scale of 1\u201310, I\u2019d put it at a 3 (moderately low risk). I would go. And I wouldn\u2019t be overly concerned if someone else in my pod had gone.<\/li>
    2. IF the provider is not following safety guidelines and community transmission is declining, THEN I would consider finding another provider. <\/strong>Even if community transmission were contained, I\u2019d still want to know that my provider was doing their utmost to keep us all safe. And if my provider weren\u2019t doing the needful, it would make me question their judgement pertaining to other elements of their healthcare practice\/provision. I\u2019m not sure how to rank this on a scale of 1\u201310; it really depends on how far your provider deviates from the safety guidelines.<\/li>
    3. IF the provider is following safety guidelines and community transmission is increasing, THEN I would: <\/strong>a) consider whether you can wait until community transmission is declining; b) if you decide that you need to go, then talk with your provider about how you can further mitigate risk, especially if you have underlying conditions\/risk factors (perhaps you could be the first patient of the day, for example). On a scale of 1\u201310, I\u2019d rank the risk at a 4 or 5 (moderate risk). And if I had a good experience with my visit (unlike our friend who had to go to the ER with a bunch of sick people the other day!), I\u2019d probably keep hanging with my pod, but limit interactions to outdoor, socially distanced interactions only.<\/li><\/ol>\n\n\n\n

      A few more things:<\/p>\n\n\n\n