In April, New York was the epicenter of the COVID-19 pandemic in the U.S. Numbers of positive cases, hospitalizations and deaths skyrocketed as the rest of the country looked on.
But now, as the state—and New York City—suppresses the virus, numbers are climbing in new hot spots across the country: Arizona, Florida and Texas, and attention is turning back to New York for guidance.
During a CMS COVID-19 Lessons from the Front Lines call Friday for providers, Dr. Theodore Long, vice president of ambulatory care at New York City Health + Hospitals, offered three tips to areas seeing a surge in new cases.
1. Keep people out of the emergency department.
"It's critical to keep people out of the emergency department," Long said.
New York City set up a COVID-19 hotline that people could call and be connected to a clinician who could talk through their concerns, he said.
"People really needed to have a way to engage with NYC when they were worried on an instantaneous basis," Long said.
Otherwise, people who had low-risk exposure to the virus would often go to the emergency room where the chance for exposure was even higher, he said.
2. Use telehealth.
Telehealth gave healthcare professionals ways to treat patients without potentially exposing them to the virus. Long recommended both phone and video visits as options. Some patients, he said, aren't comfortable with video visits, and others have trouble with the technology.
3. Don't undervalue the importance of testing.
"Testing is how you get out of this," Long said.
While what's hard to do while you're in a surge because there's limited lab capacity, "it's important to do as much testing as you can," Long said. During periods of community spread, testing can help to cohort patients when they arrive at the hospital, he said.
NYC now is performing more than 30,000 tests per day at 200 sites across the city, he said. All positive cases are entered into a database, and contact tracing is done for each person.
The city also set up hotels for Covid-19 patients and offered rooms free of charge to both people from the community and the hospital who had tested positive but couldn't go home without the risk of exposing others. The hotels were set up with medical monitoring and telehealth, Long said.