Lesha Estrada showed up to my house looking ready for a home visit. Beautiful, professional, and eager to teach something new, not unlike how I met her 5 years earlier at a CrossFit gym. Seeing her at my door gave me a vision of what medicine would have looked like when my parents were growing up. When your Primary Care would come to your house to treat you and have a personal relationship with you. But Lesha, wasn’t here to diagnose me. Instead, she would share with me the realities of healthcare during COVID-19.
Growing up Lesha always had a passion for health and science. It became even more real for her when she needed knee surgery. Her time in hospitals and with doctors made her realize this was a career path she wanted. In 2016, after having been a nurse assistant (CNA) at Children’s Hospital, Lesha went back to school to become a Physician Assistant. Now she could combine her love of people and science into a career that would fulfill her.
Fast forward to the Fall 0f 2019, Lesha began her first job as a PA in family medicine. An adjustment from college life, starting in the healthcare world had it’s learning curves, but it also pushed Lesha to learn more and retain all that she had already been taught. In four 10-hour shifts a week she would work with multiple patients a day diagnosing anything from the common cold to high blood pressure to diabetes and so forth.
Just as things were starting to become normal for this just out of school Physician Assistant, everything changed. COVID-19 hit Colorado at the beginning of March 2020 and sent the entire state, and country for that matter, into quarantine by March 24, 2020. This meant that the landscape of healthcare would look different for all patients. Before COVID-19 hit, Lesha’s office saw roughly 12-15% of their patients via telehealth (video) but once the state shut down they went up to 100% of their patients they saw view telehealth. This would help reduce community exposure and keep both the patient and the medical staff safe from spreading the disease.
However, The change in approach to medical appointments and the fear of Doctor’s offices and hospitals would create unforeseen consequences. Patients with COVID symptoms called in and would go to the ER if their symptoms progressed. However, patients with other life-threatening medical needs were refraining from coming to the Doctors. Fear of catching the disease kept almost everyone at home including those who needed periodic preventative care screenings. These included screening for high blood pressure and diabetes. Because of this, Lesha and other medical professionals were seeing an increase in at-home deaths. It would seem that the fear of COVID was becoming almost as deadly as the disease itself.
“There is still so much unknown, and we still have so much to learn but I’m really optimistic.”
Not only were preventative care appointments in a decline but mental health as well. Living through a worldwide pandemic and isolated at home has caused a rise in depression and anxiety. Something I myself have battled with throughout this period. In a recent study of 129 participants put into quarantine if found that “28.9% of participants had symptoms of post-traumatic stress disorder (PTSD) and 31.2% had symptoms of depression.”
The health and well being of our medical professionals including Doctors, Nurses, and Physician Assistants is another drastic change since the onset of COVID-19. Lesha explains what it was like for her boyfriend to work as a nurse on the nightshift in a COVID ICU the first few weeks of everything. Having to wear a full suit to protect himself from the virus along with the N-95 mask, a heavier mask from what you see on Grey’s Anatomy.
Even Lesha’s office had to change all the ways they worked when they returned. This included rearranging all their desks to be 6-feet apart, wearing masks all-day, and caring for the masks so they could recycle them. While mask shortages are no longer an issue, in the beginning, PPE masks (like in Grey’s Anatomy) were hard to come by. Therefore Hospitals and Doctor’s offices were forced to reuse their masks for as long as possible. In order to preserve their PPE masks, precautions of not wearing makeup and refraining from touching your mask were all put in place. Lesha’s team didn’t need to send their masks to the recycling plants but other offices were forced to.
The realities and protocols for COVID-19 change all the time for all of us, but especially the healthcare industry. Lesha checks in with the CDC website and the Colorado Public Health website every day to make sure she is on top of the latest protocols. 60% of appointments are back at the office but things are still not “business as usual”. COVID symptoms are asked about before any patient is allowed to come into the office. For those with the symptoms, they are asked to manage at home. Lesha’s team checks in with any COVID positive case on a regular basis to ensure symptoms aren’t getting worst and when they are to go directly to the ER. The disease acts quickly and therefore they’re taking no chances.
Otherwise, Lesha is happy to report that she does have patients who are recovering from COVID. They are still self-quarantining for as long as possible, but their lives are getting back to a place of normalcy too. There is hope for what is to come next. With businesses opening up every day and communities striving for things to not “go back to normal”, we’re seeing progress. “I feel like we as a people are going to be a lot stronger just coming through this pandemic which I love to see.”
Lesha concludes with some hope by saying, “There is still so much unknown, and we still have so much to learn but I’m really optimistic”. We continue to take each day one-at-a-time and realize that no one has all the answers. We’re all in this together, and we’ll continue figuring it out together as a community.