Is now the time to go for an annual physical exam or health screening?

  • By Alan Yu/WHYY

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Hospitals and clinics are open now for routine, preventative care that was postponed in the early days of the coronavirus pandemic. But still some people wonder: Is it safe to go?

Michael LeVasseur, a visiting assistant professor of epidemiology and biostatistics at Drexel University, said a lot of his friends and family members have been asking him that question, along with others about the pandemic. So many questions, that he put together two YouTube videos to try and address them at once.

LeVasseur’s advice is to contact your doctor, but said he’s confident that physicians who are accepting patients will be cleaning their offices regularly and taking other precautions.

“People are really looking for answers to very specific questions, and it’s hard because everyone has very different personal circumstances and not everyone understands all of the nitty-gritty transmission dynamics,” he said. “It becomes unmanageable when I’m getting 50 messages from people in a day … but I’m happy to do it from time to time.”

When preparing for a trip to the doctor’s office, there are some questions people can consider while also trying to prevent the spread of COVID-19, said LeVasseur and other experts.

Neal Goldstein at Drexel University and Aimee Palumbo at Temple University, both epidemiologists, said those questions include:

  • Do the staff and patients wear masks at all times?
  • Do the staff have enough masks and protective equipment?
  • Will there be a limit on how many people can be in a waiting room?
  • Are the staff being tested for COVID-19?
  • How often are staff cleaning the waiting rooms and offices?
  • If you don’t drive, can you take public transit while keeping your distance from other people and washing your hands before and afterward?

The places opening back up for elective and routine medical appointments all highlight the precautions they are taking, as well as other measures such as screening patients days before an appointment, temperature checks and COVID-19 tests for patients who stay at their hospitals.

“For these routine checkups, it’s easy: The people that are at highest risk of COVID or poor outcomes from COVID are also the ones that … are going to benefit the most also from these routine procedures, so we have to recognize that these things still do need to happen,” Palumbo said. “It’s better to treat something sooner than later, so it is still important to continue their care even while this is going on.”

Neil Fishman, an infectious disease specialist and chief patient safety officer at Penn Medicine, said that, broadly speaking, fewer patients have been coming in with routine medical problems. That worries him.

“We know COVID-19 did not cure cancer, COVID-19 did not cure heart disease, so that means that there are a lot of people who have been afraid to get routine health care either for existing conditions or for … as-yet-undiagnosed conditions,” he said. “It’s critical for people to get their annual physical exam, to get gynecologic checkups, to get mammograms, and colonoscopies, and particularly flu shots during cold and flu season.”

“We have seen what a world without vaccines looks like,” he said. “It looks like this pandemic that we’re experiencing, and it would be even more devastating if we saw a recurrence of vaccine-preventable illnesses because people are avoiding health care out of fear.”

Some of that has already happened. A report from the Centers for Disease Control and Prevention last week showed a drop in vaccinations among children age 2 or younger in Michigan during the pandemic compared to similar periods in the past few years.

“The observed declines in vaccination coverage might leave young children and communities vulnerable to vaccine-preventable diseases such as measles,” the authors wrote. “If measles vaccination coverage of 90%–95% (the level needed to establish herd immunity) is not achieved, measles outbreaks can occur.”

At the same time, it can be difficult to talk to patients about coming back for routine appointments. In an editorial in JAMA: Internal Medicine, a medical journal, David Asch, a professor of medicine and health policy at the University of Pennsylvania, wrote that “the biggest challenge in helping patients feel safe is doing so in a way that is not itself scary.”

“Hospitals should pay attention to how they may be perceived to ensure that they do not inadvertently scare away the patients who need them,” Asch wrote.

Fishman at Penn Medicine agreed. He said he now frequently tells patients who ask that going to the grocery store is riskier than a routine visit to a doctor’s office.

“People are anxious when they’re visiting physicians or other health care providers; the anxiety is going to be ever more increased by the changes that COVID-19 are mandating now,” he said. “I always try to think about how a patient would feel, how my mother would feel if they saw someone walking in the room with a mask and a face shield on, because that’s not what you normally experience.”

Fishman has, indeed, talked to his mother, who has a chronic illness, about whether she should go to her routine follow-up visits after being hospitalized at the beginning of the pandemic. He said she goes to those appointments, but he does the grocery shopping for her.

There are some procedures that might be done virtually or just postponed. Jeffrey Jahre, an infectious disease specialist at St. Luke’s University Health Network in Bethlehem and senior vice president of medical and academic affairs, said physical therapists at St. Luke’s have been seeing a lot more patients virtually.

The American Physical Therapy Association put out general guidelines for their members this month, suggesting virtual visits for patients at risk of getting severely ill from a COVID-19 infection, who are concerned about an inpatient visit, or if the alternative to a virtual visit is no care at all.

WHYY is the leading public media station serving the Philadelphia region, including Delaware, South Jersey and Pennsylvania. This story originally appeared on WHYY.org.

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