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Most people in the US have withdrawn from their daily routines unless their jobs are essential. Quiet streets, shuttered stores, silent schools. More than 400,000 live with the knowledge that they have the disease, but the slowness of our testing means that multiples of that number are likely to be infected. In pockets around the country, hospitals feel the earliest surges from those most vulnerable to COVID-19, but countrywide, the tsunami is still out at sea.
The devastating effects of a tsunami are usually preceded by an abnormally fast and long low tide, as water is actually pulled away from shore toward the epicenter of the underwater earthquake. Most of the US currently sits in that temporary equipoise. Most Americans who receive any health care in a given year do so in a primary care setting, where they generally have the relationships that they count on most when they are sick—or scared that they might be.https://www.healthaffairs.org/do/10.1377/hblog20200415.293535/full/
While Emergency Departments, hospitals, and intensive care units are in the headlines for their battles against the growing wave of COVID-19 infections, a quieter, but just as dire, struggle unfolds in primary care offices all over the country. Primary care clinicians have been asked to keep our patients safe from COVID-19, screen them, tell them what medicines to use, when to stay home and when to go to the ER. And we are trying to maintain personalized delivery of acute, chronic and preventive services for all our patients. Everyone has been asked to practice social distancing, but we are trying to use our ongoing patient relationships to enable physical distancing with social connectedness.https://www.usatoday.com/story/opinion/2020/04/07/coronavirus-family-physicians-provide-telehealth-care-risk-bankruptcy-column/2942535001/