April 20, 2020

COVID-19 Policies & Thoughts

For urgent or compelling needs, our office is open for face-to-face (with a mask), hands-on (with gloves) good old fashioned in-person office visits and examinations for the most accurate diagnosis and the most effective treatment. If and when you need us for urgent issues, we will take your temperature, have you wear a mask, and gel your hands. And when you leave the exam room it will be disinfected with 70% alcohol. Dr. Holmes is seeing patients with urgent needs in the office on Monday and Wednesday mornings and afternoons as well as Friday mornings. Please call 919-782-9003 to schedule an appointment.

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In these COVID-19 days, it is very challenging being an ENT or any surgical subspecialist. The conditions of the virus are limiting patients coming to see us and patients having needed procedures.

What most surgeons do is necessary of course, but most is also elective, meaning it can wait a few weeks. Now breathing problems, bleeding, or pain move these issues to the front of the line.

To preserve masks and other PPE, operating rooms and hospitals are limiting surgery to only urgent cases, defined as needing to be done in next 30 days or there will be harm to the patient’s health.

A special nuance of this virus is that it lives in the lining membranes (mucosa) of the nose and sinuses, as does any respiratory virus. This one then goes down into the lungs. Any procedure done in the nose or sinuses can potentially release the virus into the air and infect any unprotected healthcare worker in the room. We have learned this the hard way in China, Italy, and France with many ENT docs getting severe infections and dying. For this reason, most of the nasal and sinus procedures we do routinely are being delayed until this crisis is over. If urgent or emergent, the patient must undergo testing that shows that they are COVID-19 free. And just now rapid tests have been developed. We will see how long it takes to produce and disseminate them. So far I haven’t had an emergency case, but I do have an urgent case this week and will wear appropriate N95 mask.

For these very important reasons, ENT docs in the country are closing or severely limiting their practices to prevent viral spread. We, at ENT & Audiology Associates, are open for urgent appointments, in other words, it just can’t wait.

Back in 1918 when the flu was pandemic, most docs were general practitioners and were overwhelmed with patients. But in 2020, unless and until we are needed to staff COVID-19 hospitals (like what happened in China), we ENT docs
and other surgery specialists (neurosurgery, orthopedics, plastics, urology, ophthalmology, etc) are wondering when this will end and what will be the status of our practice and our employees (nurses, receptionists, billing, etc.) when the dust clears.

So, bottom line is we will be there for you if necessary. Call first if you have cough or fever or shortness of breath or recent loss of smell (due to virus zapping your smelling nerves), so we can advise you properly. Please note that we will take your temperature upon arrival, and that all staff will be wearing masks, and we’ll ask you to put one on also.

Also please note that audiology support is the bare minimum.

Stay at home if you can, stay safe always.