Eyeworld

N EWS 32 | EYEWORLD | MAY 2020 COVID-19 NEWS YOU CAN USE by Liz Hillman Editorial Co-Director 48 hours before operations and close moni- toring the day of the procedure. NYEE oph- thalmologists, like many around the country, have full personal protective equipment (PPE), including fitted plastic shields on slit lamps, and visits are now designed for minimal exposure. Dr. Tsai said NYEE has been in commu- nication with state and local health officials from the outset, with the potential for NYEE to increase its bed capacity to serve COVID-19 patients, if needed. "This has really been something that has turned our world upside down, and I think we as ophthalmologists recognize that we can switch gears as physicians, and we have to be able to help out with this crisis," he said. Dr. Tsai said he can't predict when things will get back to "normal," but he believes the pandemic will change healthcare delivery going forward into the future. At present, he said the pandemic is raising questions about how to provide care to patients who are not able to seek medical care and guidance with in-person visits. In the future, he thinks it will change how telemedicine and teleophthalmology is viewed and how eye emergencies are handled. "I think it's a higher level question of whether medicine will go back to what it's been, a fee-for-service, volume-driven in-person type of practice vs. a greater focus on protecting patients with a more comprehensive, telemedi- cine-assisted in-person service." Stephen McLeod, MD Chair, Department of Ophthalmology University of California, San Francisco (UCSF) San Francisco, California Dr. McLeod detailed the protocols at UCSF to prevent further spread of SARS-CoV-2. In a pre-clinic call, the patient is interviewed by a staff member for various symptoms. As much of the visit as possible is performed over the phone and the physician explains that the eye examination in the clinic will be targeted and performed thoroughly but quickly. It's explained that patients and physicians will keep talking to N o medical practice was spared from taking some action in response to the COVID-19 pandemic, but responses varied depending on the type of practice and location. James C. Tsai, MD President, New York Eye and Ear Infirmary of Mount Sinai (NYEE) System chair of ophthalmology, Icahn School of Medicine at Mount Sinai New York, New York As of April 23, according to the New York State Department of Health, New York was considered the epicenter of the COVID-19 pandemic in the U.S., with more than 15,700 deaths and 263,460 positive cases. Dr. Tsai described the atmosphere at New York Eye and Ear Infirmary. "I think the atmosphere has gone from one of fear and trepidation to 'what can we do to meet the needs of the communi- ty,'" he said in early April. "We are the oldest specialty hospital in America, and we were founded in 1820 to meet the needs of the community, which at that time were untreated eye and ENT disease. Now, in 2020, we think we are meeting the needs of the community in terms of the COVID crisis." Many NYEE physicians and staff members have been redeployed across the Mount Sinai Health System hospitals. NYEE is still serving as a specialty hospital and clinic for emergency and urgent eyecare needs of not only Mount Sinai patients but referrals from other practices and health systems in the New York metropoli- tan area, including New Jersey and Connecticut. Dr. Tsai said they have an extensive screen- ing process for patients, conducting a virtual visit before patients even come to the walk-in eye clinic. Prior to the pandemic, Dr. Tsai said the hospital talked about telemedicine offerings, but the focus was still on in-person visits. Since COVID-19 hit, teleophthalmology at NYEE took off. The symptoms of patients are monitored, with surgical patients having COVID-19 testing How different practices responded to COVID-19 continued on page 34

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