While hospitals around the country are dealing with spread of the coronavirus, a pair of small practices in the region have been keeping a close eye on the pandemic as it unfolds.
Siobhan Benham, owner of Hearthside Family Health in Peterborough, knew she needed to be prepared for anything that might come up with her patients. Three weeks ago, Benham saw her shipment of testing kits for the coronavirus get delivered.
As of Friday, Benham had administered less than 10 tests and all those tested had shown symptoms and a “pretty good history of potential exposure,” she said, through travel out of state or visiting high incident areas. Of the tests, Benham has received just one positive result of COVID-19 where the patient had reported symptoms of cough and fever.
In order to give the tests, Benham meets her patients outside her Grove Street practice, fully garbed, and conducts the test in the parking lot without the patient getting out of the car. She checks their temperature and oxygen levels before getting the swab to be sent out for processing.
While she has suspended in-person visits, her goal is to get the tests done as quickly as possible so the patient can return to self isolation.
“It’s just trying to keep people who are sick at home,” Benham said.
If there is enough concern for a test, Benham said she will assume the results will come back positive.
“Just making sure we identify what this is,” she said.
Benham said she ordered a modest amount of tests through Quest Diagnostics, the laboratory company she works with, and getting the tests not an issue. As of Friday, Benham still had testing kits available for patients.
As more laboratories have become available to accept COVID-19 tests, Benham is hoping to see faster results. She said that she is able to classify a test as urgent, which places more immediacy on the turn around times.
One thing that has made testing easier is the direct primary care model, where patients pay a monthly subscription, avoiding the need to involve insurance companies.
“We don’t have to worry about how to bill it,” Benham said.
In an unfortunate turn of events, Benham had been behind in ordering supplies and then the pandemic hit making it harder to find the necessary stock that is needed to safely administer care. But her patients stepped up, dropping off gloves and masks, including homemade ones.
She has received a number of concerned calls over the last few weeks and Benham has been educating patients on symptoms, testing options and when to start discussing a trip to the hospital. She has heard about a number of different symptoms, including fatigue and GI issues, which hasn’t been publicized as much as a cough or fever.
“It can be really hard to decipher,” Benham said.
Ruth Galbraith, owner of Granite State Natural Medicine, first inquired about testing kits on March 13, but had no luck – not much of a surprise with a national shortage. Galbraith recently said that no patients had called with symptom concerns or requested testing, “but any patient needing to be tested based on CDC guidelines would not come to my office. I would send an order to Monadnock Community Hospital or Cheshire Medical Center Emergency Departments, and they would conduct the test.”
She said most patient visits in the past few weeks begin with a short discussion of patients’s stress around the topic and how much life has changed. Galbraith said some patients have stated they wonder if they have had a mild case of COVID-19, but none have reported any serious or concerning symptoms.
Galbraith said she switched all patient visits to telemedicine since March 17, “out of a desire to flatten the curve of the pandemic, and in conjunction with Governor Sununu’s orders.”
Galbraith said first and foremost, adhering to public health guidelines of washing hands, social distancing, etc. is the best form of prevention.
“We all know that nothing is known to prevent, treat or cure COVID-19 as a novel disease. But naturopathic medicine has a rich toolkit for providing supportive care to patients. We have strategies to support the immune system, protocols to mitigate symptoms in upper respiratory tract infections, and approaches for helping the immune system fight off other, known, viral infections which may be helpful with COVID-19,” Galbraith said.
But at the same time and more importantly, she said that people’s normal health concerns haven’t stopped during the pandemic.
“People still have chronic diseases, pain, and now more than ever possibly heightened anxiety and/or depression. Naturopathic doctors play an essential role in continuing to see patients on all these fronts to keep people out of the hospital,” she said.
Galbraith said she first started paying attention to reports out of China in February and began to consider the need for telemedicine after reports of deaths in Seattle at the end of February. The decision to switch to telemedicine came after Gov. Chris Sununu issued his emergency order ensuring insurance companies would cover telemedicine visits.
And when it comes to advising her patients of best practices, Galbraith said she is referencing the CDC guidelines.
“The absolute most important things people can do during the pandemic are: stay home, wear a mask if you need to go out in public, observe social distancing guidelines, and wash your hands with soap and water frequently,” Galbraith said. “Aside from that, strategies for managing stress, getting enough sleep, remembering to continue to eat well and move your body are at the top of my list right now. I’m sharing online resources for yoga with many patients, as this is a wonderful way to lower stress and prevent pain associated with the less active lives many of us are living, currently. I’m giving individualized ideas for supporting the immune systems of my patients. These are different, depending on a person’s underlying health conditions, so they cannot and should not be made into a generalized list of suggestions.”
Galbraith also wants to ensure her patients are not self-medicating with anything.
“That’s why I’m still available through telemedicine, because any approach, any recommendation should be customized to the patient’s specific healthcare needs,” she said.