The COVID-19 global pandemic is forcing telemedicine-only connections with patients and bringing existing rheumatology research to a standstill. However, these challenges are spurring opportunity and innovation, according to Vaneet K. Sandhu, MD, FACR, RhMSUS, director of rheumatology clinical operations at Riverside University Health System and associate fellowship program director in rheumatology at Loma Linda University Medical Center, Calif. She spoke with The Rheumatologist about how the pandemic is affecting her clinic and research.
Q: How are you and your staff adapting to the sudden changes brought about by the pandemic?
The practice of medicine has changed dramatically in the last four weeks. Although some of our staff are working from remote locations and others are still going to the hospitals and clinics, we continue to work together as a team with frequent telephone and video contact. We have far more virtual meetings than before, and it seems as though we’re actually making more contact with one another than before this pandemic—it’s interesting. Nonetheless, there’s nothing quite like that physical interaction with one another.
Additionally, our division has assisted with establishing an algorithm to manage cytokine release syndrome, a complication that can be seen with COVID-19 infection. With this [project], we have established a biologic stewardship program to promote appropriate use of biologics.
Q: How is your research being affected by COVID-19?
Unfortunately, my research has come to a near standstill. I cannot bring patients in for physical examination, which is key in many rheumatology research studies. Even a video visit, although better, can be limiting.
I have been able to continue telephone follow-ups with patients as needed. But truth be told, the mood and effect of the pandemic has also impacted my bandwidth to conduct research. Despite a hold on my prior research, however, I now seek answers to new questions, particularly the role of our treatments in managing cytokine release syndrome due to COVID-19 infection. So with every closed door opens an opportunity for something more.
Q: What types of appointments are you conducting and what are patients’ chief concerns regarding COVID-19’s potential risks and symptoms?
In our practice, we have spent the past six months trying to set up telemedicine. However, within days of the shelter-in-place orders, we managed to have all services set up. So patients and providers are continuing with their appointments remotely with minimal disruption in care. At this time, we’re doing both video visits, as well as telephone visits, at each of our institutions.