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A monthly exploration of the many benefits available to you through your TRICARE health plan.

The Doctor Is In offers tools, information and resources focused on topics that are trending and may be affecting you and your family. Your TRICARE health benefit is robust – and we want to make sure you take advantage of everything your benefit has to offer. 

December 2022

Written by Dr. Joyce Grissom, HNFS Chief Medical Officer

 

The holidays are here, and the nip of winter is in the air. It is the season of hope, joy and respiratory illness. So, let’s see “what’s shakin’” this respiratory illness season and what each of us can do to participate (or better yet, to not participate) in it. This year we are visited by three ghosts of respiratory illness past, specifically respiratory syncytial virus (RSV), the ever-popular flu, and of course COVID-19 (2022 version). Unlike polite guests that come one at a time, these ghosts are making a party of it and have shown up all at once. Add to this a post-COVID shortage of health care workers, we go into winter with the health system we have, not necessarily the health system we may need.

The U.S. health care system is like a subway car in Washington DC. Most of the time it is convenient, clean, and much better than parking on the street downtown. During rush hour, however, when there is no more room on the train, the pushing and shoving starts and the idea of convenient, comfortable public transportation kind of evaporates. This is what’s happening to hospital beds and emergency departments this time of year. 

When we or our children are struggling to breathe, we want to go to an antiseptic, well-lit place where efficient, unhurried, compassionate people can diagnose us and render excellent care, such as an emergency department. But when too many people have the same (and completely appropriate) idea at one time, emergency departments become overwhelmed. In November 2022, we saw headlines like:

“Pediatric hospitals short on beds as respiratory illnesses surge among children” and 

“RSV, covid and flu push hospitals to the brink — and it may get worse” 

At one time, the idea of our health system becoming overwhelmed and ineffective was unthinkable. We live in the greatest country in the world. Unfortunately, we have seen this replay during COVID surges over the past three years. If COVID is “over” and everything is “back to normal,” health system capacity shortages should be a thing of the past. But that is not the case. 

After the stresses placed on our medical facilities and staff these past few years, many health professionals retired or moved away from bedside medicine. We are not short beds or ventilators, but our health system capacity has shrunk like an all-cotton T-shirt in the hot cycle. Post-COVID, there’s a limited number of health care workers to staff inpatient and critical care beds. According to a recent article in the Washington Post,

“More than half a million people in the health-care and social services sectors quit their positions in September — evidence, in part, of burnout associated with the coronavirus pandemic — and the American Medical Association says 1 in 5 doctors plan on leaving the field within two years.”

We each need to do our part to protect hospital emergency department and inpatient capacity. 

Rules for the road:

  1. Don’t get sick. Get your flu shot and COVID boosters. If you have an infant at high risk for RSV, talk to your health care provider about the drug palivizumab, also known as Synagis. While not a cure, according to the Centers for Disease Control and Prevention (CDC), Synagis can help prevent serious RSV disease in children who don’t already have serious RSV. Keep a reasonable distance from people and remember that if you are at high risk, masks are good to avoid all kinds of respiratory illnesses. 

  2. Consider your care options. If you are ill or injured, the least intensive level of care may be appropriate. This means, home test kits for COVID, virtual visits with your primary doctor or urgent care centers, or use of other telemedicine options. COVID 19 and flu both have oral treatment available for high-risk patients when diagnosed early. This can shorten your illness and keep you out of the hospital. Before heading to the emergency room, consider whether you really need that level of care. The MHS Nurse Advice Line offers 24/7 options for getting health care advice.  

  3. If you are sick, don’t share with others. Isolate as much as you can for a few days at home. Do not go to work while ill. Catch up on your binge-watching on Netflix instead. Wear a mask if you are at day 5-10 post COVID, per CDC recommendations.  

  4. If you have a true emergency – threat to life or limb, such as chest pain, shortness of breath, sudden onset of neurologic symptoms, significant blood loss, etc. – call 911 or go to the emergency room. Trust that your fellow citizens will have saved you a space. 

During the winter, there are still heart attacks, car accidents, and people diagnosed with cancer. Just as previous generations used ration cards and grew “victory gardens” during World War II to ensure our troops had what they needed to win, we need to consciously do our part so people who urgently need hospital care have access to it.  

Wishing you a happy and healthy holiday season. 

 

 

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