ChesterCountyMedicineSummer2020 - 27

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Brian called the Chester County COVID-19 hotline in April
because he was experiencing frightening symptoms. At the time,
COVID-19 testing was available only through a physician referral.
He had no insurance and no primary care physician, so he was
directed to CVIM. After telehealth triage confirmed he needed
testing, we referred him to a test site at one of our hospital
partners. Brian tested positive for COVID-19, had a rough week at
home, and has since fully recovered.
CVIM patients are more vulnerable than most of us during
this pandemic, and at-risk for more than just COVID-19. Our
patients struggle to stay healthy and make ends meet even without
the extra stress of a global pandemic and the resulting economic
downturn. Many patients work in the service industry, and have
lost jobs, and very few had the opportunity to work from home.
They have no savings and some of them will not be eligible for
unemployment insurance or other government payments. Others
are deemed essential workers and must continue to work despite
risking exposure to the virus.
Cynthia came to CVIM to pick up her prescription refills.
Living with diabetes and hypertension, she needs maintenance
medications to stay healthy. Cynthia is raising her young
grandson, and is recently unemployed due to the COVID-19
pandemic. This time, she needed more than just her meds. Dr.
Mary was able to give her a grocery gift card to help feed the
family, and a thermometer in case someone at home gets sick.

The COVID-19 pandemic has lots of us feeling unsettled.
People diagnosed with anxiety and depression are especially
vulnerable right now. While counseling, talk therapy, and
psychiatry are traditionally conducted during in-person
appointments, CVIM transitioned to telehealth appointments for
ongoing care immediately after social distancing practices began. It
is important to our patients and aligned with our comprehensive

healthcare model, that
individuals who need behavioral
health treatment continue,
without delay, to have access to
their caregivers through virtual
appointments.
Soledad, CVIM's bilingual
Behavioral Health Coordinator,
works with volunteers to provide
remote counseling and treatment
to patients via phone and video
chat. "Telehealth for behavioral
health appointments has proven
to be very effective. We need
to recognize the psychological
impact of the COVID-19
pandemic, and the importance to engage with our patients during
uncertain times. We have patients that have a long history of
anxiety and depression and they are at higher risk at times like this.
But even people who don't generally struggle with this are expected
to develop psychological symptoms due to stress and reduced
autonomy, as well as concerns about income, job, security and so
on. This is why telehealth is key at a time like this."
A Behavioral Health patient tells us that during this time
"having someone to talk to has been really good." They "feel a lot
better, are very grateful, and it's a wonderful opportunity" to have
telehealth behavioral health appointments during these stressful
times.
CVIM has been here to provide essential health services so
that our patients can remain healthy and informed during the
COVID-19 pandemic. This includes the 40% of our patients
who have been diagnosed with a chronic disease that requires
careful attention and ongoing management. Diabetes education,
treatment, and counseling has continued with our bilingual
Diabetes Care Coordinator and volunteer endocrinologist seeing
patients via telehealth. In addition to lifestyle modifications, most
chronic disease treatment plans include ongoing maintenance
medications. The CVIM dispensary continues to be busy during
the pandemic, dispensing free medications that enable chronic
disease patients to stay healthy and avoid an acute health crisis that
might lead them to the emergency department.
Miguel was a new patient to CVIM at the start of the year,
after being referred by a family member. He came to us because
he wanted help managing his diabetes like his brother. He works
as a truck driver and drives four days per week to and from
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