Curbside Consult with Dr. Jayne 3/9/20

I’m beyond aggravated at the lack of communication from HIMSS regarding hotel cancellations and refunds.

All of the FAQ entries on the conference page say they’ll provide a notice within 14 business days. I called my hotel on Friday and tried to cancel and inquire about a refund, but was told that, “Our GM is handling it and we’ve been instructed not to speak with you.” I emailed the HIMSS refund email address with a formal request instead. (Did I mention I still haven’t received a notification that the conference was canceled?) Today, I was reading Mr. H’s Monday Morning Update and saw the link to an OnPeak refund. Although the link is no longer live, it instructed me to call the hotel directly.

After multiple calls and being rolled over to Marriott’s corporate reservation line, I was at least given a cancellation number, as well as the direct phone number for an assistant GM at the hotel. We’ll see if she returns my call. I’ve stayed at the same hotel eight years in a row and have status with Marriott, so I hope they at least make an effort. I don’t expect a full refund, but anything at all would be appreciated for those of us who pay for our trip to the show out of pocket.

Many of the folks I was scheduled to meet with at HIMSS just rolled our already-scheduled appointments into ones by phone, which made things easy. I’ve decided I’m still going to keep other pieces of my conference schedule, including starting to drink wine, whisky, or other cocktails at 4 p.m. on Tuesday and Wednesday, depending on which vendor events I was scheduled to attend. I’m going to be sure to eat seafood on Monday night in honor of Nordic Consulting’s elegant (but canceled) event at The Oceanaire Seafood Room. Tuesday’s dinner will be Italian in honor of the canceled Citrix event at Maggiano’s, and Wednesday will be contemporary Southern cuisine in honor of Red Hat’s event at Itta Bena. Thursday night I was most likely to be eating some kind of granola bar on the plane while flying home, so I don’t plan to replicate that evening.

I’d like to invite all our readers to participate in my own virtual “Shoe-A-Palooza” and “Sock-It-To-Me” competitions. Send me your photos of the shoes and socks you planned to wear this week and I’ll pick my favorites. Be sure to let me know if you want to be added to the history books using your real name or if I should pick a kicky pseudonym to keep you anonymous.

COVID-19 has made it to my community, leading to considerable angst as patients panic and community physicians struggle to understand how we are supposed to care for patients. The biggest point of contention is the fact that we can’t even protect ourselves. Outpatient physicians who aren’t employed by big health systems have either no access to simple surgical masks or access that is intermittent at best. An informal survey of close friends reveals that 10 out of 10 of us don’t have access to gowns.

I’ve had to call the state epidemiologist several times for suspected patients. It’s an arduous process that hasn’t led to testing for any of the patients involved. Due to the shortages, we can’t care for flu patients properly by having them wear a mask when they’re diagnosed, which might be contributing to a bump in flu in our area despite numbers from the CDC that it should be waning.

I never thought I’d have to start thinking about whether to quarantine myself when I come home from work, emerging from my room only to run out the door and head to the office. I’m fortunate in not having small children or childcare issues. Many of my physician peers are struggling to figure out how they’re going to be able to see patients if more schools close. Right now it’s just a handful, but only time will tell.

It’s unclear how the recently-passed $8.3 billion in funding will impact the efforts of frontline providers. I’m monitoring news sources from across the country as well as around the world to see how our local response compares to that of others. Kudos to the Washington Post for offering free access to their articles covering the novel coronavirus. You have to subscribe to an email newsletter to get the access, but it’s good to have multiple sources of information. I’m heartened by the decision of some insurers to cover coronavirus testing, but the devil will be in the details as far as how it actually works out. Some payers are considering policies to waive co-pays for testing, but most patients won’t know how their coverage is until they get the bill.

In positive news, the CDC’s Advisory Committee on Immunization Practices voted to recommend a pre-exposure vaccine for the Ebola virus. It’s at least some comfort for the healthcare providers who work at federally designated Ebola treatment centers in the US, for those who work at Biosafety Level 4 labs, and for the genuine heroes who volunteer to respond to Ebola virus outbreaks across the globe. The single-dose vaccine has been shown to be 100% effective when used in a ring vaccination strategy, which basically means that everyone socially connected with a patient within 21 days of their illness must be vaccinated. Ebola virus outbreaks have taken a back seat to COVID-19, but the virus is still classified as a “public health emergency of international concern” in the Democratic Republic of the Congo.

The focus on vaccines is also good news for biotech firm Moderna Inc. whose experimental coronavirus vaccine is being tested on a small group of adults. The study is only a test of the safety of various doses of the vaccine and whether the subjects produce an immune response. Actual vaccines are likely to be more than a year away. Participants will receive two vaccines over the course of a month and will have to complete 11 face-to-face visits and four phone visits during a 14-month period. Those completing the entire trial will receive $1,100. I would say the real value of participation is priceless, should the vaccine progress to a full recommendation. My medical school is also working on vaccine research, so I’m eager to follow the developments.

I’ll be reporting later this week on my at-home virtual HIMSS efforts, so be sure to send those shoe and sock photos along. I’ll be glad to have something else to focus on than the reality of counting the days until I’m personally exposed to COVID-19.

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