J Am Board Fam Med
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The COVID-19 (C-19) pandemic required swift response from health care organizations to mitigate spread and impact. A large integrated health network rapidly deployed and operationalized multiple access channels to the community, allowing assessment and triage to occur virtually. These channels were characterized by swift implementation of virtual models, including asynchronous e-visits and video visits for C-19 screening. ⋯ Given ongoing patient interest and opportunity, virtual health care services will continue to be available for an expanded number of symptoms and diagnoses.
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Advance care planning (ACP) is especially important during the COVID-19 pandemic. Previously identified barriers to ACP include lack of time during patient visits, billing, clinician and patient discomfort and lack of resources, and difficulties with documenting and accessing ACP documents. ⋯ The shared risk for COVID-19 that all people face brings urgency to institutional policy changes to ACP form completion. However, research should assess acceptability and effectiveness of these strategies.
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The worldwide spread of the novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic since its identification in Wuhan, China in December 2019.1 Few cases of COVID-19-associated dermatologic manifestations have been reported in the literature to date. This report describes the clinical features of a localized pruritic scarlatiniform rash of the ears and antecubital fossa on defervescence in a 29-year-old patient with COVID-19. Our case stands to further illuminate the dermatologic manifestations of this novel disease.
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In response to the COVID-19 pandemic, many physicians and health care systems have shifted to providing care via telehealth as much as possible. Although necessary to control spread of the virus and preserve personal protective equipment, this shift highlights existing disparities in access and care. Patients without the skills and tools to access telehealth services may increase their risk of exposure by seeking care in person or may delay care entirely. ⋯ Currently, federal programs have given physicians greater flexibility in providing care remotely and have expanded internet access for vulnerable patients to promote telehealth services. However, these changes are temporary and it is uncertain which will remain when the pandemic is over. Family medicine physicians have an important role to play in identifying and addressing these disparities and facilitating more equitable care moving forward.
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Certain members of society are disproportionately affected by the COVID-19 crisis and the added strain being placed on already overextended health care systems. In this article, we focus on refugee newcomers. ⋯ This includes how the clinic has initially responded to the crisis as well as recommendations for providing services to refugee newcomers as the COVID-19 crisis evolves. Recommendations include the following actions: (1) consider social determinants of health in the new context of COVID-19; (2) provide services through a trauma-informed lens; (3) increase focus on continuity of health and mental health care; (4) mobilize International Medical Graduates for triaging patients based on COVID-19 symptoms; and (5) diversify communication efforts to educate refugees about COVID-19.