Dr. John Destito sees his fair share of patients who are worried they might be infected with the coronavirus that’s upending life around the globe.
They have a cough, sometimes a fever or a sore throat, much-publicized symptoms of COVID-19, the illness caused by the virus. Except, in an overwhelming majority of the cases, it isn’t that.
“People are still getting strep throat and bronchitis and the flu, which can seem very similar to coronavirus,” said Destito, who’s handled a handful of suspected coronavirus cases at the American Family Care center in Buckhead. “One thing we’ll want to do is rule out the flu, or rule it in.”
In normal times, American Family Care and other urgent care clinics are exactly where people would go to get treatment for conditions not serious enough to warrant the services of an emergency room, but too pressing to await an appointment with a primary care doctor.
But these days in metro Atlanta, the way urgent care centers operate has been upended too.
Many are turning away anyone with potential symptoms of virus, while acknowledging that, in a lot of cases, the person may be suffering from a cold, the flu, seasonal allergies or a number of other mundane ailments.
They are prescreening patients to stop potential COVID-19 sufferers at the door. Or, better yet, in the parking lot.
Urgent care centers are trying to protect the other patients who come in with cuts, sprains and a host of non-coronavirus related ailments, said Laurel Stoimenoff, CEO of the Urgent Care Association.
Ironically, the facilities are seeing fewer of those patients, too.
"Everyone is afraid to come in because they worry they might catch it," said Dr. Anthony Ferrara, owner of two Atlanta Urgent Care facilities.
Also, because people are spending more time at home, they are less likely to get hurt in the kinds of accidents that bring people into urgent care centers, said Ferrara.
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At the same time, many patients seeking routine care at urgent care facilities are being asked to postpone non-emergency appointments as clinics try to limit the number of people in their waiting rooms and increase cleaning and sanitizing.
Patients sometimes are asked to make an appointment, instead of walking into a center as they normally would, so they can wait at home until their rooms are ready. That also provides the center with a heads up if a patient is potentially sick with an infectious disease.
It’s all quite a departure from business as usual.
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The country’s urgent care clinics handle about 122 million patient visits each year, or about 23% of all primary care visits and nearly 13% of all outpatient physician visits, according to the Urgent Care Association.
Georgia has 310 urgent care centers. Traditionally, fevers and upper respiratory infections are among the conditions they treat most often.
Of the facilities that are seeing patients with respiratory symptoms, patients often enter through separate doors from the general public, according to Stoimenoff. They are then moved immediately to exam rooms.
At Piedmont Urgent Care by WellStreet, which has several of locations in metro Atlanta, patients with fever, cough, cold and sore throat are being screened in their cars and kept out of clinics. On its web site, Piedmont Urgent Care by WellStreet says some clinics may close.
Other centers, Stoimenoff said, are making use of video telemedicine services.
The majority of people with the infection can safely recover at home by treating the illness the same way they would a common cold – plenty of rest, fluids and over-the-counter medications, the Georgia Department of Health says. So that’s the advice many urgent care centers have been giving to those who may have symptoms of COVID-19 — stay at home.
That’s not because the centers don’t want to help or to ease worries, said Stoimenoff. They sometimes aren’t equipped to help, she said.
Many don’t have enough of the necessary protective gear, and they don’t have COVID-19 tests. According to the latest guidance from public health experts, testing is prioritized for hospitalized patients, health care workers, first responders, those working in longterm care settings and people living in congregate settings where the disease can spread quickly.
Without testing, it can be difficult to distinguish COVID-19 from other illnesses, like the flu.
People should go to a hospital if they think it’s an emergency, but the Centers for Disease Control and Prevention says call first. “Emergency warning signs” for COVID-19 include difficulty breathing or shortness of breath, persistent pain or pressure in the chest, and bluish lips or face.
Ferrara is providing telemedicine appointments for patients with symptoms and he is also providing virtual appointments for other patients who want to avoid medical care settings.
CVS MinuteClinics are no longer accepting walk-in patients; all patients, even those problems not related to coronavirus, must make an appointment online. CVS, which has 1,000 urgent care clinics across the country and 46 in Georgia, also has started screening patients before appointments either by phone or outside the store.
Meanwhile, Destito believes American Family Care, after undergoing multiple training drills over the years, is well-prepared for a pandemic like this.
And, he said, he feels confident his facility in Buckhead can and should care for patients, even if they are sick with COVID-19.
The clinic currently has an adequate supply of equipment and masks, he said. Special sanitizing protocols are also in place. Patients with respiratory symptoms are given a mask as soon as they enter the clinic.
Seeing patients in person allows him to offer guidance and reassurances, Destito said, not advice over the phone.
“There is nothing like old old-timey doctor who can listen to their patients,” he said, “and we are happy to do it the old-fashioned way.”
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