Workplace in Focus Podcast Episode 3 Transcript

A candid conversation on the growing surge of the COVID-19 pandemic in Arizona

ANNOUNCER: You have COVID-19-related workplace questions. Banner|Aetna has the answers. Welcome to Banner|Aetna: Workplace in Focus. 

Now here’s your host Banner|Aetna Market Head of Sales, Jon Dingledine. 

[Jon Dingledine] Welcome everybody to this week’s Banner|Aetna Workplace In Focus. Today were really excited to have Doctors Ed Clarke and Rob Groves to talk about all the recent developments we’ve seen here in Arizona around COVID-19. We felt this was a very important session to have, because there’s a lot of important information that is, that is out there, and needs to get out there. And we want to make sure that we provide clarity to all our listeners. So first of all thank you for joining. Before we get into the questions, I’d like to ask Dr. Clarke and Dr. Groves to introduce themselves. So, Dr. Clarke we’ll start with you. Tell us a little bit about yourself and your role at Banner.

[Ed Clarke] Thank you. My, my name is Ed Clarke. I’m the chief medical officer of the Banner Insurance Division, and our Banner Health Network of physicians. So I help the Banner Health system, and our line providers really bring value-based care to those members and patients in our markets.

[Jon Dingledine] Ok great. Dr. Robert Groves is also on the line. Dr. Groves will you tell us a little bit about yourself

[Robert Groves] Sure, hi my name is Robert Groves, and I am the Chief Medical Officer for the Banner AETNA joint venture. And what that means is I sit between the payer and the provider if you will or sit in the middle of that collaboration. And so my job really is to understand both sides of the equation and try to integrate and collaborate with both teams to deliver something that is better and more efficient and higher quality in the state of Arizona.

[Jon Dingledine] Great. Thank you very much for that. Let’s start our questions with Dr. Clarke. Dr. Clarke what is Banner doing to address potential issues in capacity due to COVID-19?

[Dr. Clarke] Great question. So with Banner’s footprint in Arizona and really being the largest provider of healthcare in the state we have to do a lot to make sure were prepared to help out. 

The first thing we have to do is understand really what the current situation is on the ground, not only statewide but locally. We have teams that keep a very close eye on the number of cases diagnosed in the state, where those are and having a sense of which facilities might be at capacity. And so we are working with the physicians leaders of all the other healthcare systems to make sure were helping each other out in that. 

So the second part of that is understanding what our internal capacity is to take care of these patients. So we've had great folks in both the IT and Informatics teams have created a number of dashboards so we can’t rack all of the relevant metrics at all of our hospitals across the state to realize what capacity we have. So an example of this is understanding first how many patients are in the hospital at all, how many of those have COVID, or how many of those are suspected to have COVID, and most importantly is understanding how many ICU beds we have to take care of those folks. 

And then the last part is how many ventilators do we have. That’s a very important statistic, because if we don’t have enough ventilators to care for these folks um given that many of our COVID patients do need that level of care. Then that would put is a really rough spot, so it really nice we have a team developing those tools, so we can kind of had an Air Traffic Control you know of what’s going on. So once we have a sense of the statewide demand, and what we can offer, we then really work on the ground at our hospitals to have our teams be the most efficient. 

So we do have sections of the hospital that are COVID only wards where we take care of only those patients with a diagnosis or suspected diagnosis. That’s really important, because we don’t want to expose patients without it to the folks in that area. And secondly, there’s different protocols that we have to do in those wards regarding wearing of the PPE to keep our teams safe, and also different staffing ratios are needed, because these patients are very sick so there’s a higher level of both physician and nursing care that, that we need in those areas. It’s very important that we have enough of those wards at each site. 

Also we have to make sure that we have plans in place to know that as capacity increases beyond 100%, looking at 125% and 150%, what the next stage can be. And so were looking at how do we kind of convert other parts of the hospital where we traditionally don’t have patients to be those patient care areas. So very important work there, and all the hospitals in the state are doing this with us. Also I’d like to say one of the things that we do is we want to create capacity on the backend as well. So we are looking at lots of different technologies, and are actively launching these now. So patients who might have just met the criteria to be in-patient status or admitted to the hospital. We now can monitor them at home with home monitoring technology, which could include us having a remote team us things to make sure were keeping a good look at their oxygenation levels and constant contact with them with video monitoring and other things. So that we could take care of them safely at home while creating space in our facilities. So lots of really great work is happening with our teams. 

So now I’m going to pivot real quick to talk about even more on the front end what we’re doing as were working with our PCP’s and the Banner Health Network to really make sure that they have telemedicine capabilities stood up, because what we would like is to have is as few patients go to the hospitals, the emergency room, for suspected COVID diagnosis. And so if patients know that they can visit with their provider in the comfort of their home on telemedicine that could potentially prevent them from getting exposed to COVID illness if they go to an emergency room. So were really pleased that 90% of our physicians in our Banner Health Network offer a telemedicine capability. And also we have some other technology partners through Banner AETNA who are also rendering virtual care. Lots of great work going on this space to make sure that were up to speed and able to render care for our members.

[Jon Dingledine] Thanks Dr. Clarke. There’s definitely more moving parts that I know you and your teams are juggling every day. Certainly more than I realized, or can even imagine, and I’m sure many of our listeners are in the same place as well so it’s great information for us to be more aware of. Obviously we want to do is as Arizonians everything we can to try and stay out of the hospital. So I’d like to move to Dr. Groves, and Dr. Groves can you explain to our listeners why it’s so important to wear a mask.

[Dr. Groves] Yeah thanks Jon, I appreciate the opportunity to address that issue, because the evidence is mounting that wearing a mask makes a difference. It makes the biggest difference when everybody wears a mask, and the reason that's true, it’s because masks trap and knock down some of the particles we emit when we cough, sneeze, laugh, or even talk. There’s evidence that even breathing can create some particles. Those sorts of things can spread the virus quickly in an environment where no one has their face covered, everybody’s vulnerable. 

Now the reason this is traditionally important with this virus, is because transmission occurs in asymptomatic individuals. That really is important. These folks are walking around, don’t even know that they’re sick yet. And so may not be aware that they need to stay home. But if you got a mask on and you’re sick, you’re much less likely to transmit the virus to others. The only way, on a broad scale, to protect ourselves, given that many of the folks that have this disease are asymptomatic, is for everyone to wear a mask and we've seen this work with other countries, other respiratory diseases, and there’s even physical evidence. You know I read this paper the other day, that when you wear a mask, if you have the illness, not only does it knock down large particles but even the micro particles are impaired, instead of falling six feet from the individual is about, its one and half feet from the individual. So you can see how logically if you have an asymptomatic infection and you're wearing a mask your far less likely to pass the disease along to someone else. 

It's a gesture of taking responsibility for yourself really not to affect other people, and perhaps even cause unnecessary death. That's really what we're talking about. I mean I hope you are hearing from a variety of sources almost every day: wash your hands, use hand sanitizer if your hands aren't directly soiled or don't have soap handy, stay at least six feet away from people, at least, wear a mask, I mean all of those things are important in controlling the spread of the virus. Now those are the specific things we can do to minimize the risk of unnecessary death in Arizona.

You just heard from Dr. Clarke that all kinds of contingencies are in place, and that’s because the spike is still rising. Now plans are in place to address this trend, and were hard at work across the system but every single person in Arizona, we want you to do your part to help us slow this down so that we can have enough resources to take care everybody and we don’t have any unnecessary deaths.

[Jon Dingledine] Ok great thanks Dr. Groves. That’s certainly helpful to understand that and that’s great information. I appreciate your thoughts on that. One of the things I’ve heard about is flu shots. Here we are talking about COVID and flu shots and for me it was confusing about why flu shots are important so Dr. Groves I’ll just continue to direct this to you. Why should our listeners get a flu shot?

[Dr. Groves] Yes, there’s some confusion around this. First of all let me point out that a flu shot will not protect you against COVID. Well why should I get one? Well in the flu season we hear that a lot of people get the flu. And there’s some of those people, behind the scenes, you may not hear about this much and it’s a little hard to predict, but some of those people end up being hospitalized, and it varies from year to year depending on how severe that specific flu is. Now if they need hospitalization and with the numbers that were already seeing with COVID-19 we don’t want to have a wave of influenza on top of this COVID-19 pandemic. That could create a real problem. The influenza wave would increase the number of patients who are ill and critically ill in the same way as many COVID patients. We had a flu season just a few years ago that put a lot of folks on a ventilator, and this is especially important during this pandemic when ventilator usage is critical. You know were needing to use a lot of them for COVID patients, and so we don’t want any other people, we want to prevent every episode of flue that we can is the bottom line. We need to take one player out of the mix as best we can. The best way to do that is for everybody to get vaccinated against the flu. Now you’ve heard about this interest in developing a vaccine for the coronavirus. Why is that? Because if you can give enough people protection against either virus then it can’t spread anymore, because its bumping up against people that are not susceptible. The R Zero, the number of people that one individual can infect them, starts to go down and if that number goes to less than one, then that particular episode of influenza will peter out and the other thing would complicate is testing. Now we have to figure out, because they’re so similar, who has the flu, who has the coronavirus. He treatments are slightly different. Now I know that we’re just starting to learn about treating coronavirus, but we do know a little about helping with the flu. And there are medications that can help with that. Having to separate those out, and figure out who has what adds another layer of complexity to what is already a very complex situation in our hospital, in our intensive care units, and even in our primary care clinics. So it is critically important that we eliminate every episode of influenza that we can, so that we can focus on the pandemic and getting that right.

[Jon Dingledine] Thanks Dr. Groves. That’s certainly helpful in connecting the dots and makes sense, so I appreciate your thoughts on that and laying it out as you did. Let’s go back to Dr. Clarke. Dr. Clarke what happens if we don’t comply? What’s the impact on the healthcare system?

[Ed Clarke] Great question and a very important one. So in the short term, given that were already at 90% capacity, if you look statewide at our ICU’s. It puts in a really tough spot if we continue to see the cases go up and then to not having enough room for folks in our hospitals. In the short term, it’s very important for folks to wear a mask, socially distance, do all the things that Dr. Groves said. And then building upon the discussion around flu shots which is a bit longer term. And again a rough Flu-C Season which in itself has folks be admitted to the hospital to take care of them for flu related illness. If you add that on top of an already taxed system dealing with COVID positive patients. Again where does that concern that we won’t have enough space for these folks. It’s very important for everybody to consider these things seriously so that we as a healthcare system make sure we have space to take care of those who are most in need.

[Jon Dingledine] Ok. Great, thank you very much. That was our last question. I really just to thank Dr.’s Clarke and Groves. There’s so much information out there that people have access to. I think this has gone a long way in clarifying certain aspects of how we think about COVID and how we think about how we can care for ourselves and for others. So, thank you both. Very good information. I want to thank everybody for tuning into this episode of our podcast, Banner AETNA Workplace in Focus. Our goal with these podcasts is to bring you current, relevant, and actionable information. Right now its COVID-19. Down the road well certainly bring other topics of interest, and hope that you will continue to tune in.

[Announcer] You’ve been listening to Banner|Aetna Workplace in Focus. Learn more at banneraetna.com.