The coronavirus crisis will have a lasting impact on Rhode Island after the immediate danger of the pandemic passes, on both the business community and the health care industry.
That was one of the themes sounded by panelists who participated in Providence Business News’ Health Care Summit on April 1, an event in which panelists participated by web conferencing at separate locations and an audience of about 300 watched at their computers.
Not all of the lasting effects of the pandemic will be negative, according to physicians on the summit panel. COVID-19 is forcing them to change the way they practice medicine, and in a hurry.
One of the few bright spots is the successful adaptation to telehealth, said Dr. Claire Levesque, chief medical officer for commercial projects at Tufts Health Plan. The technology allows patients easier access to medical professionals without violating the stay-at-home advisories state officials have put in place to slow the spread of the coronavirus.
Tufts Health Plan had been looking to get more health care providers involved with telehealth before the pandemic, but it had been difficult because only a small portion of patients were adopting the technology, Levesque said. Now, it’s a different story.
Dr. Edward McGookin, chief medical officer of Coastal Medical Inc., agreed.
‘Telemedicine is now a huge part of our ability to communicate with our patients.’
DR. EDWARD MCGOOKIN, Coastal Medical Inc. chief medical officer
Coastal Medical, which operates numerous offices in Rhode Island, has 110,000 patients. “We have a huge responsibility to keep them informed, keep them connected,” McGookin said.
The practice was in the process of assembling a telemedicine infrastructure for patients, but the initiative suddenly became an urgent priority.
“We had set a real ambitious goal to have tele-medicine capabilities up and running by June of 2020,” McGookin said. “With the arrival of [the] coronavirus, we turned a six-month initiative into a one-week initiative. It’s hard for me to put into words the magnitude of the resources and manpower that had to rally to make that happen.
“Telemedicine is now a huge part of our ability to communicate with our patients in a way we could not have imagined eight weeks ago,” he added.
Levesque and McGookin were joined on the panel by a mixture of medical and business representatives. They were Dr. Terrance Healey, a thoracic radiologist at Rhode Island Medical Imaging Inc.; Dr. Christopher Ottiano, medical director for Neighborhood Health Plan of Rhode Island; Edward Huttenhower, state director for the Rhode Island Small Business Development Center at the University of Rhode Island; and Alicia Samolis, chair of the labor and employment practice at the Providence law firm Partridge Snow & Hahn LLP.
Asked when most of the laid-off workers in the region will be able to go back to work, Huttenhower predicted that it would probably be at least a couple of months. And even then businesses will probably reopen in stages, he said.
Huttenhower said there are resources available for small businesses at the state and federal level, particularly with the passage of massive federal stimulus legislation designed to help the economy weather the crisis.
“It’s an evolving situation,” he said. “We’re not only looking at the situation in the short term but also the longer term. We’re trying to assure business continuity and survival.”
Samolis painted a grim picture of the long-term effects on local commerce.
“I don’t want to be negative, but I see a devastating impact on business,” she said. “When people are ready to go back to their jobs, there might not be jobs to go back to.”
Panelists gave Gov. Gina M. Raimondo high marks for her efforts to slow down COVID-19 in Rhode Island. But they said the real test will come in the coming weeks, when the respiratory disease is expected to peak in Rhode Island.
Ottiano called Raimondo’s approach “appropriately aggressive,” particularly given projections for what could happen if the state, and the nation, did nothing.
“Everything will be graded out on how we mitigate this virus. That’s the key word, mitigation,” he said. “Very early, very consistently the governor and her team put out the message, and continue to put it out, on how our behaviors can flatten that bell curve … we’ll know how we did when we get to the third, fourth week of April.”
Panelists were asked where the state stood as the pandemic runs its course, and whether they felt social-distancing provisions were working.
“I think we’re still on the rising side of the curve,” said McGookin. “But I feel we are flattening the curve. … We will have a surge, but I think we will be able to manage the curve.”
He said he’s encouraged by the efforts Rhode Island’s hospitals have made to prepare, including opening additional spaces and freeing resources by postponing many elective procedures. “Right now, I think we are in a calm before the storm,” he said. “But all the right people are thinking about what will be necessary to do to handle the surge.”
If the need for social distancing and isolation lasts a long time, McGookin said, there will likely be a negative impact on behavioral health. Humans are social animals, he said, and we crave contact. Continued isolation, he added, means depression will get worse, anxiety will grow, domestic arrangements will be strained.
“We are going to need to be as imaginative about behavioral health needs as we are to the medical issues of the coronavirus,” McGookin said.
As for business owners, this is a time of tremendous uncertainty and stress.
Ottiano acknowledged that the same measures necessary to control the virus have had a profound impact on many state businesses.
At a PBN economic summit in February, keynote speaker Thomas Tzitzouris, a director for Strategas Research Partners in New York, said he did not believe the U.S. would face a recession in 2020. The wild card, he said, was the coronavirus, but at that point he was mostly concerned about the virus disrupting supply chains between the U.S. and China.
Times have changed. The world economy is in chaos, the stock market has fallen off a cliff and Rhode Island is being bombarded with an unprecedented number of unemployment claims.
“It’s very hard for employers, because [closure orders] can be so sudden,” said Samolis. “It’s tough because you really don’t know what’s coming.” Initially, she said, employers have been willing to go along with the measures to contain the virus. But if the closures continue for a long time, there is likely to be pushback from both owners and the public.
Samolis said business owners are faced with very tough decisions when they are forced to close down because of the cornonavirus threat, such as whether they should institute layoffs, furloughs or pay cuts. Layoffs, she said, are the hardest thing to do, but sometimes there is simply no other choice.
At the same time, Samolis noted, the increased unemployment benefits provided in the $2 trillion CARES (Coronavirus Aid Relief and Economic Security) Act create an unusual circumstance.
“People are going to be able to collect more from unemployment than they would if they are working,” she said. “That’s a fascinating part of that act. It really does not encourage or incentivize people to work.”
Even businesses that remain open may have to deal with employees who can’t come to work for health or family reasons, which in turn means that the employees who remain on the job must be cross-trained to cover for missing people.
A member of the PBN virtual audience asked what companies should do if employees are afraid to go to work.
Samolis said employers are legally obligated to grant unpaid leave for employees who are at risk because of a disability, such as an immunity disorder.
If the risk is not related to a disability, however, the employee doesn’t “get to just stay home and not work if they’re afraid to work,” she said. But “just because somebody is not legally entitled to stay home, employers always have to weigh what they should do.”
For example, fear in the workplace could lead to an effort to unionize the workforce, Samolis said.
“You might be facing a union if people do not feel safe to come work,” she said. “So, there is some business and legal interest in potentially trying to quell the fears.”
