The attached graphic illustrates the “series of aftershocks” with which me must contend as we move forward in our response to #COVID-19.

To mitigate the impact of interrupted care in chronic conditions as well as deferred care for acute conditions, I have begun a virtual network among area physicians using the Slack platform which they have kindly donated to this effort.

Our usual referral patterns most typically performed in a “curbside” manner or via direct referral for an office visit are now impacted. My goal is to create a network encompassing primary care and specialty physicians so that we can share data,impressions and formulate a clinical plan in these challenging times. Organizing these efforts as ‘threads’, the Slack platform will allow multiple providers to work together on a single or multiple cases. We may not even yet be aware of the individual and creative resourcing for clinical evaluation, testing and data interpretation that are out there.

There is ample evidence that typical case load of both acute and chronic illness is not being observed at the hospital level. This perhaps due to patients not wishing to overload the medical system or out of concern of contracting coronavirus in a healthcare setting. For those of you who do not follow Dr. Bob Wachter (@Bob_Wachter) on Twitter, I highly recommend his nightly updates from @ucsfhospitals. He wrote the following 4 days ago: “Still headscratching re where other patients went: typical night shift=20 admits, last nt < 3. I’m glad but v. worried there’s a powderkeg of illness out there that will reveal itself.”

I am hopeful that a virtual network such as this will be helpful in softening the impact of this 3rd wave on our healthcare system. Please message, email or text me if you would be interested in joining – hopeful that both generalists and specialists will find this useful.