Recovering From COVID-19

An innovative new program treats lingering symptoms.

For many COVID-19 patients, “getting better” is a long journey. “This is a new disease and our understanding of it is still developing,” says Stephen Zieniewicz, President and CEO of Saint Barnabas Medical Center (SBMC). “We are seeing patients who are experiencing ongoing health and behavioral impacts. Family members have been deeply affected as well.”

To meet these needs, SBMC has created the Post-COVID-19 Comprehensive Assessment, Recovery and Evaluation (CARE) program. CARE is designed for patients who are still having symptoms four or more weeks after a positive COVID-19 test, says Vanessa Trespalacios, MD, RWJBarnabas Medical Group provider and CARE Program Director.

At the forefront of post-COVID-19 care: Stephen Zieniewicz, President and CEO of SBMC, with Vanessa Trespalacios, MD, Program Director, and nurse navigator Christina Davis, RN, CCRN, at the CARE offices.

ALL SPECIALTIES AT HAND

“Weakness and fatigue are common lingering symptoms of COVID-19, but we are hearing from patients with many different symptoms—pulmonary, cardiac, neurological. We’re also hearing about cognitive changes, such as ‘brain fog’ and lapses in memory,” says Dr. Trespalacios. “In many cases, patients’ primary care providers have become a little bit frustrated because patients have continuing symptoms that they can’t find a successful treatment for.”

Physicians involved with the CARE program have worked intensively with COVID-19 patients and have become, in effect, specialists in the field. “We’ve been spending these months consulting with other doctors from all over, reading reports and case studies, and gaining experience in treatments,” says Dr. Trespalacios. “You learn things as you go along—for example, one medication that works better than another for cough, or when the best time to begin steroids is.”

In addition, CARE patients have the advantage of being connected with SBMC’s and RWJBarnabas Health’s vast range of specialists. “Because we are such a complete system, we have excellent providers in multiple specialties,” Dr. Trespalacios explains. “We have their commitment that they will be able to accommodate our patients in a timely manner.”

Many of those specialists, as well as other services, are in the Barnabas Health Ambulatory Care Center at 200 South Orange Avenue in Livingston—the same place where the CARE program is located. “We have a full physical therapy and occupational therapy department right in the building, as well as a pharmacy and full radiology department,” Dr. Trespalacios says. “Patients will be able to get most of their testing in the same place, with visits to subspecialists in other locations as required.”

HOW IT WORKS

Knowing that complex medical care can be intimidating or confusing, the CARE program has a nurse navigator in place to guide patients. “As soon as a new patient calls, the nurse navigator will reach out to assess whether they are eligible for the program,” says Dr. Trespalacios.

To qualify, a patient must have a documented positive COVID-19 test. The nurse navigator will also take a thorough health history.

If the patient meets the requirements, he or she will receive a call from a clinical pharmacist to go through every medication taken, what seemed to help and what didn’t. “All of this happens before a patient even steps foot in the office,” says Dr. Trespalacios.

At an initial visit, a patient will receive a thorough physical, including checking strength and reflexes for any neurological deficits. “Further tests will be done depending on the nature of the complaint,” she says. “Even if you’ve had X-rays or cardiac tests in the past, it’s never a bad thing to have a second set of fresh eyes take a look.”

EMOTIONAL AFTERSHOCKS

For post-COVID-19 patients, mental health issues can loom large. “I knew that Behavioral Health was the number one service I needed to make sure I had a commitment from,” says Dr. Trespalacios.

Many survivors suffer with a form of post-traumatic stress disorder, she explains.

“Imagine if, in the middle of a pandemic, you had to be intubated and be in the ICU for three weeks, without being able to see loved ones,” she says. “As good of a job as healthcare workers do, they are in full personal protective equipment, masked up, and all you can see are eyes. Patients often ended up with anxiety disorders stemming from this traumatic experience.”

Other survivors struggle with grief. “One man who was sick had a wife who had to go to the ICU and a son who also had to go to the ICU, who later died,” she says.

“He is now suffering significantly from depression because of this loss. There are many patients like this. You can’t imagine what they, and their families, have gone through.”

“We knew this was a necessary resource and program to have for patients and their families,” Zieniewicz says. “This service is available to anyone in our community who has had COVID-19. Our doors are open to all.”

To learn more about the Post-COVID-19 CARE program at the Barnabas Health Ambulatory Care Center, call 888.COVID94, visit www.rwjbh.org/covidcare or email postcovidcare@rwjbh.org.