By Richard Rourk
Ballad Health is already at work getting ready for the next phase of the ongoing COVID-19 pandemic.
Ballad Health’s team members and physicians have worked tirelessly to care for everyone in the Appalachian Highlands who has contracted the novel coronavirus (COVID-19).
In its latest undertaking, the healthcare system is shaping what care for those patients may look like as they continue their recoveries. At a news conference on Monday, April 5, Ballad Health announced its new Center for Post-COVID Care, an innovative approach to COVID-19 care that creates an access point to comprehensive clinical care for patients who are struggling with post-COVID symptoms.
Currently in its initial phase, the center operates as a virtual care model where a navigator is assigned to patients with long-term symptoms and coordinates between primary and specialty care providers across a range of services, including pulmonary rehabilitation, behavioral health, cardiovascular care and support groups.
“Since the first cases of COVID-19 were diagnosed in this region, we’ve learned a great deal about the virus – how it spreads, how to treat it and how to prevent it. However, there’s still much we don’t know, including the long-term effects of COVID-19,” said Ballad Health’s Chief Operating Officer Eric Deaton.
Deaton will serve as Incident Commander for the health system’s COVID-19 Corporate Emergency Operations Center.
“It’s clear, as we work to vaccinate people and get the Appalachian Highlands to the other side of this pandemic, we must provide care that extends beyond our patients’ initial COVID-19 diagnoses and potential hospitalizations,” Deaton said.
Through the Center for Post-COVID Care, Ballad Health can provide a full spectrum of services, including care navigation and case management, for post-COVID patients. The health system will also foster research and learning opportunities and collaborate with other leading institutions to understand post-COVID care and increase awareness to healthcare providers, patients and community members of this condition.
“Since early 2020, our approach to the treatment and prevention of COVID-19 has changed,” Ballad Health Medical Associates physiatrist Paul Jett, MD, said.
Jett will serve as medical director for the Center for Post-COVID Care.
“Ballad Health, like healthcare providers and health leaders across the nation and world, had to adapt quickly as our understanding of this virus has grown and changed – sometimes, seemingly, day-to-day,” Jett said. “But while we’ve developed excellent care protocols and treatment options for patients with active COVID-19, we still have a lot to learn about the long-term repercussions of this virus. And that doesn’t even scratch the surface the effects COVID-19 can have on behavioral health and the social determinants of health.”
A recent study by the Centers for Disease Control and Prevention (CDC) notes more than one in three COVID-19 patients are not back to their usual health within two-three weeks, and one out of every five of those was a young, healthy person who’d had mild COVID-19 symptoms.
In another study, more than half of 60 former COVID-19 patients who had been hospitalized still had neurological symptoms such as memory loss, vision problems and mood issues three months later. Research on similar conditions also suggests possible significant and extended impairment: For example, more than a third of patients with severe acute respiratory syndrome (SARS) experienced reduced lung capacity even 15 years after diagnosis.
“Hospitals and healthcare providers across the country are grappling with how to address the need for sustained, supportive services that address all aspects of post-COVID care,” Jett said. “Highly-regarded healthcare leaders such as Mount Sinai in New York, Penn Medicine and others are all developing multi-specialty models of care that focus on post-COVID recovery – and now, our Center for Post-COVID Care is joining them to embark on this next phase in COVID-19 treatment and research and collaboration for the future.”
Ballad Health’s Center for Post-COVID Care is the first of its kind in the region; previously, patients seeking these services could have experienced a fractured or disjointed care plan, or sought care from providers farther from home.
Laila Cowell, who contracted COVID-19 earlier this year, was exploring care options with providers such as Johns Hopkins Medicine before Jett contacted her to enroll in the Center for Post-COVID Care.
“My COVID-19 was relatively mild – I was never hospitalized or faced life-threatening symptoms,” Cowell said. “But 30 days after diagnosis, I still had a fever and hadn’t recovered. My primary care provider said it was anxiety, but I knew something else was at play.”
Cowell turned to online support groups for COVID-19 patients and learned that her lingering symptoms were fairly common. Meanwhile, she struggled to climb stairs, and even though her appetite had dissipated, she gained weight. She needed help – help she found through Jett.
“With the Center for Post-COVID Care, I’ve started physical therapy, and I’m working with a cardiologist,” Cowell said. “Dr. Jett and his team are even working to connect me to a rheumatologist – all this time, I might have also had an undiagnosed autoimmune disorder.”
Sandi Wolever, the registered nurse case manager for the Center for Post-COVID Care, manages every patient in the program and sees many people with conditions like Laila’s.
“Younger patients, especially, are the ones who are struggling – the ones who were healthy before contracting COVID-19. They walked, they ran, and now they can’t get over it. So then emotional distress comes in, because they can’t get better, but they thought they’d recover,” Wolever said. “It’s a little easier on older patients or those with comorbidities, because they’re used to not feeling 100%. But even then, fatigue and loss of stamina are major issues, and they can’t do what they used to. They’re seeking answers, but no one has them yet. We don’t know what’s going to come in a year or two years.”
Patients who could qualify for the Center for Post-COVID Care include those over the age of 12 who have recovered from COVID-19 and experience lingering symptoms such as:
Behavioral health issues, such as PTSD, insomnia, anxiety and depression
Impaired renal function
Myocardial injury, or heart attack-like symptoms
Trouble breathing, residual pulmonary manifestations and coughs
Weakness and poor endurance
“As of last week, more than 92,000 people in the Appalachian Highlands have tested positive for COVID-19, and early estimates indicate about 10% of those who test positive for COVID-19 might end up developing post-COVID syndrome,” said Ballad Health’s chief medical officer for population health and behavioral health Dr. Shari Rajoo. “Providing a service focused on post-COVID syndrome is essential to helping our communities. The Center for Post-COVID Care will provide the navigation and clinical services to those who need it most, and our offering for this population will evolve as knowledge of the syndrome increases over time. This new program is a very important, holistic approach to the ongoing support of our region.”
As Ballad Health evaluates early results from the Center for Post-COVID Care and continues learning about post-COVID syndrome, it will consider plans for physical locations and enhanced support groups. “The Center for Post-COVID Care does not represent the end of this COVID-19 crisis,” Deaton said. “Rather, it’s the next chapter of this story – the story of how Ballad Health will protect and serve our communities through every stage of this pandemic.”
To seek care with the Ballad Health Center for Post-COVID Care or to learn more, patients and referring providers can call (423) 952-2183 or email [email protected]
Additionally, in continuing its ongoing fight against COVID-19, Ballad Health conducts community vaccination centers in Kingsport and Elizabethton in Tennessee and in Abingdon and Norton in Virginia. Community members can schedule vaccine appointments by calling Ballad Health Nurse Connect at (833) 822-5523. Online scheduling for eligible patients is also available on the health system’s main webpage at www.balladhealth.org and its COVID-19 page at www.balladhealth.org/COVID19, as well as the Ballad Health mobile app on Apple and Android smartphones and tablets.
The health system also still maintains a strong presence in testing, with six drive-through testing sites in the region. Anyone who is experiencing symptoms and believes they might have been exposed to COVID-19 is advised to call Ballad Health Nurse Connect, visit www.balladhealth.org or download the Ballad Health mobile app.
“COVID-19 is a long road, and this has been a long journey for everyone – healthcare providers, patients and community members alike,” Deaton said. “But it’s a road no one has to walk alone.”
COVID-19 news and updates will continue to be shared to www.balladhealth.org/COVID19.
To prevent the spread of COVID-19, all Ballad Health facilities are taking crucial safety precautions, including visitation restrictions, enhanced physical distancing measures, increased infection control and processes and systems to safeguard patients’ care journeys.