June 3, 2020 | Megan Carr
As we all face the reality of day-to-day life during a pandemic, I consider myself in the lucky category. My husband and I may struggle as we manage two full-time jobs and educate four young boys at home through distance learning, but we are all healthy and safe. Cabin fever has set in, however, and my husband wants to get back to the work travel involved in running his small business. How we manage work and the safety of our family involves long discussions, a few grumpy words (by overcautious me) and even a few tears (again, me).
I can’t help it. Truth is, I’m anxious for normalcy, but I’m also scared. While I’m concerned for my husband and kids, I’m really scared when it comes to my parents. They live in St. Paul, far from me as I currently live in Washington D.C. Now in their 80s, my parents have health issues and are right in the sweet spot for vulnerability to this awful virus. They still venture out to the store despite my pleas and my Amazon deliveries to their house. Neighbors, friends, and family stop by with essentials, for which I’m grateful. I just hope my mom, a wonderful, caring person who LOVES to hug, doesn’t hug them for their efforts.
So it was with interest that I read a recent editorial in my hometown newspaper, the Star Tribune, “Minnesotans need to understand and act on COVID-19 risks.” I strongly agree with its recommendations. Written by the newspaper’s editorial board, it calls for better research into the underlying conditions that contributed to the COVID-19 infections and fatalities recorded to date across Minnesota. Without more information, the editorial states, it may seem that only those who are elderly or acutely ill are vulnerable. The reality is that many people with common, treatable chronic conditions, such as hypertension, appear to be at higher risk for becoming seriously ill or dying after becoming infected. As states begin the process of reopening, it is critically important that we understand individual susceptibilities. The editorial board calls for this information gap to be filled, noting that “Data-driven tools under development may soon help doctors more precisely calculate individuals’ risk of a poor outcome after contracting COVID-19.”
My work involves supporting government regulatory efforts around health program risk adjustment and provider and program quality performance. I know firsthand that the research advocated by the Star Tribune is already underway across a number of states. A clinically based patient risk stratification approach can go deeper than just analyzing the basics of age and a person’s general medical conditions. It can look in a more detailed way at a patient’s comorbidities and health status. This in-depth analysis can help identify patients that may have chronic conditions, placing them at higher risk, or it can pinpoint those who should shelter in place longer than others. Data could also aid with prioritizing future vaccinations to ensure the most vulnerable are protected first.
My colleague, Dr. Gordon Moore, recently blogged about international efforts to apply risk stratification to the challenges of COVID-19. For example, the Ministry of Universal Health and Public Health of the Valencian Community of Spain is stratifying their patient population for targeted distribution of personal protective equipment. Using the 3M Clinical Risk Grouping (CRG) methodology, the Region of Valencia will be identifying the most vulnerable members of the population, who, if infected, would be at the highest risk of hospitalization, admission to ICU or in need for mechanical respirator.
We are anxious for the world to start returning to some sort of normal. We are hopeful when we hear the numbers of infections and mortalities are going down, and that states will reopen at an appropriate pace. We know our state government leaders are facing complex challenges; they worry and care deeply about their people and state economies. I know in my heart they are all trying to do what they think is best, and I appreciate their efforts and difficult decisions. My hope is that more direction for those at greater risk of experiencing serious illness from the virus can be provided.
The need to get back out there is real, both for our mental health and for our economy. Data-driven approaches are critically important because they allow us to plan for the future with a little more clarity around how to establish a new normal while keeping people safe and healthy. Those most vulnerable to the virus need better guidance on when it makes sense to venture out. Data and science can help us move forward as safely as possible so that one day again my mom (and all of us) can get back to sharing those hugs.
Megan Carr, head of the Regulatory and Government Affairs team at 3M Health Information Systems.
Click here to visit the 3M HIS COVID-19 resource page.
During a pandemic, healthcare information is gathered, studied, and published rapidly by scientists, epidemiologists and public health experts without the usual processes of review. Our understanding is rapidly evolving and what we understand today will change over time. Definitive studies will be published long after the fact. 3M Inside Angle bloggers share thoughts and expertise based on currently available information.