By RON FIELDS
Post News Network
First in an occasional series reflecting on the COVID-19 pandemic
Kansans have gotten to know the name Dr. Steve Stites well over the past couple of years.
Stites, chief medical officer for The University of Kansas Health System, has been the face of medical information throughout the COVID-19 pandemic via the Morning Medical Update video series that has been helping keep the public informed, educated and safer from misinformation.
As the pandemic that shook the state, nation and world transitions to the endemic stage, Stites reflected on the last two years and the changes they have brought in an interview with the Post News Network.
Telemedicine
One of the most impactful changes brought by the pandemic, he said, was the increased acceptance of telemedicine.
"That's a huge win for our patients," said Stites, who has led the medical staff at the hospital organization since 2018.
In rural areas, patients often are separated from specialists by distance, lack of transportation, income restrictions and life circumstances such as not having day care.
"That patient experience has changed significantly," he said, noting COVID-era reimbursement policies need to remain in place in order for telemedicine to continue to be a success. “Some providers may find this controversial, but we’re trying to build good relationships between tertiary and primary providers. We’re not trying to take patients. We know patients often need access, and are usually best cared for in their own community.”
Stites also said he hopes the waiver of the state line rule in telemedicine can also be reinstated. Pre-COVID and currently, only doctors licensed in the state the patient resides can offer treatment via telemedicine.
Stites also said millennials have benefitted from telemedicine, saying "they expect to be able to do this." He said the technology is quickly advancing so your smartphone will be a key medical device and help doctors increase their use of remote treatment.
The pandemic also created an impressive "bench to bedside" story with the creation of mRNA vaccines to fight coronavirus.
"Despite what people want to believe, this year's influenza vaccine is 16 percent effective ... the mRNA is 75 to 85 percent effective — and 95 percent effective against hospitalizations and deaths," he said. "The simple reality is they are incredibly safe and incredibly effective, and they saved millions and millions and millions of lives and kept people out of hospitals."
'Cumulative fatigue'
As hospitals battled patient overloads during the peaks of COVID variant waves, keeping people out of the hospital was critical — because other health issues didn't vanish during the pandemic.
“As hospitals battled patient overloads during the peaks of COVID variant waves, other patients who needed care could not get timely access because other health issues didn’t vanish during the pandemic," he said. “People who had a stroke or a heart attack were dying because they could not get here fast enough.”
That crush of patients over the past two years has waned recently as vaccination rates and immunity from past infection have made COVID symptoms less traumatic for most people. But the exhaustion health providers feel persists, Stites said.
"We've all figured out how to cope better. Omicron is severe, but it's not as severe. The number of people who have died or were in the ICU is not as big," he said, noting patient counts in his system have dropped from 250 patients to single digits recently. "It's so much better, but there's a cumulative fatigue that hasn't totally ebbed. Yes, it's better, but we're all nervous about what the next wave will bring.
"And I think people (in health care) are tired, tired of having people say things that are so patently untrue. We're all a little disappointed in that. People want to believe the internet and it's frustrating."
Masks off
While masks have become a divisive issue, Stites said while he was among the most vocal proponents of masking, the time has come to relax for those not vulnerable because of other health issues — although another wave might change that advice as the virus continues to shift and mutate.
Stites agreed COVID numbers likely have fallen so dramatically not because omicron has vanished, but because symptoms are milder and there is more at-home testing going unreported.
The University of Kansas Health System was considering lifting its mask requirements in administrative areas recently, but pushed that policy change back as cases began to tick up recently in the Kansas City area. In patient areas, Stites said masks could be around for a long time — maybe for good.
The big yawn
"Is it OK for a cold to be a cold again?" Stites said, pondering the interview question. "The struggle is we don't know if (omicron) is associated with 'long COVID.' A cold may just be a cold again, but it's only a cold until it's not."
He pointed to the effectiveness of Paxlovid, a therapeutic drug he called "Tamiflu for COVID."
"If you test (for COVID), you need to tell your doctor. Paxlovid is a remarkably powerful tool against COVID-19. If your primary care physician knows it, together you can assess the risk-benefit of Paxlovid," he said.
Stites agreed the next inevitable COVID wave likely will be met with a "big yawn."
"People have already made that choice," Stites said. “Our target needs to be the people who are vulnerable and helping them stay safe when the community doesn’t want to help, and learning how to pivot nimbly and quickly.”
Still educating
The Morning Medical Update video video series runs each Monday, Tuesday, Thursday and Friday. On Wednesdays, Stites hosts Open Mics with Dr. Stites. There have been approximately 525 video broadcasts since March 2020.
The series in recent weeks has shifted from near-constant COVID coverage to other areas of health care.
"It's fun to be able to do that, to give people hope," said Stites, whose area of practice is pulmonology. "Hope is not itself a medicine, but hope is a powerful, powerful therapy that helps you endure the hardship of getting treatment.
"With the internet and the myths that people hold, the noise is so great. We're helping them sort out what's true and not true, helping them sort through what's really hope and what's really snake oil."