Anthony S. Fauci, MD, on How Physicians Can Talk to Patients About COVID-19

Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID) for 36 years, spoke with The New England Journal of Medicine in a podcast about how physicians can approach talking to patients about the coronavirus disease 2019 (COVID-19).

Fauci first suggested that the conversation should depend on the location of the practice, given that the situation of COVID-19 is specific to different areas. However, the situation is also constantly evolving, therefore it is the role of the physician to know how to advise patients specific to their location. 

“So, you give them the broad picture, that should take like 2 minutes in the office to tell them that. Then you tell them what you need to do,” Fauci explained. “So, if you’re a 35-year-old person who feels healthy and you have someone in your home that’s on cancer chemotherapy, you’ve got to protect them. You’ve got to physically distance yourself from them. Now that’s now in Massachusetts. If you happen to be in Seattle you’ve got to do more than that.”

The best sources of information according to Fauci, for both clinicians and the general public, to check for changing information are the CDC’s website and coronavirus.gov, which is a website specific to the virus itself. This resource explains what to do at home, the workplace, in the hospital, etc. 

For clinicians themselves, the NIAID director indicated that it is critical to look at China and the impact that COVID-19 has had on healthcare providers. Given the severity of what’s been observed thus far, this means that physicians should be taking the strictest precautions they possibly can. 

“I would clearly wear an N95 mask, absolutely. I would wash your hands until it starts getting chaffed. I mean, we do that anyway with universal precautions, but I would clearly do that,” said Fauci. “When people call in… you’ve got to tell them… Stay at home for now and if you’re going to come in, figure out a way that they don’t come in and essentially infect 5 other people when they come in. That I think the clinicians need to know. First instinct is that if this person has it, I want to take care of them. You can take care of them, but you got to be careful about essentially making the matter worse.”

Overall though, Fauci recommends that physicians and individuals alike in the general public remember not to panic. He suggested that it’s important that we don’t overwhelm the various systems at work during this pandemic when they don’t need to be overwhelmed. However, there is still a need for everyone to act differently than they would normally, according to Fauci, and continue to practice social distancing. 

“Without panicking and without making it dominate your life, pay attention to the fact that you have to act differently like you’ve never acted before. You’ve really got to be socially distant,” Fauci said. “I mean, we’re all social beings but for the next few months, and I hope it does go down, it might not, but I hope it does the way flu does, we just got to hunker down. It’s part of what we need to do, we need to hunker down.”

Reference:

NEJM. Clinical Conversations Podcast 256 – Anthony Fauci: Talking with patients about COVID-19. NEJM website. Published March 2020. podcasts.jwatch.org/index.php/podcast-256-anthony-fauci-talking-with-patients-about-covid-19/2020/03/10/. Accessed April 1, 2020.