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Massachusetts health experts talk post-pandemic 'curves', mental health and returning to care

Boston Herald - 6/23/2020

Jun. 23--Massachusetts residents and Americans across the nation continue to flatten the curve, but health experts are preparing for more "curves" in mental health care that will be seen in a post-pandemic world.

"I'm very concerned about the social isolation. Everybody is talking about the curve ?-- I see three curves," said Maureen Bisognano, co-chair of the Massachusetts Coalition for Serious Illness Care in a virtual summit on Monday.

Bisognano said in addition to the current curve which involves case counts, hospitalizations, deaths and personal protective equipment, the second curve will be in mental health care for families, patients and health-care workers who took on trauma during the pandemic.

The third curve will be when everyone starts to return for regular care they missed while staying home, said Bisognano.

"It's important we focus on what we've innovated and really focus on how do we really keep the telehealth," said Bisognano.

Blue Cross Blue Shield of Massachusetts President and CEO Andrew Dreyfus said that in February, about 200 telemedicine claims were paid per day and by April that number jumped to 40,000.

Dreyfus said half of those claims were for mental health visits, adding that some therapists reported arriving at breakthroughs with patients who became more comfortable talking via telehealth appointments.

"The speed and pace of the change tells us we can move other things really, really fast if we want to," said Dreyfus during the Massachusetts Coalition for Serious Illness Care's 2020 Summit.

Dr. Atul Gawande, a surgeon at Brigham and Women's Hospital, said switching to virtual health care can offer good solutions to those looking for convenient options, but some people such as the elderly or low-income communities don't have equal access.

"We have not overcome these issues yet and they do create further isolation," said Gawande.

The coronavirus has also offered a "safe space" for many families to venture into the difficult conversation of end of life care with their loved ones, said Gawande.

"It's allowing people to take seriously what they are willing to do and not willing to do for the sake of safety," said Gawande.

He added, "That's exactly the kind of conversation everyone needs to be having and COVID makes it more concrete."

Dreyfus called those tough conversations a "breakthrough," considering many put off the topic until later in life.

"We should find a way to really capitalize on this moment," said Dreyfus.

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