Slowly opening the door

Community Health Brandon will see more patients, clean more surfaces, and mandate face masks


BRANDON — It’s been six weeks since Dr. George Fjeld stopped seeing patients in-person at the Community Health Brandon.

This week, Fjeld said Community Health Brandon is seeing patients in-person on a limited basis, after Gov. Phil Scott announced a partial re-opening of certain areas of the economy, including construction, landscaping and manufacturing with social distancing restrictions.

“We’ve been putting off chronic care visits for over a month,” Fjeld said in a phone interview Tuesday. “That’s not sustainable. People need health care visits, so we’re sorting out how to go about that.”

The COVID- 19 pandemic forced Fjeld, his partners and the staff to mask up and split the 20-member staff into office mode and work-from-home mode, switching each week. All patient visits were done remotely over the phone or via video conferencing.

This reporter’s interest was peaked with the news that Fjeld would allow more in-person visits. Having just been on the phone with my father’s doctor, who wanted to arrange an office visit in Brandon, the thought of taking him anywhere terrified me. My father is 85 and lives with my mother at a senior living center in Middlebury. They have has been in lock down since March 18. The facility’s policy is such that if a resident leaves, they must go through a 14-day quarantine off site in order to be allowed back into their apartments. That is simply not an option.

In the end, it was decided that more phone calls were needed and that remote medicine would work until the lock down was over. But what of a waiting room and potentially sick patients? Fjeld said he and his staff narrowed the issues that needed to be addressed down to three: respiratory spread, social distancing and cleaning.

On respiratory spread:

“We have a mandatory mask rule,” Fjeld said. “Staff must be masked at all times, and we are asking patients to wear masks. The cloth masks are fine. They reduce the spread of germs well.”

If patients do not have their own mask, Community Health Brandon can provide one, but like most Personal Protection Equipment (PPE), there is a shortage.

“We don’t have the supply to give everyone a mask,” Fjeld said, “which is unfortunate.”

Regarding social distancing, Fjeld said personal vehicles will serve as the new waiting room.

“Patients will be screened and registered at the front door and given a restaurant-style buzzer,” the doctor said. “Then they can go to their cars and wait.”

Fjeld said this policy will be in place for patients seeing a provider, needing lab work or pharmacy services.

Lastly, cleaning. Fjeld said the office’s new cleaning plan means every exam room gets cleaned every time a patient is seen.

“Every high touch surface, including doorknobs, handrails, bathrooms and counters, get cleaned at the minimum of once an hour,” he said.

Fjeld was asked how the staff will manage the their regular duties and all of that cleaning, which will be time-consuming. He said they have scheduled patient visits for 30 minutes instead of 15 minutes in order to building time for cleaning into the day.

“So, doing these three things addressed the three biggest risks,” Fjeld said. “Our whole goal is to reduce risks. As we get used to this new normal, we will be able to add more visits per day per provider.”

Fjeld said he was heartened by the fact that Vermont’s COVID-19 infection cases and death number are low (907 and 53 as of Tuesday, respectively.)

“The prevalence of the disease in Vermont is very low,” he said. “We’re not seeing a lot of COVID-19). That’s not to say we won’t see more next week.”

There have been no more than 1-5 cases reported in Brandon and 50 cases in all of Rutland County. Fjeld added that none of the patients tested for the virus at his practice have tested positive for COVID-19.

The doctor also said he thinks people need to be able to see their doctor.

“I think people need that connection,” he said. “Especially if you’re older and isolated. I just talked to a lady yesterday and she was crying. “’I’m so lonely’,’ she said. “I only see my granddaughter through the window every few days.’ It’s really sad.”

At its peak, the Community Health averaged about 100 patients seen per day. Fjeld said he anticipates they will see roughly 50 patients a day under the new in-person rules. Since the pandemic began, Community Health had been seeing roughly 10 patients a day, if that.

“It’s seeing a lot more patients,” Fjeld said, “and we want to do it, but we need to protect our patients and we need to protect our staff.”

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