Home Care An Option For Some Wisconsin COVID-19 Patients

Dec 8, 2020

With COVID-19 patients filling many hospital beds, some health care systems are expanding care of milder coronavirus cases at the person's home. When Green Bay resident Dan DeGrave tested positive for COVID-19 in late September, he wasn't admitted to the hospital. He was sent home, and soon after, an iPad was delivered to his house.

"And with that iPad, I got to test my oxygen levels, my blood pressure and my temperature. And that was hooked up, that iPad, to a nurse in Milwaukee. She could see me, I could see her,” DeGrave tells WUWM.

DeGrave's health care provider Advocate Aurora also sent a nurse wearing protective gear to his home once a day for more vital sign testing and to explain what was going on with COVID-19. DeGrave recovered without a hospital stay, but says he never felt shorted on care.

"No, I think I actually did better, and it was kind of a good feeling too that instead of me being in the hospital, that freed up a bed for somebody that really did need it, you know," he says.

DeGrave concedes home care is probably not the way to go for many COVID-19 patients. He says that's up to health care experts.

Advocate Aurora calls its program Home Hospital. It launched last spring during the first COVID-19 surge, and has ramped up this fall. Company executive Denise Keefe says in the firm's eastern Wisconsin and northern Illinois service area, about 50 or 60 people with COVID-19 are enrolled in Home Hospital, a tiny fraction of the giant provider's overall number of patients.

She says Home Hospital patients are chosen after a health care team reviews data. "So, when a patient presents in the emergency room and is identified as having COVID, we work with the emergency room physicians, the family and the patient, and then our care team. We have clinical criteria that will say this patient will be safe to take home into this program,” Keefe tells WUWM.

Advocate Aurora says the clinical criteria include whether the patient has a stable oxygen level, is medically stable, and has no complications or comorbidities that may put them at increased risk for a poor outcome, such as a history of high blood pressure or diabetes.

Still, Keefe says a very small percentage of COVID-19 home care patients have to go back to a hospital. "You know, one of the things with COVID is that, sometimes, the symptoms can change quickly. So, we always have a plan now that if something isn't going to go right to get that patient back to the hospital, if necessary," she says.

Advocate Aurora says it also has about another 800 coronavirus patients in another home care program.  It's not the only U.S. health care provider expanding home care options. But a New York-based health care firm that heavily used the option in the spring recently warned it learned the importance of medical protections for staff that go into the homes.

While there’s an increase in COVID-19 patients being treated at home, an infectious disease professor at the Medical College of Wisconsin would like some of them to take part in a federally-funded nationwide clinical trial called ACTIV-2.  Dr. Zouyan Lu says the trial aims to help the home care patients recover faster, or not need to be admitted to the hospital, or use the emergency room.

"Right now, there's really not anything that we are able to treat patients with when they are not in the hospital. So, I think it's important to see if there's anything beneficial for patients who aren't sick enough to be there,” he says.

Lu says presently the trial is only testing one drug, a monoclonal antibody designed to block the spike protein of the coronavirus from attaching to and entering human cells. But he says other drugs may be tested later.

The trial requires the patient to come into to the Froedtert and Medical College of Wisconsin campus in Wauwatosa for an IV of the drug. Lu says patients will be compensated for taking part in the minimum four-week trial.

He says even if a COVID-19 vaccine is coming, the trial is still important. "If someone still gets the infection, we want to offer them the best treatment option to prevent them from getting sicker,” Lu says.

And to keep them in the ranks of COVID-19 patients being cared for at home.