Primary Care Works to Keep COVID Patients Out of the Hospital

January 20, 2022
Mercy Hospital. License rights expire 09.30.23. (© Grant Ordelheide)

While a majority of the media’s focus during the COVID-19 pandemic has been on hospitals and hospital capacity, primary care has also faced challenges because of the pandemic. The providers and associates at Mercy Primary Care have met these challenges head-on, from implementing more telehealth options and availability, to hiring a full-time provider to care for and monitor COVID-19 positive patients.

Mackenzie Morgan, NP, joined Mercy’s primary care team on Sept. 20. Prior to joining Mercy, Mackenzie, who has a background in public health, worked in emergency medicine, hospice care, reproductive health and served as a traveling nurse. Her new position at Mercy Primary Care provides the perfect opportunity to use her knowledge in public health, varied experience in health care and her nurse practitioner degree to serve our patients and community.

“It has always been my goal to get back to Durango, and this position provided that opportunity as well as builds on my background in public health,” Mackenzie explained. “I believe we need to keep people in primary care and out of the Emergency Department (ED).”

In her current role, Mackenzie does just that. She monitors people suffering with COVID-19 keeping them out of the ED while ensuring they are receiving the appropriate care when recovering at home. She serves as a bridge until the patient can be seen by their primary care provider if they have one established. Visiting with 20 to 50 patients a day, Mackenzie sees patients through telemedicine. Some of the patients Mackenzie treats struggle with internet access so she checks in whatever way works best for the patient, whether that be over the phone or through a telemedecine appointment. Mackenzie tailors the time and frequency of her patient appointments to the patient’s needs. She’ll speak with some patients daily while others she’ll visit with at least once a week until they can safely be seen in person by their primary care provider. During her patient visits, Mackenzie covers a lot of ground including determining if a symptom the patient is experiencing needs emergency care or if it can safely be managed at home. Patients are referred to her through ED and hospital discharges, as well as within the Mercy Primary Care patient caseload.

“My patients are quite sick, but hopefully not sick enough to be hospitalized,” Mackenzie said. “I care for people who have been recently diagnosed with COVID as well as people who have been discharged from the hospital to continue their COVID recovery at home.”

As part of her role, Mackenzie provides referrals to receive monoclonal antibody treatment. To receive this treatment patients must:

  • Test positive for COVID-19 (suspected positive COVID patients can be referred to the Colorado Department of Public Health and Environment (CDPHE) mobile antibody treatment unit)
  • The onset of COVID symptoms must be less than 10 days
  • Have no increased oxygen requirements
  • Must meet one of the following requirements:
    • Age 65 or older
    • A BMI over 25
    • Underlying medical conditions such as diabetes or cardiopulmonary disease, chronic kidney disease
    • Assistance needed from external medical equipment

“The antibodies must be infused in the early stages of the virus,” Mackenzie said. “The treatment is not beneficial after patients have passed 10 days. The antibodies have been shown to cut down the duration and severity of the illness and reduce the risk of needing hospitalization.”

Patients can receive the antibody treatment in Mercy’s Emergency Department or when possible, from the mobile bus provided by the CDPHE that travels through the Durango area monthly. The CDPHE unit can treat 15 patients per day.

Prior to the introduction of Mackenzie’s role, Mercy Primary Care providers were juggling the care of outpatient COVID patients in addition to their regular patient loads.

“The providers have carried the torch as best as they could,” Mackenzie said. “I hope that I have decreased some of their burden. I’ve been able to offload the acute care of COVID patients from their plates and I’m happy to do it.”