SCIENTIFIC
Understanding Provider Health Crisis Preparedness Levels at the Initiation of COVID-19 in West Virginia Medical Practices
AUTHORS : William Lewis , MD 1-4
Aaron McLaughlin , MD 1 , 2 Tracy Sun , MPH 4 , 5 Jennifer Lukas , MPH , MS 3 , 4 Stacey Whanger , MPH 3 , 4
1
West Virginia University Medicine , Morgantown , WV
2
Harpers Ferry Family Medicine , Bolivar , WV
3
West Virginia Clinical and Translational Science Institute , Morgantown , WV
4
West Virginia Practice-Based Research Network , WV
5
Asian & Pacific Islander American Health Reform , Washington , D . C .
INTRODUCTION
The rapid intensification and progression of the 2019 coronavirus disease ( COVID-19 ) placed a heavy burden on healthcare professionals , especially those with limited patient resources and support . Community healthcare providers and clinics continue to face unique challenges when addressing COVID-19 and other public health emergencies . West Virginia ( WV ), a predominantly rural state found completely within the Appalachian region , has had to combat challenges associated with rurality , including limited patient resources , transportation issues , and access to remote areas of the state . 1-4
WV was the last state to report its first COVID-19 case on March 17 , 2020 . Throughout the month of March 2020 , WV ’ s rate of COVID-19 increased relatively slowly , with a total caseload of 178 by the end of the month . However , many public health officials were well aware of the likelihood that cases would begin to increase more rapidly in the coming weeks . Although the state gradually applied executive orders for businesses to close , by mid-April 2020 , WV had
ABSTRACT
INTRODUCTION Rural community healthcare providers and clinics face unique challenges when addressing public health emergencies . The novel 2019 coronavirus disease ( COVID-19 ) has led to new challenges exacerbated by a lack of experience , resources , and support . In West Virginia ( WV ), the largely elderly and rural population is cause for significant concern to the healthcare community due to decreased access to healthcare and increased risk of complications from COVID-19 .
METHODS At the dawning of the COVID-19 crisis , the WV Practice-Based Research Network evaluated rural healthcare providers ’ confidence and preparedness in public health emergencies .
RESULTS A total of 149 primary care providers ( 52 % physicians and 47 % certified registered nurse
a steady increase in cases around the state . 5
An important health resource for WV primary care is the WV Practice-Based Research Network ( WVPBRN ), which engages all parts of the state in clinical research translatable to WV populations . Through the support of the WV Clinical and Translational Science Institute ( WVCTSI ), WV has not only developed and maintained a successful practice-based research network ( PBRN ) in a rural state but has developed innovative strategies for addressing recurring barriers to research , effectively driving improved quality of clinical research projects . With a rich history of prior experience and collaborations alongside clinical staff and providers , the WVPBRN currently has 108 individual primary care clinics , encompassed by 24 health systems throughout WV . These clinical sites are familiar with public health crises , with experience from common regional emergencies , including winter storms , water supply contamination , and frequent flooding . A recent example is the severe flood in June practitioners , physician ’ s assistants , or registered nurses ) anonymously responded to the survey . The majority of respondents ( 81 %) indicated they had not previously experienced a public health emergency before 2020 . Sixtyfour percent felt they had access to timely information and identified organizational leadership and federal government as the top two trusted sources . Only 13 % of respondents personally felt “ very confident ” in being adequately prepared for public health emergencies , while 30 % felt their healthcare site is adequately prepared .
DISCUSSION The WV primary care perspective about public health emergencies has been elucidated during the pandemic , along with determining where healthcare workers get their information and their awareness of resources available to them .
2016 , which led to a state of emergency declaration by then-active Governor Earl Ray Tomblin , for 44 of WV ’ s 55 counties . This flood , which devastated parts of Kanawha , Fayette , Nicholas , Summers , and Greenbrier counties , is now considered one of the deadliest floods in the state ’ s history . 6-7 Another example of a health crisis is the opioid epidemic , as the state experiences a wide-reaching toll of misuse and overdose across all sociodemographic groups . Clinics across the state have engaged in research endeavors that have resulted in the dissemination of valuable resources , including trainings and tools , in an effort to improve the delivery of clinical care and health outcomes to address the epidemic statewide .
To date , the primary targets of disaster and / or emergency preparedness generally focus on the operations of larger critical healthcare facilities or services , such as hospitals and emergency care planning . 4 This practice is troublesome to many primary care clinics or affiliated sites , as demonstrated in the existing literature ,
24 • www . wvsma . org