Getting to the hospital during a pandemic

Going anywhere during a pandemic is difficult but getting to medical appointments is even more fraught. Whether you need to get to the pediatrician, dentist, vet, internist or hospital, this five-part series from CNN Science and Wellness has you covered.

(CNN)Earlier this month, Dia Sue-Wah-Sing faced a dilemma.

The 41-year-old living in Toronto had a history of kidney stones. She had been feeling some renal colic symptoms recently, a type of pain that can indicate the stones are worsening.
But during the coronavirus pandemic, routine medical appointments get a little more complicated. Was it worth it to go in? "It was a solid 'maybe,'" she said.
On April 15, she had a six-month follow-up appointment for a kidney ultrasound at Toronto Western Hospital. Although other hospital departments weren't seeing patients during the pandemic, radiology was still open -- with strict social distancing rules.
    If her kidneys went unchecked, she worried there was a possibility she'd end up in the ER in June passing kidney stones.
    Many of us will face our own version of Sue-Wah-Sing's decision in the coming months. So here's what you you need to know if you're going to the hospital, clinic or doctor's office in the time of coronavirus.

    Call your doctor first

    "Emergencies still continue to happen," said Dr. Patrice Harris, president of the American Medical Association. During the pandemic she advised patients to still call 911 for urgent needs, particularly chest pain or stroke symptoms.
    Beyond that, though, Harris cautioned that there's no "one-size-fits-all" approach" when assessing whether or not you should go for an in-person hospital visit.
    That's likely to be determined by your individual case, the health care available in the patient's area and the severity of the Covid-19 environment in your region.
    But Harris noted there was still one constant through all of that: shared decision-making. "Patients shouldn't need to make decisions alone about whether their problem is urgent or emergent," she said.
    Certain new symptoms or follow-ups for existing conditions might warrant starting with a telehealth appointment with your doctor. If it turns out you need to go to the hospital, call the hospital ahead of time to learn which entrance to use to avoid areas where Covid-19 patients are receiving treatment.
    "Please don't let the pandemic stop you from reaching out to your physician," Harris said. "You don't want symptoms now to go unreviewed and then turn out to be worse later."

    Decide with your doctor whether you should seek care in person or online

    In the US, the Centers for Medicare and Medicaid Services has published a tiered framework to help explain how hospitals can still offer certain in-person services during the pandemic.
    In the first tier, the guidelines recommend postponing in-person hospital visits for routine primary care, preventive medicine and services such as supervised exercise therapy.
    In the second tier, initial visits for services such as evaluation of nonurgent symptoms consistent with Covid-19, pediatric vaccinations or early childhood care can be done via telehealth, with subsequent follow-ups at appropriate care sites.
    The third tier describes the most acute issues, and the government's framework recommends proceeding directly to in-person hospital or clinic visits. In these instances, CMS urges patients to seek in-person care if forgoing it would result in harm.
    One immediate rule of thumb to determine is whether you'd be capable of calling for help later if you don't now, said Doug Lindsay, a personal medical consultant who advises patients on how to seek care for complicated conditions.
    If there's a likelihood of heart attack, stroke or se