SPECIAL REPORT: COVID-19 Impacts O&P Facilities, Distributors

The O&P profession continues to address updates issued by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) regarding the ongoing threat of the novel coronavirus COVID-19. O&P clinics and distributors have been taking the required precautions for their facilities since news broke that it had reached the United States. The effects included declining patient visits and orders, reducing employee hours, and increased sanitation of office equipment and waiting and exam rooms. "Right now, the spread of the COVID-19 virus presents a very dynamic situation, so we are being vigilant and open, listening to the best advice we can get from the city and state," said Séamus Kennedy, BEng(Mech), CPed, Hersco Ortho Labs, Long Island City, New York. "Planning is literally one day at a time." John Caputo, LO, president, Body In Motion Sports & Orthopaedics, Toms River, New Jersey, concurred. "As any business owner, I am kept up at night worrying about the business, my employees, and how things in general will be paid for," said Caputo, who has seen a 15 percent overall drop in new business. "I am fortunate that I have always monitored my business on a daily basis for the last 24 years. I have experienced trends on a weekly and monthly basis. This data has also been very helpful to me in times of crisis, which we now find ourselves in." Safety Awareness Protocols While O&P facilities and distributors have relied on guidance from the CDC and WHO, as well as following recommendations from their respective state and federal governments, they have developed additional safety and awareness protocols for their clinics and facilities. "It's been a hot topic to say the least," said Zach Harvey, CPO, Creative Technology Orthotic & Prosthetic Solutions, Denver, who has seen a drop in out-of-town patients. "I have a couple of people who have cancelled due to being immune comprised as well," he said. Creative Technology established new guidelines for patients coming into the office for treatment that involved screening patients by telephone before scheduling. The clinic also practices thorough cleaning protocols and distancing of people in space and time, Harvey said. At Body In Motion, patients are required to wash their hands before going to the front desk, and gloves are mandatory for practitioners, Caputo said. "As for our hospital work, we now wear gowns and masks when we treat patients," he said. "The same applies at rehab centers." United Kingdom-based Blatchford, with US headquarters in Miamisburg, Ohio, is relying on technology to conduct business, according to Sue Borondy, marketing manager. "All nonessential travel has been suspended," she said. "We are doing our part to control the spread of the virus and following the recommendations of the CDC and WHO." Blatchford employees who can work remotely are encouraged to, and sales and clinical visits are restricted to only those that are necessary, Borondy said. Some aspects, however, remain business as usual at Blatchford. "Customer service and logistic functions are still in place to service customer requests," she said. At Fillauer, Chattanooga, Tennessee, operations have continued with few consequences, according to Katrina Farmer, marketing project coordinator. "We've restricted employee travel and nonessential visits to and from our offices," Farmer said. "We are also working to understand the impact on our industry at large, including how we can engage customers despite event cancellations where we'd typically have an opportunity to interact." Cascade Orthopedic Supply, Chico, California, has implemented procedures to ensure it is able to provide customer service during the pandemic, said Kristen Pierson, marketing manager. "Cascade has created a temporary remote working environment for select internal department team members to limit contact between colleagues and reduce the risk of potential transmission," she said. "Staff who remain in the distribution centers have been instructed (according to CDC guidelines) to stay home if they are sick or exhibit any symptoms, refrain from using public transportation, keep a safe distance (at least six feet) from others, practice good hygiene, sanitize common areas and surfaces, and conduct all meetings in a virtual setting." Not Business As Usual COVID-19 has created an unprecedented environment for O&P clinics and distributors. "The truth is, it's not business as usual, because it's not for our customers," Farmer said. "We are keenly tuned in and relying on guidance from the CDC and are following recommendations from our state and local government." As a central fabrication facility, Hersco does not see patients. "So to some degree that limits our exposure," Kennedy said. "As a company, our primary concern is our team. We are reminding everyone to follow CDC guidelines and wash their hands frequently, cough into their elbows, etc. Many of our production technicians already wear face masks as part of their job." Caputo is aware of how COVID-19 has affected business. "I have been honest with my employees moving forward that we may have to implement rotating furloughs should patient visits fall through the floor," he said. If there are furloughs, Caputo said he has assured his employees that they will continue to receive company paid health benefits as well as collect temporary unemployment benefits from the state. Practitioners don't have the option to treat patients from home, however. For facilities such as Orthotech Prosthetics & Orthotics, Flint, Michigan, clinicians will visit a patient's home when necessary, said Mike Bugg, CPO, CEO, Orthotech P&O. Though the service was previously reserved for homebound patients, it has been opened up to any prosthetics patients who do not wish to come into the office at this time. Cascade has implemented a travel restriction for nonessential office visits by its management, sales, and clinical team, Pierson said. Communication will be by telephone, email, and video conferencing. "We are confident that through the use of technology and consistent communication, Cascade can maintain the same levels of contact with customers and industry associates," Pierson said. Not everyone in O&P, however, appears to be reacting as strongly to the COVID-19 situation. Tyler Harrison is in the O&P master's program at the Baylor College of Medicine in Houston. She attended the Academy's annual meeting in Chicago last month. She said the college provided helpful information regarding precautions to take while traveling, which alleviated her concerns. She believes the media has added to the frenzy. "The media has over-hyped this and made many people paranoid, similar to other outbreaks in previous years," Harrison said. "I am a firm believer that practicing good hygiene and keeping your immune system healthy, [such as] eating right and getting enough sleep and exercising, will give your body the best chance to fight off any illnesses." Contingency Plans Now that marketing and business development have come to a standstill as hospitals, and skilled nursing and assisted living facilities have stopped allowing outside visitors, O&P clinics have had to get creative. Kathy Sauvola, marketing director and patient liaison at Orthotech P&O, said the company has adopted new measures in reaching out to its homebound patients via social media and personal phone calls. "We offer not only home visits from our staff, but a trip to the grocery store or pharmacy, if needed," Sauvola said. Cascade, Blatchford, and Fillauer will continue to follow CDC and WHO recommendations. "We are prepared to shut down if need be," Borondy said. There is a plan to allow high-risk employees at Fillauer to work from home, Farmer said. "We are also committed to providing product and other training and service by way of digital and web capabilities," she said. If the situation continues to escalate, detailed contingency plans have been developed so Cascade can remain fully operational, Pierson said. "An internal notification process has been created to ensure all team members are informed and ready to act in the event of an emergency situation," she said. "Our primary goal during this time is to do our part to minimize risk to employees and lower the probability of the spread of the virus to customers, business partners, associates, and communities." If New York City mandates a reduction in population density as it did with restaurants and night clubs, Hersco is expecting a slow down in business, which may mean splitting the team into two shifts, Kennedy said. "While we do not look forward to it, we are reasonably well positioned to absorb a short-term decline," he said. In addition, most of Hersco's employees depend on the subway to get to work. "If that shuts down, or the city schools are closed, much of the team will be unable to get to work," Kennedy said. Despite the current gloomy outlook, Kennedy remains optimistic. "I am confident we will navigate any and all of these circumstances if and when they arise," he said. "Now is the time for all of us to come together, remain ready and prepared for any challenges we face." The last time Caputo and his staff experienced something of this magnitude came in November 2012, when Hurricane Sandy struck. "During that crisis we had offices that had no power and no patients for over three weeks. It took months to return to a semblance of normal," he said. "We survived that ordeal and we will survive this." Editor's note: The conditions reported in this story were current as of the time of this writing, but responses to the COVID-19 pandemic are developing rapidly. Visit www.opedge.com for regular updates . Betta Ferrendelli can be contacted at betta@opedge.com.

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