Experts are sounding the alarm about the “tripledemic” driven by a spike in Covid-19 cases accompanied by a particularly challenging flu season and a surge in RSV hospitalizations. As the weather has grown colder, people living with chronic obstructive pulmonary disease (COPD)–and those who care for them–must contend with a fourth risk on top of these concurrent waves in respiratory illnesses. Just as respiratory illnesses typically follow a seasonal trajectory, the colder months also correlate with a marked increase in COPD exacerbations, occurring two times more frequently than in the summer months. People living with COPD need proactive support from their care teams to manage their conditions and stay above water during the crashing waves of the coming “COPD season.” Payers and providers need to come together to make this proactive support possible.
We’ve seen how quickly Covid-19 can push hospitals to the brink while depleting the resources and bandwidth of our healthcare system. With flu hospitalizations on the rise and COPD exacerbations leading to more than 700,000 hospitalizations in the United States each year, it’s not hard to imagine an overwhelming winter for our healthcare system. Beyond the strain these surges place on bed capacity and provider burnout, an unchecked COPD season could inflict a painful financial toll on our system. A quarter of patients with COPD discharged following an exacerbation are readmitted within 30 days, and COPD hospital readmissions account for $15 billion in US healthcare costs each year.
I saw this firsthand in my time working as a hospitalist—patients with COPD would continue to churn through the emergency department with exacerbations, never getting the help they needed between those visits. When you consider the increased frequency of exacerbations during COPD season and the fact that exacerbations comprise 70 percent of COPD-related costs, the winter months look all the more challenging.
But these stark forecasts aren’t written in stone. COPD season doesn’t need to tip us over the edge. Despite popular misconceptions, COPD can be proactively managed before patients reach the point of exacerbation. It’s a tall order, but we have the tools we need to change the care paradigm.
First, by investing in preventive care, we can keep our health system from being overwhelmed this winter. Incentivizing proactive COPD care over a reactionary framework–one that largely consists of hospitalizations and emergency department visits–is foundational to buttressing our healthcare system and helps ease pressure on bed capacity and care providers in the midst of convergent surges.
Second, we can expand virtual options to bridge gaps in care and provide patients with access to effective therapies and resources from the comfort of their own homes. Because the symptom burden of COPD often impacts mobility, many people find themselves homebound as the disease progresses—making access to care even more difficult. Evidence suggests that integrated COPD care can reduce 30-day hospital readmissions by as much as 57 percent, and using virtual tools to connect patients to that care can help ensure they have the resources and support to stay healthy and out of the hospital.
Third, we need to facilitate improved COPD self-management. At the hospital, we’d often send discharged patients home with reading materials meant to guide them in their self-management, but it was so clear when they ended up back in the ER that alone was not enough to drive lasting behavior change. Integrating regular coaching into a patient’s care can help them make connections between their actions and their health, build their confidence, and improve their self-efficacy so they can better manage their COPD.
And lastly, we need to promote coordination and increase visibility across providers. This means prioritizing proactive information-sharing between patients and their care teams to manage COPD before it deteriorates. This is especially important around traditions of care where the needs of vulnerable patients can fall through care gaps.
Colder weather will always pose an additional risk to people with COPD, but this COPD season does not need to be so detrimental. To turn the tide, payers and providers must invest in preventive care to meet patients where they are before their conditions deteriorate. Investing now will make our healthcare system more resilient, reduce unnecessary costs, keep patients healthy, and avoid repeating the patterns of seasons past.
Photo: milan2099, Getty Images