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winter, Dr. Matthews feels much more prepared than she did in the spring. "It's incredibly fortunate that we've got this infrastructure established so any vulnerable person has the opportunity to see us this way," she says. "We're actively encouraging patients to take advantage of the technology so we can limit the exposure to the clinic staff and to other patients. Everyone benefits." For Dr. Matthews, telehealth dovetails into her enthusiasm for patient-centered outcomes. "Patients need awareness that this is an option for them, and that they actually may have more indi- vidualized, dedicated attention from their telemed- icine provider as compared to someone who's jumping from room to room," she says. "From a patient-centered perspective, I've found the dedi- cated time they get from the practitioner may actu- ally be improved in a video as compared to in a busy office." Preventing the next pandemic When the first wave of COVID-19 deaths in the U.S. was first reported, Donna Nucci, RN, MS, CIC, could- n't sleep for days. Ms. Nucci, an infection prevention- ist at Lawrence and Memorial Hospital in New London, Conn., has struggled to cope with the wide- spread death caused by this once-in-a-generation pandemic. With more than 275,000 U.S. residents already succumbing to COVID-19, Ms. Nucci is reel- ing from the damage the insidious virus has caused on many fronts. She's currently in a support group consisting of other infection control professionals who discuss the emotional toll of the pandemic and the impact it's having on their mental health. "The hardest thing I've ever had to do was change the way we provided guidance because of the nationwide PPE shortages," says Ms. Nucci. In spite of all the heartache, anger and frustration caused by COVID-19, Ms. Nucci is encouraged by the renewed focus on proper infection control prac- tices. She's hellbent on making the most of the extra attention her profession is getting. "The safety protocols and precautions we creat- ed as a response to the pandemic will need to remain in place," says Ms. Nucci. "We need to have adequate PPE for all the 'what-if' scenarios, no mat- ter how remote the risk." The effects of the pandemic will be felt long after it's over, and Ms. Nucci sees COVID-19 affecting much more than just the day-to-day infection pre- vention protocols in place at outpatient facilities. "I think this pandemic will ultimately change the phys- ical design of facilities," she says. Organizations — particularly smaller, freestand- ing surgery centers that didn't have the infrastruc- ture to handle a respiratory pandemic and were hit hardest by the coronavirus — will need to make major changes to their air exchange systems. Superior HEPA filtration will become a necessity. "We can't retrofit every facility, but even freestand- ing ASCs will need to have some type of HEPA fil- tration system in place," says Ms. Nucci. Ms. Nucci says even though the task of combating COVID-19 today is herculean, the nation's periopera- tive community must begin to prepare for another potential pandemic. That includes keeping the cur- rent stringent infection control protocols — and looking for ways to be even better. "There will be a next one," she says. "We were ill-prepared this time around, and we could have done more. That can't happen again." If the surgical community's response to a pan- demic — making operational changes, addressing workers' mental health needs and participating in a civil rights struggle in the middle of it all — the prospect of an improved performance in 2021 is bright. OSM D E C E M B E R 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 2 9 VIRTUAL EXISTENCE Dr. Catherine Matthews has bought into the benefits of telehealth, and hopes use of the technology increases, even when the pandemic eases. Wake Forest Baptist Health