Most Coloradans are feeling some fear and anxiety surrounding the novel coronavirus, but for one population in particular, these psychological concerns carry extra weight. Colorado has an estimated 200,000 undocumented immigrants, many of whom work in the hotel and restaurant industries. With many unable to qualify for unemployment benefits, government stimulus checks, or other aid, this segment of the community is already vulnerable. But for those who are experiencing COVID-19 symptoms, the concerns only increase.
Dr. Josh Emdur, medical director of Clinica Colorado, a nonprofit that provides low-cost primary health care, says that many undocumented immigrants are unaware of the resources available to them. Add to that language barriers, economic factors, and fears of deportation, and the current public health crisis may make these individuals feel like they have nowhere to turn for care. “Under the Trump presidency, there’s just so much uncertainty with being deported. Now with COVID-19, it escalates that fear,” says Emdur. “There’s a lot of misinformation out there, like, ‘If I’m sick and I go to the emergency room, will I be deported?’”
To fill a gap in the healthcare system and provide service to this population, Clinica Colorado has partnered with a group of volunteer software engineers from the Innovation Response Team to create CovidLine, a free, bilingual tele-health hotline people can call to speak with volunteer doctors and medical students if they are experiencing symptoms of COVID-19.
CovidLine also provides services to uninsured Coloradans, who have their own misgivings regarding the virus. “They really don’t want to go to the emergency room. They worry about what that bill is going to do for them long-term—their house, their everything,” says Vanessa Vergara, a clinician with Clinica Colorado who is working on the CovidLine.
CovidLine uses an Interactive Voice Response system (IVR), a chatbot that walks callers through a series of questions based on the CDC’s symptom-checking algorithm. Created with privacy concerns at the forefront, all the data collected by the IVR system is HIPPAA compliant.
If a caller meets the criteria for risk factors related to COVID-19, they are given a free tele-medicine appointment. In some cases, a medical provider will remain in frequent touch with the caller, providing tips on how to manage the disease from home. The overall mission is to “prevent any kind of surge on the health care system,” says Emdur. “It’s about making sure people who don’t need to be going to the emergency room don’t just show up wanting a test.”
In other cases, providers educate patients on when to go to the emergency room,” says Vergara. “When you feel like you are really short of breath and your inhaler’s not helping you, that’s not a reason for you not to go to the emergency room because you don’t have insurance,” she says. “We’re talking about breathing. You need to be able to breathe.”
CovidLine and other telehealth initiatives will be here to stay following the pandemic. In fact, it’s a trend that was already growing before the COVID-19 outbreak. Nationwide, telehealth use rose dramatically—by 1,393 percent—between 2014 and 2018. According to Emdur, certain medical issues are simply better suited for being handled remotely. “One of those is you have a fever and a cough, and it’s COVID times,” he says.