To respond to the
daily public health needs of Louisianans, the Louisiana Department of Health
has divided the state into nine regions. Each of these regions is led by a
regional medical director (RMD) or administrator who oversees the parish health
units in their region. Regional medical directors are in constant contact with
state health leadership and local leaders to help guide Louisianans through the
COVID-19 pandemic, particularly among key demographics.
In this Q&A blog
series, these public health leaders will be answering the same questions, and
together they will paint a statewide perspective of the COVID-19 pandemic and
their communities’ response. Today, you’ll hear from Region 3’s Dr. William
“Chip” Riggins, Regional Medical Director for the parishes of Assumption,
Lafourche, St. Charles, St. James, St. John, St. Mary and Terrebonne.
I get questions about the number of cases in the community
from many folks I meet. I always refer them to the OPH Dashboard but they are most
interested in the experience in their specific neighborhood. I remind them
about the need for confidentiality and how easily that can be broken when we
get too far down and the numbers are low. For most purposes, I think parish-level
data is really sufficient to make decisions around our daily lives. If it’s in
the parish, it’s not very far away — especially since the majority of our
region’s land mass is swamp or marsh.
I think folks are aware of the recommendation but they may
be confused by the differences, even when subtle, in the messages they are
hearing and the examples they are seeing. Those who have personally had
COVID-19 disease or know someone who has been ill or died are the most clear on
the importance of social distancing and masks.* That is always the case.
Old habits are hard to break, and I see a lot of effort to
create safe spaces with signage and markings on the floor, with sanitizer,
wipes and masks, sometimes being observed and sometimes being overlooked. The
trend I’m seeing is that while everyone struggled to safely be open or re-open,
the larger facilities and chains have come the farthest in terms of their adjustments
— not surprising. The smaller businesses and unaffiliated organizations like
churches have wider variation in their plans and processes but I have seen some
really innovative things in smaller spaces, too.
I think one of the biggest challenges is overcoming the
expectation, that as a community, we have to be either fully open or fully closed.
I see our new normal as a balancing act between opening up until the data shows
the disease is spreading again and then slowing down or even backing up in our
reopening if necessary until the disease slows. Fighting COVID-19 reminds me of
riding a unicycle: it requires a lot of minor adjustments, and that means a lot
of minor changes to our recommendations. It’s not as easy to follow constantly
changing recommendations, but that’s what’s going to help us flatten the curve
over the months ahead until we get a vaccine. I am afraid that if we all don’t commit
to constantly watching our community’s data, and making the minor changes and
respecting the limitations in each of the phases of reopening, we could see much
larger swings in disease rates again — and no one wants to see that.
We are proud of our friendliness as a community here down
the bayou, and there is a reluctance to correct others or address issues like
social distancing and masks with each other. I think we maybe we are going to
have to all try to thank the folks we see doing it well and use our
friendliness to emphasize the positive.
On one of our early regional ESF-8 calls, the nursing home
rep reported that many residents were distressed (and depressed) by not being
able to leave their rooms and even walk a little. Within a week or so our
social services representative had linked seamstresses in the region to the mission,
and each and every nursing home resident in this region was provided a cloth
mask of their own — amazing!
Our region has the fewest hospital and ICU beds and
ventilators per capita in Louisiana. That means that our region is more
vulnerable to having this virus overwhelm our emergency rooms, hospitals and
healthcare system. Flattening the curve in our region truly means saving more
lives than just the victims of COVID-19 — it means having the capacity to help
those with other disease and injuries and saving those lives as well.
*According to the LSU Manship School Survey of Public Reactions to Coronavirus in Louisiana (June 2020), those with personal
experience are the most risk adverse/compliant with social distancing and
wearing masks.
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