As the COVID-19 pandemic makes its way through North St. Louis County, Christian Hospital remains a resource for testing, health care and nutrition for the elderly and food for residents living in food deserts.
Longstanding health disparities conflate the damage COVID-19 is doing in North County, which has the highest prevalence of illness and deaths from COVID-19 in the region.
“It’s a high impact in 63137, 63138, 63033 – all of those ZIP codes and many more around North County have a high incidence of COVID patients and COVID-related people who have the virus right now,” said Rick Stevens, president of Christian Hospital.
“North County has the highest prevalence of diabetes. And with diabetes, if it’s not taken care of, come other things, such as heart disease, kidney disease, high blood pressure, congestive heart failure, COPD. So, the community is sick.”
He said COVID-19 is shining a light on those health disparities and inequal access to care, and that’s where Medicaid expansion comes into play. Stevens helps to lead the push for Medicaid expansion in Missouri in the medical community. Last fall, advocate groups began gathering signatures throughout the state to get the question to voters on the November 2020 ballot.
On Friday, May 1, the Healthcare for Missouri campaign on Friday submitted nearly twice as many signatures from Missourians as required to get Medicaid expansion on the November 3 ballot in Missouri.
“Medicaid expansion will give individuals an opportunity to go to the doctor,” Stevens said. “If you are a childless adult and your income is $4,000 to $5,000 a year, that’s what you would have to qualify for. But if your income is like $10,000 per year, $12,000 per year, you don’t qualify now. And so, what you do is, delay going to the doctor.”
Stevens said the public health crisis with COVID-19, along with millions of people losing their jobs to the pandemic, is increasing the need for Medicaid.
“The Medicaid rolls have really increased here in the last few weeks because individuals have lost their jobs,” Stevens said. “I think this gives a lot of momentum to Medicaid expansion on the ballot and for it to pass.”
According to the website for MO HealthNet, as Medicaid is called in Missouri, persons who tests positive for COVID-19 may qualify for Medicaid. Proof of diagnosis, along with an application and other information needed, can be found at mydssmo.gov/healthcare.
Stevens said widespread testing is the key to overcoming the pandemic, but there are not enough tests. Although Christian Hospital would not give out individual hospital-specific data, as of April 23, the BJC system had conducted 11,920 tests, 1,800 of which (15.1%) were positive for COVID-19.
“Christian has been very busy taking care of our COVID-positive patients in the North County community,” Stevens said, and they celebrate as each recovered patient is discharged from the hospital.
“On any one day, Christian has 10-12% of the inpatient COVID-19 patients in the St. Louis region,” said a BJC spokesperson, who provided numbers from the St. Louis Metropolitan Pandemic Task Force, which includes BJC, SSM Health, Mercy and St. Luke’s hospital systems. As of April 28, there were 678 patients hospitalized with COVID-19, with 159 in the ICU and 113 on ventilators. This number includes all hospitals systems that are a part of the task force.
With North County being impacted heavily by COVID-19 cases in the area, Stevens said it is important that Christian hospital participates in clinical studies as health researchers seek a vaccine or a treatment to curb the spread of COVID-19.
“We’re going to be part of a clinical trial for COVID,” he said. It is the Convalescent Plasma Study, a trial that uses plasma from persons who have recovered from the coronavirus and injects it into COVID-19 patients to help them recover.
“I think that’s important, too, that we are part of the clinical trial,” he said, “because clinical trials should happen where the high impact areas are, the hotspot areas.”
Social distancing, and the lack thereof
Stevens said he thinks COVID-19 has scared a lot of people, with people heeding the medical advice to wash hands frequently, staying inside and, when they do go out, to wear a mask. ‘
“But I also know there are a lot of people in North County who are not physically distancing,” he said. “There are a lot of people who are not wearing masks, because in the black community, there is a lot of mistrust. You look at the Tuskegee Experiment, you look at some other experiences at well. So, we have some individuals who don’t trust what they are hearing.”
But he said those same people are now seeing multiple family members and friends who are being sickened by COVID-19 and even dying.
“I try to be as careful as I can, because it’s easy to just walk around and you be in the presence of someone and not have your mask on,” he said. “And now we’ve found out that you’re pre-symptomatic, and you can share it; you’re asymptomatic, you can share it; so, we just have to be very, very careful.”
The Centers for Disease Control and Prevention added additional symptoms that may indicate COVID-19 infection. In addition to fever, cough, difficulty breathing or shortness of breath, the CDC has added chills, repeated shaking with chills, sore throat, headache, muscle pain, and new loss of sense of taste or smell. It says older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19.
“Our employees have been coming into this new war, ready to go to battle every day. And the fact is they have the possibility of taking this home to their families,” Steven said.
“You think about the housekeeping. We can’t do this without the housekeeping. They are the ones who have to clean the rooms after people leave, or if a person is in there. The food service worker – they go in there and deliver the food to someone who may have coronavirus. And then you have your nurses and your doctors, your respiratory therapists, your physical therapists – all your ancillary staff, your people who draw blood – all our staff is going into these rooms, day in and day out, taking care of very, very, very sick individuals.”
It is certainly to be commended.
“I really want to say a big thanks to our staff to our teammates that do this every day,” Stevens said. “The staff at Christian is very proud of the work they do, and they are very proud to see when someone goes home, and they can recover.”
In the meantime, the hospital remains open to other medical needs. Though a slowdown in other health services is part of a national trend due to fears of COVID-19, Stevens encouraged people to seek medical care if they need.
“People are delaying their care; they are scared to come,” Steven said. “People are masked. We are doing a lot of screening before you come in. You just need to come in and get taken care of.”