A robust response to COVID-19 means focusing resources in the areas where transmission rates are highest, Dr. Alex Garza, chief medical officer for SSM Health told the St. Louis American earlier this week.
In St. Louis, those areas are nursing homes, North St. Louis County, North City and parts of South City, he said. This response includes ensuring that residents in these areas have access to masks and gloves — also called Personal Protective Equipment (PPE) — and to social services that would allow them to isolate and quarantine, he said.
“The whole goal is to decrease transmission,” Garza said. “Everything that we should be focusing on should be directed towards that goal. If there are things that are negatively impacting that goal, such as people don’t want to get tested because they can’t afford to take off work, then you have to support them so they can take off work. Otherwise you are going to just keep increasing your chance of transmission.”
Garza is also the incident commander for the St. Louis Metropolitan Pandemic Task Force, which includes metropolitan area’s largest healthcare systems: BJC HealthCare, Mercy, SSM Health and St. Luke’s Hospital.
During Garza’s May 8 briefing, he responded to the American’s question: if decreasing transmission is the goal, has the task force advised regional leaders about the immediate need to create a stockpile of masks that can be distributed to under-resourced communities when the shelter-in-place orders are lifted on May 18?
Garza responded, “High-risk groups do need more attention.”
The task force has been in discussions with both the providers for long-term care and assisted living facilities, he said, as well as public health officials on how to best get them resources, including PPE.
“Some of those communities that are harder hit, such as North St. Louis County and North City also need some additional resources as well,” Garza said.
The task force has been in discussions about different approaches to help with isolation or quarantine, including providing hotel rooms and kits including thermometers and PPE.
“A lot of the people who can’t afford to take two weeks off to quarantine, what kind of wraparound services can we provide to those people?” Garza said. “Those discussions are going on right now.”
Buses and some businesses will be able to turn people away for not wearing masks, when public health restrictions are lifted on May 18 in St. Louis County and the City of St. Louis.
That means people who can’t afford or find masks will be denied services that they desperately need, said Rebeccah Bennett, founder and principal of Emerging Wisdom and InPower Institute.
“What we require we must support,” Bennett told the American. “We should not as a society require protections that are not readily accessible or affordable for our most vulnerable without doing everything we can to make them widely available.”
Bennett is the community engagement and outreach lead for PrepareSTL — the joint protection and education campaign for the City of St. Louis Department of Health and the Saint Louis County Department of Public Health.
Bennett and Dr. Will Ross, a professor at Washington University School of Medicine, have called on regional leaders to provide up to 200,000 masks to areas that will not be able to access and afford them, but are the most vulnerable to the virus.
“We have to give the public the assurance that on May 18, the masks will be available,” Ross said, during the May 7 Joint Board for Health and Hospitals for the city, which Ross chairs. “If we can’t do that, then we are doing an injustice.”
After Garza’s briefing, the American sent a follow-up question to the task force’s spokesman asking whether or not the task force is supportive of this call for masks to the general public. The American is awaiting a response.
On Friday, May 8, Garza reported that there were 506 patients in the task force’s hospitals and who had either tested positive for COVID-19 or were awaiting test results.
That’s down from 596 on Thursday. The number of patients in the intensive care units is 133 ― down from 147, and the number of people on ventilators is 104 ― down from 106.
Garza has said that the seven-day moving average of the total number of COVID-19 patients in the hospitals is a good indicator of transmission in the region. It was 625 on May 8, which was down from 646 yesterday.
Another important data point is the seven-day “moving average” of new hospital admissions, which is an even more timely data trend than the hospitalization average, Garza said. That average falls between 33 and 38, he said, and has seen a steady decline with a “few upticks.”
Across the system hospitals, 56 COVID-19 patients were discharged yesterday, bringing the cumulative number of patients discharged to 1,609.
