Tuesday, June 30, 2020

Q&A with the RMDs: Dr. Lacey Cavanaugh


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 5’s Dr. Lacey Cavanaugh, Regional Medical Director for the parishes of Allen, Beauregard, Calcasieu, Cameron and Jefferson Davis.


I receive lots of questions regarding testing. Who should be tested? When should they be tested? What type of test should be used? What does the result of that test mean? The challenge here is that this area has rapidly changed since the onset of the pandemic, with new test types becoming available and new sets of people being tested as supply changed. In addition to guidance changes, people receive mixed messages. I usually recommend that people consult with their individual doctors to determine what test is appropriate based on the situation, and always consult CDC or LDH guidance because it is ever changing. However, in general, PCR testing (the nasal swab) is what tells us if you have the virus RIGHT NOW. PCR testing takes a few days to become positive, so if you were exposed yesterday and get a PCR test today, that’s not very useful. Antibody testing (fingerpick or blood draw) tells us if you have been exposed to the virus in the past — but it can take weeks after exposure to turn positive. We also don’t know that this means you are immune, so these test types are more for curiosity than for serving a medical purpose right now. They should definitely not be used to justify return to the workplace.

I think many people do understand the importance and want to follow guidance. I see people being more understanding during times when the number of cases locally is high, and I have seen increases in mask wearing and social distancing since our cases started to increase. There are also those people who choose not to follow guidance for a variety of reasons. My advice is to follow guidance from reputable sources — many of the reasons cited for not wearing masks come from social media and are not backed by science. Just as with anything else, people should be really cautious in receiving advice from social media.

I have seen challenges in social distancing and mask wearing. It’s hot outside. Masks are uncomfortable. People are tired of COVID. These are all real challenges. I do think that people in Southwest Louisiana care deeply about our community and want to do the right thing. I think we can continue to improve here, and I am seeing some improvement since our cases started to rise.

One of our biggest challenges is our culture. In Southwest Louisiana, we are a small town at heart. Friends and family, gatherings, food, parties and festivals are part of our core sense of identity. We are proud of our roots and social culture, and this makes it difficult to properly socially distance. It’s hard to change community norms when gatherings are such an important part of our lives. The longer COVID is with us, the more difficult this has become. I encourage us to find new and safer ways to gather and celebrate. I don’t think social distancing and celebrating are incompatible, but I do think we will need to find different ways to do both simultaneously in the near term.

It strikes me that this virus has gotten so personal. It’s hard to even go into the grocery store without seeing people I know who have been impacted by COVID in some way. Everyone has had a different challenge, but COVID has challenged everyone in some different way. There isn’t a person I know untouched by the far-reaching effects of this virus. People are handling it as best they can and trying to stay positive, and are understanding that we have a long way to go before recovery.

One situation that really made me smile is the medical community coming together and stepping up to the plate to organize a drive-thru testing site. It took coordination and cooperation from several local hospitals, the Office of Public Health, parish leadership, local labs, the Louisiana Army National Guard, EMS and many others. I am proud that we could all work together as a community to accomplish standing up that site with limited supplies, limited PPE and limited time. It was a true testament to the power of strength in numbers and working together.

Stay strong, SWLA! I know it’s hard, but I have confidence that we will get through this.

16 comments:

  1. How can I report a business where the workers were not masked or wore them below their noses? My husband and I needed filters and wood working supplies and thought Home Depot would be the best place to go. We were both supprised to see the blantant disregard for their customers.

    ReplyDelete
    Replies
    1. Please contact your local sanitarian (health inspector). To find your local sanitarian’s office, please visit this link: http://ldh.la.gov/index.cfm/page/3745

      Delete
  2. Good insight. THank you Dr. C!

    ReplyDelete
  3. The bottom line is masks and social distancing are the only way to save lives. As the virus gains a new foothold, more and more people will become sick and many will die. Those who refuse to follow the mask and distance rules are not just exposing themselves to serious illness or death, but are also exposing everyone who comes in contact with them. There is a difference between freedom and demanding the right to put others in possible deadly situations over some issue of pride and defiance. If Louisiana really IS a family, then we should protect each other even MORE than other states but we only pay lip service to STAYING STRONG. Staying strong means not giving in to the temptation to go out unprotected and perhaps bringing a deadly disease home to your family and loved ones.

    ReplyDelete
  4. Where can I get information and help as an employee of a small business? One of the owners of this business is sick and has tested for COVID19 and awaiting results. The owners Are a couple and live together. The one that is sick is staying away. The other owner comes to work daily. We deal it’s the public DAILY. A gym where we have 130-190 clients enter daily. The owner has close direct contact with customers by shaking hands and does not wear a mask. Our members have potentially been exposed and are not aware of this. This business is becoming a hot spot as some members reported testing positive. Those members have stayed away and quarantined. The owners are not being truthful to us as employees and they are not protecting customers.

    ReplyDelete
    Replies
    1. Concerns about ill employees or owners should be addressed to Sanitarian Services. Visit this link to contact a sanitarian nearest you: http://ldh.la.gov/index.cfm/page/3745

      Delete
  5. Where can I get information concerning the safety of the apartment where I live. One of the managers is sick and has tested positive for COVID19. This is a Senior Residence and many of us have very serious health issues. So far the office has not been closed and the building has not been sanitized. There is not any signs posted asking that everyone wear a mask upon entering any of the 3 buildings especially the main building where the office is located (and where I reside). Will you please provide me with any information that will help with this problem.

    ReplyDelete
    Replies
    1. All residential care facilities (nursing homes and assisted living facilities) follow strict guidance for the isolation of residents with COVID-19, staffing and testing requirements and reporting requirements. Apartments, including those that serve seniors, are not required to follow the same requirements.

      Those who live in apartments should take the necessary personal precautions to protect themselves including staying at home as much as possible, practicing good hygiene, keep at least 6 feet apart from others and wear a mask when leaving your apartment. If you feel sick, you should contact your healthcare provider.

      Delete
  6. I was in Roosters today getting my grandson a haircut Two men cane in and didn’t wear a mask and were not asked to put on a mask. Some employees weren’t wearing one either. Who do I call to report this? My grandson is 6 and has health issues, including asthma. It’s just blatant disrespect to not care about others.

    ReplyDelete
    Replies
    1. If someone has a concern about a business that has reopened and is not following state guidelines, they can call the Louisiana Office of State Fire Marshall at 1-800-256-5452.

      Delete
  7. Hi! I’m finding many different answers coming from the medical field! I was tested Positive of Covid 19. I was told to quarantine for 14 days and until my fever and other symptoms have gone away. I had knee injections paid for and scheduled. But the dr insisted that I must supply him with 2 negative test results for Covid, before he will see me! Ok the CDC GUIDELINES say only one test ! So how and where do I get the other test done? It’s is very frustrating and confusing! Someone help please!

    ReplyDelete
    Replies
    1. Persons with COVID-19 symptoms and/or a positive test who were directed to care for themselves at home may end self-isolation when at least 3 days (72 hours) have passed since recovery, meaning:

      • Fever free without the use of fever-reducing medications, and
      • improvement in respiratory symptoms (e.g., cough, shortness of breath), and
      • At least 10 days* have passed since symptoms first appeared.

      Persons with laboratory-confirmed COVID-19 who have not had any symptoms may discontinue self-isolation when at least 10 days** have passed since the date of their first positive COVID-19 diagnostic test and have had no subsequent illness.

      Delete
  8. What is dhh/oph doing as far as public awareness on regards to known businesses with a high number of cases and the people whose positive are risking the community by not being quarantined and not disclosing. IT SHOULD BE A MATTER OF COMMUNITY AWARENESS

    ReplyDelete
  9. Many are reporting on social media that once a person takes a test and it is reported as positive for Covid 19, that they may take multiple tests thereafter (such as to be able to return to work they must have a negative test); but each subsequent test is being reported as a NEW coronavirus case. Therefore the argument goes that the number of positive cases is being over-reported. What is the truth? Are multiple tests of the same person reported as new cases for each test?

    ReplyDelete
    Replies
    1. Case counts reported on the LDH website represent individual persons with positive results for COVID-19, not numbers of positive test results received. An individual may be tested multiple times and receive multiple results (positive, negative or otherwise), but regardless of repeat tests that person is represented a single time for case counting.

      LDH uses an extensive de-duplication process involving automated and manual review to account for non-exact person matches due to data entry errors, incomplete data and other issues in the lab data reported to LDH. Also, great care is taken to correctly assign cases to a home parish to avoid duplication in instances where a person is tested in more than one parish.

      Despite our best efforts, there may still be a small number of duplicate records in our dataset, and these will be resolved as they are detected, which may lead to changes in case counts.The actual number of positive cases is likely higher than reported on the LDH website due to test reporting lags, incomplete testing, and undetected cases among asymptomatic individuals and those who become sick but never get tested. You never know who around you may be sick, which is why LDH continues to recommend personal protective measures including handwashing, wearing face masks and physical distancing of at least 6 feet from others.

      Delete