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.