Friday, August 14, 2020

Q&A with the RMDs: Dr. Tina Stefanski

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 many of 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 4’s Dr. Tina Stefanski, Regional Medical Director for the parishes of Acadia, Evangeline, Iberia, Lafayette, St. Landry, St. Martin and Vermilion.

The most common questions now are about the transition back to schools and how they will open again, safely, for teachers and students. We have been assisting public and private schools with their plans to open, reviewing our guidance with local school officials and answering their questions.

These are not just pre-opening conversations, as I fully expect to be having these discussions and addressing questions over the next several months. You have to remember: There is no playbook for this. We must be ready to deal with each new situation as it comes up. Although this will be challenging, we are committed to having schools reopen safely.

What safeguards will be put into place to limit the spread of the virus on school campuses? What is the notification process if a child or faculty does become ill? What are the triggers for quarantining students and, potentially, classes?

It is not just a school-to-parent communication. We need parents to be fully transparent and notify the school if their child is ill and if they have or may have COVID-19. This information will help us and the schools determine if there were any possible exposures in the school setting.

Earlier on, I think people did not fully understand the reasoning behind the wearing of a mask. All of that seems to be improving. It has been great to see the increase in compliance with mask wearing in our Acadiana area since the Governor’s mandate. The people of Acadiana really have responded to this preventive measure, which is encouraging.

When it comes to large gatherings, the news isn’t the same. We still see people gathering in large groups and not maintaining physical distance, especially at social events like weddings and dinner parties. We’ve had more than one report of a guest who becomes ill shortly after attending a wedding. They were contagious at the wedding and inadvertently exposed other people, who then became ill.   

Changing behavior is hard. We have a very friendly, outgoing culture here in Acadiana. The idea of social distancing is very new for all of us, but it is such a critically important piece to slowing down transmission, flattening the curve and, ultimately, saving lives.

When people test positive, feel ill or were a close contact of someone with COVID-19, they must stay home. We really need to do a better job of protecting our friends, family and community. 

A big challenge is getting the message across about the role of asymptomatic spread: people who have COVID but no symptoms, or their symptoms are very mild. They are still contagious. When people don’t feel so bad, they are often reluctant to stay home. Or, they think that their symptoms might be related to something other than COVID. With this virus, there is such a wide range of symptoms and the clinical picture is quite diverse — it really is challenging. Some people may have only a sore throat, mild headache and fatigue. Others, a cough and fever. Still others might only lose their sense of taste or smell.

When you live in a community with such a high level of viral activity — as we have now — you have to suspect COVID when you have any of these atypical symptoms. Then, stay home and monitor your symptoms. If they persist or progress, seek medical attention and testing. But, please remember to stay home while you await your test results.

While staying at home, be sure to avoid close contact with people who have high-risk conditions such as high blood pressure, heart disease, diabetes, obesity or lung problems, or those who are older than 65. Older people are more at risk of becoming severely ill or dying from infection with this virus.

It’s uplifting to hear the stories of people who have had severe cases and are fortunate enough to survive, but it’s also hard to hear of their lingering health problems.

The most upsetting thing has been the loss of life in our communities.

This is ultimately what we, as a community, need to pull together to prevent. We don’t want any other person or their family members to suffer from these sad outcomes.

On a very positive note, we have a tremendous healthcare community in Acadiana. The medical care delivered through our outpatient clinics and hospitals is top-notch. We are incredibly fortunate to the have the resources that we have here in Acadiana.

We have been busy with community-based testing. Our goal is to direct testing to the places where we are seeing higher numbers of cases, elevated positivity and hospitalizations, and to communities where access to testing may be limited. I am still concerned about the slow turnaround times, but they are improving. This is another hopeful sign.

We also remain very focused on nursing homes. As a state, we have implemented routine facility-wide testing. This helps identify cases early on and limit the spread of infection. Nursing home residents are the most vulnerable of us. We are committed to doing all that we can to protect them.

We continue to work with our public officials, medical professionals, community leaders, non-profit organizations and the general public. We are sharing information and answering questions so we all have the tools we need to protect the health of our families and communities. 

We are fortunate to have multiple, active workgroups and healthcare coalitions, well established and extremely helpful communication networks between hospitals, physicians, public health and public officials. This remains a rapidly evolving pandemic — guidance is updated, situations change — and we communicate well and often through these networks.


  1. Thank you, Dr. Stefanski, for your hard work and calm, reasoned, evidence-based approach to managing this pandemic. I have a question:
    When we say significant exposure means close contact with an infected person for 15 minutes, does that mean 15 consecutive minutes or 15 cumulative minutes? If a teacher in a classroom has brief close contact with an infected student, and over the course of the class time that amounts to 15 cumulative minutes, is that a significant exposure?

    1. Close contact is defined as a 15-minute duration of time in one setting.

  2. What happens to the students that can’t stay home because there parents work and have no one to keep them and they can’t wear a mask To school due to medical conditions

  3. What happens to the students that can’t stay home because there parents work and have no one to keep them and they can’t wear a mask To school due to medical conditions

  4. I understand the need to protect our vulnerable population, but given that children have been statistically less impacted by the virus, why can’t there be an option to remove masks at school if a waiver has been signed by the parent/guardian? What respiratory complications may arise in otherwise healthy children after the continued use of masks? Is there a foreseeable end to this mandate? And if masks are effective at preventing the spread of the virus, why is our board of education requiring partitions be installed in classrooms? I understand it is due to the desks not being separated by 6 feet but I think federal funds could be better spent elsewhere. Perhaps use the funds for a daily fogger to sanitize the rooms instead. Also, have we considered what long term effects these precautions will have on the mental health of our children? The virus isn’t going away and a majority of parents will not vaccinate their children with a rapidly developed vaccination. Does that make these past months of isolation and implementation of safety precautions pointless?

    1. The goal of guidance is to protect all members of the public since everyone is at risk for getting the virus and transmitting it to others. Allowing for waivers results in more pathways for the virus to be transmitted and puts more people at risk.