Louisiana Department of Health: Questions and Answers with RMDs: Dr. William ‘Chip’ Riggins

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To meet the Louisianans’ daily public health needs, the Louisiana Department of Health 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 series of question and answer blogs, these public health leaders will answer the same questions and together paint a statewide perspective of the COVID-19 pandemic and the response of their communities. Today you will hear from Dr. William “Chip” Riggins, Regional Health Director for the parishes of the Assumption, Lafourche, St. Charles, St. James, St. John, St. Mary and Terrebonne.

I get questions about the number of cases in the community from many people I meet. I always refer them to OPH panel but they are more interested in the experience in their specific neighborhood. I remind them of the need for confidentiality and the ease with which it can be violated when you get too low and the numbers are low. For most purposes, I think the parish-level data is really enough to make decisions about our daily life. If it is in the parish, it is not very far, especially since most of the territory of our region is swampy or marshy.

I think people are aware of the recommendation, but they may be confused by the differences, even subtle ones, in the messages they are hearing and the examples they see. Those who have personally had the COVID-19 disease or know someone who has been sick or died are the clearest about the importance of social distancing and face masks. * This is always the case.

Old habits are hard to break and I see a lot of effort to create safe spaces with signage and signage on the floor, with disinfectant, wipes and masks, sometimes observed and sometimes overlooked. The trend I see is that while everyone has struggled to be safely opened or reopened, larger facilities and chains have come farther in terms of adjustments, unsurprisingly. Small businesses and non-affiliated organizations like churches have a wider variation in their plans and processes, but I’ve seen really innovative things even in smaller spaces.

I think one of the biggest challenges is overcoming the expectation that, as a community, we have to be completely open or completely closed. I see our new normal as a balancing act between opening up until the data shows that the disease is spreading again and then slowing down or even going back into our reopening if need be, until the disease slows down. . Fighting COVID-19 reminds me to ride a unicycle – it requires many small adjustments and that means many small changes to our advice. It’s not that easy to follow the ever-changing recommendations, but it’s what will help flatten the curve in the months to come until we have a vaccine. I’m afraid that if we don’t all make an effort to constantly monitor our community’s data, making the small changes and sticking to boundaries at each stage of the reopening, we might see much bigger swings in disease rates again – and no one wants to see that.

We pride ourselves on our friendliness as a community here at the bottom of the bayou, and there is a reluctance to correct others or to address issues like social distancing and masking with each other. I think maybe we should all try to thank the people we see doing it right and use our friendliness to emphasize the positive.

In one of our first regional ESF-8 calls, the nursing home representative reported that many residents were distressed (and depressed) at not being able to leave their rooms and even walk a bit. Within a week or so our social services representative had connected the region’s seamstresses to the mission, and every nursing home resident in this region was provided with their own cloth mask – amazing!

Our region has the fewest hospital and ICU beds and ventilators per capita in Louisiana. This means that our region is more vulnerable to this virus engulfing our emergency rooms, hospitals and the health system. Flattening the curve in our region really means saving more lives than just COVID-19 victims: it means having the ability to help those with other illnesses and injuries and saving those lives as well.

* According to LSU Manship School Survey on Public Reactions to the Coronavirus in Louisiana (June 2020), those with personal experience are the most at risk averse / compliant with social distancing and wearing masks.

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