Politics

How One Academic Medical Center in Deep-Red Louisiana Made a Difference With Early Testing

THE KEY

Louisiana is getting pummeled by the virus. But without a comprehensive early testing program in Shreveport, it would have been worse still.

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In a press conference last week, Louisiana Governor John Bel Edwards (a Democratic governor in a very red state) encouraged citizens to participate in three days of fasting and prayer during their lunch hour from July 20 to July 22. Edwards' spiritual call came as he announced the new mask mandate and closure of bars by executive order that went into effect on Monday, July 13, 2020. Louisiana was one of the hardest hit states this past spring by the coronavirus and is once again seeing spikes. As of last Friday, Louisiana registered 88,590 cases, with 3,399 dead and 1,413 in the hospital, according to The Times-Picayune

The virus exploded in the state back in March, with the epicenter in New Orleans, where Mardi Gras celebrations had just drawn more than 1 million people. Louisiana suffered, no doubt about that. And the virus is on the rise there again.

But it’s also true that the state actually rose to the occasion by keeping its numbers lower, particularly in the state’s northern region around Shreveport, up near the Texas and Arkansas borders. Louisiana has the second-largest population of Black people in the United States (32 percent) and health officials feared an outbreak due to health disparities. Louisiana ranks 49th in America’s annual CDC health rankings.

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Understanding this fact, Louisiana State University Health, located in Shreveport, commenced an aggressive testing program to create easy access COVID-19 testing for African-Americans in medically underserved areas. The hospital dispatched a “mobile van” previously devoted to wellness education on issues like cancer screening, diabetes, hypertension, and obesity, and turned it into a free COVID-19 education and testing asset.

As New Orleans began to spike, LSU Health Shreveport dispatched a “strike team” of seven residents and an ER physician to New Orleans to help assist them with clinical care. More impressive, a high-capacity, exceptionally reliable testing lab dubbed the “Emerging Viral Threat Lab” was stood up and made operational in only 12 days. LSU’s lab opened on March 25, 2020, long before most other places were able to wrap their heads around the scope of this problem.

As the country now is seeing a surge in COVID cases, red states might do well to follow the roadmap LSU health officials put in place. The key to their success was having a well established and trusted relationship with the community and more importantly, officials understood the devastating impact that the virus would have on local communities of color if they did not test early and often.

“From the beginning of the pandemic, we have focused on providing testing to minorities and medically underserved geographical areas in north Louisiana,” said Dr. Chris Kevil, vice chancellor of research at LSU. “Results from these efforts have enabled creation of consistent community testing services that we will continually expand, to be ready for and hopefully lessen subsequent waves of viral outbreaks. We are also working with nursing and assisted living facilities to expand testing to prevent further viral outbreaks in these critical areas.”

The fact that LSUH-Shreveport was able to offer this testing for free cannot be overstated. How did they do it? Funding came from Caddo Parish, which gave $175,000, while a local business, Inferno Manufacturing, kicked in the balance of $125,000, for a total of $300,000 to get the ball rolling. Support from Governor Edwards and the Louisiana Department of Health made possible the quick creation of the emerging viral threat lab—whose results were 99.7 percent accurate, according to LSU health university spokeswoman Lisa Babin. 

The good news, despite still being a “hot spot,” is that Louisiana now ranks number three in the country in testing per capita. 

“The Emerging Viral Threat Lab at LSU Health Shreveport is delivering testing accuracy just above 99 percent based on an extremely sensitive assay coupled with experienced testing staff who consistently operate within established control parameters. This combination is resulting in essentially no false negatives,” said Chris Kevil, vice chancellor for research at LSUHS.

LSU Health Shreveport has won national recognition for its quick and significant efforts to treat COVID-19 patients. Data obtained from the emerging threat lab testing samples will be used for COVID-19 research to determine how to combat the virus. Patients also had access to serology testing which determines if they have already had and recovered from the virus. With LSU Health Shreveport being the first site in Louisiana and one of the first in the nation to offer convalescent plasma therapy, serology testing was essential to identifying plasma that would be an effective match to critically ill COVID-19 patients.

LSU Health Shreveport continues its efforts to combat COVID-19, initiating a clinical trial to determine the best dose of the anti-clotting drug Enoxaparin to reduce clot formation in COVID-19 patients. Although COVID-19 is thought of primarily as a respiratory disease, approximately one in five COVID-19 inpatients show signs of widespread blood clot formation with their vessels, limiting the ability of the cardiovascular system to supply tissues of the body with needed oxygen and nutrients.  

The reality America faces right now is that the virus has not gone away and shows no sign of slowing down. Hospitals in major cities such as Houston and Miami are overwhelmed. The same is true in Los Angeles, which has issued a warning to residents to brace for a dramatic spike in cases and has reordered bars and beaches to close once again.

All these major cities are home to large populations of citizens of color. And many lag woefully behind in their testing and tracing. While there is more work to do, it appears that the awareness of LSU Health has made the difference in Louisiana’s early and present numbers. The good news, despite still being a “hot spot,” is that Louisiana now ranks No. 3 in the country in testing per capita. 

The spike we are seeing now according to experts is likely due to COVID fatigue, meaning people want out of the house, and they want to socialize, and they do not want to wear masks. As of now, Louisiana is at a Phase 2, which means 50 percent occupancy at bars and restaurants, churches are open, weddings are happening, and they all require 36 square feet per person of individual space. But the only way to keep people safe is testing, testing, and more testing. As Dr. G.E. Ghali, chancellor at LSU Health, told me, “Early testing in areas with significant racial health disparities is imperative to address the current disproportionate suffering from COVID-19.”

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