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Monday, March 23, 2020

The Mission to Teach, Heal and Discover

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It has never been more important than it is today during the Covid-19 pandemic

Having an academic medical center (AMC) is a “gem” touted frequently throughout north Louisiana and beyond. We should all be thanking those in our community, who worked diligently to bring a school of medicine, school of graduate studies and school of allied health professions to our community as the reward for their efforts has never been greater than during todays’ pandemic. While many in the nation are fearful of having appropriate access to testing and quality care during the Covid-19 pandemic, thanks to those visionaries north Louisiana is infinitely better positioned than most communities to face Covid-19.

One reason we are blessed (as shared recently by one of our school of medicine alums, Dr. Phillips Rozeman) that north Louisiana is not faced with the same level of physician shortage as many other communities is due in part to the existence of the medical school. To date, LSU Health Shreveport has trained more than 8,200 clinicians and scientists, many of whom are currently practicing in various hospital systems throughout north Louisiana. Couple that contribution of more than 50-plus scientists who are daily engaged in finding the cures and disease treatments of the future, and you can quickly see the impact of having an academic medical center during a health crisis. To support the specific and growing need for a faster Covid-19 test result, the Department of Microbiology and Immunology at LSUHSC is rapidly moving forward in the creation of an on-site Covid-19 testing lab. With the support of the U.S. Centers for Medicare & Medicaid Services and Gov. John Bel Edwards, virologists and research leadership have been working tirelessly on developing a testing kit that adheres to CDC and FDA guidelines. This testing lab at LSU Heath Shreveport is anticipated to be ready soon and could ultimately complete 500-1,000 tests a day once the lab ramps up with 24/7 staffing.

From a clinical perspective, LSU Health Shreveport faculty physicians are leading the medical teams in the Shreveport and Monroe hospitals and clinics in the Ochsner LSU Health System of North Louisiana. Our residents and fellows are also playing an integral role in patient care as they work alongside attending physicians during the Covid-19 crisis. This pandemic is providing a rare and unique learning opportunity for all involved.

With the abundance of available information regarding the Covid-19 illness, of which not all is accurate, it is important to provide clarity and facts regarding what we are currently facing as a community.

Covid-19 is the illness caused by a novel coronavirus called SARS- CoV-2. Infections with this virus have spread across the globe in just a few months, and the number of cases in the U.S. has risen quickly in the past few weeks. Infections will continue to increase rapidly unless we come together to act now.

Symptoms of the Covid-19 disease most commonly include fever and dry cough, but in many cases, the symptoms are mild so that the illness may seem like a cold or may not be detected at all. In fact, approximately 80% of people who get infected will experience mild illness and will not need to seek medical care. Even with undetectable or mild symptoms, the virus can be spread to others for up to 14 days. For the 20% of those who experience more severe symptoms, they may experience heavy coughing, difficulty breathing, pneumonia and hospitalization.

Although the symptoms resemble the flu, Covid-19 is significantly more infectious than influenza, meaning that it spreads more easily from person to person. The estimated case fatality rate of Covid-19 is approximately 3.5%, which is much higher than that of seasonal flu at less than 0.1%. The overall 3.5% case fatality rate is somewhat misleading because it is an average, and factors such as age and health play a role in the outcome of infection. While younger, healthy individuals have a lower risk of death, there is approximately an 8% chance of death in people aged 70-79 and 15% in people over age 80. In addition, people with pre-existing health conditions such as lung disease, smoking, cardiovascular disease, obesity and diabetes are at an increased risk of severe disease.

Because Covid-19 is a respiratory illness, it is spread by airborne droplets. Those droplets may infect you if you are near someone who has the virus. The airborne droplets can also land on surfaces, which can then be picked up by hands and transmitted by touching the face including the mouth, nose, eyes. Depending on the type of surface the droplets land, the virus can remain infectious for 24-72 hours. Therefore, frequent and thorough handwashing with soap and water or use of hand sanitizers are important control measures, but much more is needed. Social isolation, or avoiding close, in-person interactions with others, is also a crucial part of slowing the spread of Covid-19.

Are the seemingly extreme actions of closing schools, casinos, gyms and limiting large gatherings necessary? Yes, they are! These actions are imperative to slow the rate at which the virus spread occurs. Our healthcare facilities, especially those with the means to help severe cases of Covid-19, are usually more than 75% occupied. If a large influx of infected patients requires treatment or breathing assistance, we could run out of hospital beds for Covid-19 patients as well as any other person who might be having a heart attack, stroke or other trauma.

Without the above actions being taken, this virus will spread through the population and overwhelm our health-care system. With the imposed restrictions on social events, schools and other in-person interactions, we have a chance at reducing the burden of Covid-19 disease. Now is the time to act as a community for the benefit of those individuals most at risk.

Lisa Babin, executive director of communication and public affairs at LSU Health Shreveport with select content provided by virologists Michelle Arnold, Ph.D., assistant professor; Martin Sapp, Ph.D., professor; and Andrew Yurochko, Ph.D., professor


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