Leader of St. Louis regional pandemic task force warns of worse to come

November Online

Doctor's discussion was part of CHA's Joint Committee meeting

By LISA EISENHAUER
Nov. 20, 2020

Based on models of its projected spread, the impact of the coronavirus pandemic on the St. Louis region will soon be comparable to being slammed by a hurricane with the strongest potential for devastation, according to Dr. Alexander Garza.

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Dr. Alexander Garza, chief community health officer for St. Louis-based SSM Health and incident commander of the St. Louis Metropolitan Pandemic Task Force, gives a media briefing Nov. 13 on the pandemic.

Garza, chief community health officer for St. Louis-based SSM Health and incident commander of the St. Louis Metropolitan Pandemic Task Force, shared his grim assessment of what's ahead for the St. Louis region at CHA's Joint Committee meeting, held via Zoom on Nov. 13. That day, the region hit a record for COVID-19 admissions at its major hospitals with 125. The peak so far was 144 COVID admissions on Nov. 17. The crush of patients threatened to overwhelm care providers.

"Really now we're bracing for that Category 5 hurricane that we know is coming onshore," Garza said. Across the United States, the federal Centers for Disease Control and Prevention put the number of deaths from the pandemic at almost 250,000 by mid-November and projected that the number of deaths per week would likely increase at least through mid-December. Most of the states with the highest case rates based on population were in the Midwest.

Forming a united front
His discussion of how SSM Health is working with other health systems and community leaders to deal with the latest surge of the pandemic was one of several during the meeting. Others focused on how CHA and its member organizations are responding to the calls for racial justice and health equity, and diversity in hiring; the potential for changes in health policy based on the outcome of hotly contested presidential and Congressional elections, and CHA's accomplishments in Sr. Mary Haddad's first year as president and chief executive officer.

Garza said that by teaming up with all the major health systems providing care in the St. Louis region, SSM Health was part of a united front to share best practices on treatment of patients with the virus. They have also been united in urging public action to combat its spread, an effort that he said has been tough to accomplish in the disjointed St. Louis region. "Trying to coordinate messaging and policy across multiple different geographic areas, multiple different populations and, frankly, multiple different political ideologies, I would say that is the most challenging part," he said.

Garza added that Catholic health care with its emphasis on compassion has been a bright spot in the darkness of the pandemic for him. He shared that colleagues at SSM Health reunited a couple who had been married almost 70 years but were in separate facilities for COVID care. The reunion allowed the pair to spend the husband's last days together. "I think it's that sort of thinking or that sort of mission-oriented attitude that Catholic health brings to the table," he said.

Even with the recent good news about potential vaccines, Garza said the end of the pandemic is still in the distance. Just getting the public to accept the vaccine as safe and effective will take different messaging for different groups. "It's important that we get the correct messenger with the right message to impact communities that may not be wanting to take vaccine," he said. "I've always felt that we need to be incredibly transparent, give our best advice and meet people where they are and that's how you persuade."

Garza also said that the needs of those providing care during the pandemic must not be overlooked. "A lot of times I see things through my military lens," said Garza, who is a colonel in the Army Reserve, "and I think about these frontline workers as sort of the soldiers in this war of the pandemic and I believe that we're going to see a lot of mental and emotional issues coming out of this because we're asking a lot of them, we're asking them to do things that we normally wouldn't ask them to do."

He said the stress that caregivers are under now might need to be addressed for years.

Health equity initiative
Dr. Rhonda Medows, president of population health management for Providence St. Joseph Health, and Darryl Robinson, senior executive vice president and chief human resources officer for CommonSpirit Health, hope Catholic systems will tap the same urgency being used to address the pandemic in addressing health care inequities. They discussed a new initiative being developed within the Catholic health ministry for concerted and coordinated efforts to achieve equity in health systems, facilities and communities and to advocate for systemic change in the wider health care sector and our society.

This work is being done as the nation is confronting the disproportionate toll the coronavirus pandemic has taken on communities of color and Native Americans and responding to the calls for racial justice by protesters who have taken to the streets in recent months to denounce the deaths of George Floyd and other people of color at the hands of police or vigilantes.

"As leaders in our own communities and in our own health systems, we have an obligation and responsibility to stand up for what we believe to be right and true," Medows said.

Robinson stressed the importance of listening to and understanding the needs of the communities Catholic health ministries serve and working together in partnership to bring about sustainable change.

Political outlook
On the political front, Laura Bozell, principal with Washington-based Cornerstone Government Affairs, said the prospect for health care policy change is unclear under the new Democratic administration,  especially since control of the Senate depends on the outcome of two run-off races in Georgia in January. If Republicans keep at least one of those seats, they will retain a Senate majority. If the Democrats flip both, the Senate will be evenly split with the tie-breaking vote going to the vice president and thereby putting the Democrats in the majority. Bozell saw that latter prospect as unlikely.

Democrats kept their majority in the House, although a smaller one. That could add to the challenges for President-elect Joe Biden to put in place his policies, such as bolstering the Affordable Care Act and enacting a national strategy to address the pandemic.

In the current lame-duck session of Congress, Bozell said, there is wide support for a new COVID-related legislation. "But there's still a lot of disagreement over what provisions should be included and how much money they should spend, so we're not sure if we'll see a really big COVID relief package this year," she said.  

A more likely outcome is the passage of some small provisions related to funding for testing, vaccine distribution, support for small businesses and extension of unemployment assistance, she said.

Time to pause, reflect
In her discussion, Sr. Mary noted that during her first year leading CHA she met with leaders who direct CHA member systems and hospitals. "It was an opportunity to really build relationships," she said. That work has continued but in the virtual realm since the pandemic hit, she said.

Sr. Mary also mentioned CHA's Board of Trustees approval of the association's new strategic plan. The plan focuses on four strategic directions: access to care, healthy communities, thriving members and a strong Catholic identity.

She lauded the integration of two organizations into CHA. The Catholic CEO Healthcare Connection joined CHA on Aug. 1. The Supportive Care Coalition will join early next year.

Returning to a theme from her message at the Catholic Health Assembly in June, she said the world is at a threshold moment and it is uncertain how the future will unfold. "It strikes me how poignant it is for us right now because it gives us an opportunity to really pause and reflect upon what is emerging for our country, what's emerging for our world right now and what's the role of Catholic health care during this liminal time and what will be necessary for us to continue the mission in this new reality," she said. "Those are questions that I hope that you continue to look at and reflect upon as we go forward."

 

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