'The Monster Behind The Watermark': How A Slow Leak Of COVID-19 Diagnoses Could Turn Into A Torrent

Mar 19, 2020

Coronavirus may have taken root in New Orleans, but now it is branching out across the state. East Baton Rouge Parish and Ascension got their first cases earlier this week. 

Reporter Paul Braun spoke with Dr. Catherine O’Neal, Chief Medical Officer and infectious disease specialist for Our Lady of the Lake, about how hospitals in the capital region are preparing.

PB: Over the last two days, we saw our first cases confirmed by the LDH here in East Baton Rouge parish. What does that say about the spread of COVID-19 around the state? 

CO: Paul, have you ever stood in your house and seen just a small watermark on the ceiling? I've done that before and I've thought, man, I have to go tell my husband that there is a monster behind that watermark, right? Because that small little mark, it doesn't mean there's just a tiny little leak. It means you're about to tear apart your attic. And so those two cases to me mean that there are lots of cases behind them. And I think what you heard the governor say earlier is that there are going to be some tests that are coming up. We tested a lot of people over the last five or six days and those tests, when they finally come back, I expect to see more positives. We've been testing people waiting for those results. And so just like that watermark on your ceiling, peeling back these, these two cases that we do have in East Baton Rouge Parish, we're going to find that there were a lot of cases in the community that we haven't diagnosed yet. 

That being said, we continue to tell the public coronavirus is a virus that's going to infect most of us. And 80% of us that get infected will either be asymptomatic or have a mild infection. So if you're at home with a little fever and a cough and you say, I could have coronavirus, you could. But 80% of us are going to do just fine. We're going to have a couple of days illness, we're going to recover and go back to our normal lives. It's the people who are immunocompromised, who have underlying comorbid conditions. We're worried about those people, that they don't recover from this illness as well. 

PB: How are area hospitals preparing their facilities for an influx of COVID-19 patients? 

CO: One of the things that is recommended by the CDC for CODVID-19 patients is that when you are taking care of a patient and they need to be intubated, so they have to have a breathing tube inserted for help while they get over the illness. If you need to do a respiratory therapy treatment that you have to have the patient, um, preferably in an airborne room and definitely that the patient, the person taking care of the patient has to have an in 95 mask on. So that's a respirator. Everybody else who's doing their average daily care around the patient can wear a surgical mask. So a lot of the things that we've been doing at the hospital to help prepare for more patients is making sure that we have quantities of our personal protective equipment or PPE available. That we have the right drugs available to help these patients. That we have our ventilators ready and that our teams have been practicing so that when they see a patient who has possibly contracted COVID-19, that they are prepared to take care of the patient and they have all the equipment that they need. 

PB: So, mayor Sharon Weston Broome, with significant help from private healthcare companies in the area set up a drive through testing clinic in Mid City Baton Rouge on Monday. How does a system like that help conserve some of the resources you were just talking about? 

CO: Man, what a great, great initiative by the city. The medical community came together and the mayor knew we had this need to test outpatients, but it's just very difficult to test an outpatient because we have to again, use that personal protective equipment and be in a safe space. What we don't want to do is have these tests being conducted in the same clinics that are diabetics and our hypertensives who go in to receive regular care. And luckily, the Baton Rouge general was able to offer us up mid city. Each hospital or clinic has a day that they share. They bring their own equipment and they bring their own personnel and we were able to just test a ton of people earlier this week and those people, many of them had been waiting to be tested. They were symptomatic and sick at home and um, and not able to get the test. And of course we're seeing more and more people this week who need to be tested and are able to offer that test finally.

PB: Is there a concern about testing capacity for the commercial tests in the Baton Rouge area? 

CO: That is our concern. Paul. Everything that we use for COVID-19 we've come a little short, right? So we're at the end of flu season. I've used a lot of my masks already. We've been through this massive respiratory season that started early with flu B transition to flu A. We saw a lot of patients this year. Usually we hit a time of recovery where we bring up our stock and instead we've hit in 19. So even down to the swabs that you need for the test. We were running low and everybody in the country was running low at the same time. It's impossible to anticipate the needs of everybody. And, um, we thought we needed hundreds of tests and evidently we needed multiple hundreds. So I think that testing is going well today and that clinic will continue. So those who need to be tested will be able to be tested. 

PB: And advice to patients that are awaiting their test results?

CO: Stay home, stay [more than] six feet from everybody else in your home, wipe down shared surfaces, wash your hands, make sure that your primary care provider in your home is not also immunocompromised or has comorbid conditions, and try to isolate yourself until you get the test back so that you can infect others.