Louisiana is one of many states seeing spikes in COVID-19 cases. Gov. John Bel Edwards recently signed an executive order mandating masks in public and put the brakes on reopening parts of the economy. Warner Thomas, president and CEO of Ochsner Health, the state’s largest not-for-profit health system, says industry leaders need to be vocal about the importance of following strong safety protocols. He spoke with Modern Healthcare Managing Editor Matthew Weinstock. The following is an edited transcript.
MH: A big part of the spike in Louisiana is among younger people, right?
Thomas: We’re definitely seeing a difference in the number of cases of folks who were positive compared to when we had our first spike at the end of March and early April—a much older demographic of folks who were coming into our hospitals, much older demographic of people who were actually testing positive. Today, we’re seeing a much younger demographic, a very high percentage that are under 40, a much higher percentage actually 29 and under.
MH: How have utilization patterns changed, either in the ICU or elsewhere?
Thomas: We definitely are seeing a change in utilization. One, we’re seeing a lower admission rate. Two, we’re seeing a lower utilization of the ICU. So a much greater percentage of folks in med-surg units versus going to the ICU. A lot of folks are not being hospitalized. A lot of folks are essentially testing positive, but being able to be cared for at home. We have not seen the escalation of inpatient cases that we saw back in late March, early April. We have seen probably a doubling in our hospital census over the last two weeks. We were at a census across our system and our partners of about 100 going two weeks ago.
Today, we’re about 220. But that compares to late March, early April, when we had a census at nearly 900. So certainly a lot different than the last surge, but we have seen a pretty large escalation, and we all have to take this very seriously and be very careful.
MH: How’s your staff feeling? How are they dealing with the new spike?
Thomas: It’s certainly something that’s challenging just from a mental perspective. To go through the first spike was obviously very challenging and folks knew we had come through the spike, and now to see this escalating again, it’s very difficult for our personnel, our management, our physicians, our nurses to go through this again. And it’s something that we tried to explain as we were in March and April, that, “Look, we’re going to be taking care of COVID-19 patients for months and months and months. This isn’t something that’s going to be a spike in March and April and then dissipate to really nothing.”
We have to be prepared as a health system to have an ongoing census of COVID patients, really probably into late 2021. Who knows when we’re going to have a vaccine. But we’ve got to be prepared for that mentally. We’ve got to make sure we staff appropriately for that. We’ve got to make sure we have the right PPE, and we’re in good shape there. But it certainly is a challenge for staff because everyone wants this behind us.
MH: The governor recently announced requirements for wearing masks out in public. We’ve seen that conversation become politicized across the nation. What role do healthcare leaders play in talking about wearing masks and science and social distancing?
Thomas: First of all, I would say that the governor of Louisiana, John Bel Edwards, has done a great job handling the situation. I spoke to him (two weeks ago) and we talked about the issue around masking. I told him from our perspective at Ochsner, we recommended going to masking overall throughout the entire state. And he ultimately decided to make that decision.
COVID-19 is not a Republican or a Democratic issue. It does not care what political party you’re in. If you get it, you’re going to be sick. This comes back to protection. This comes back to doing the right thing. And it comes back to once again, when you wear a mask, you’re protecting others around you, not necessarily yourself.
We’ve adopted pretty stringent protocols at Ochsner, going back to when we started in this process, but we started our own “Mask Up” campaign.
We have our physicians out there, our nurses. We’re spending significant resources marketing this. We’re working with the (New Orleans) Saints and the (New Orleans) Pelicans—professional football and basketball organizations—to help promote this on a local and regional basis. And really, trying to take the approach that this is a public health issue. Health systems have to step up and have a point of view on this. We need to be vocal about it. We need to be communicating it to our employees, and in every venue that we get an opportunity to do so. And it’s not just masking. It’s social distancing. It’s washing our hands. It’s using hand sanitizer. It’s being mindful about not being in large groups. It’s amazing to me, you see some of these functions or parties out there that folks are in large groups. In today’s environment, that just does not make a lot of sense. We don’t view this as a political issue. We view this as a public health and a safety issue, and that’s how everybody needs to look at it.
MH: Another conversation that’s happening nationally surrounds delaying elective procedures again. What are your thoughts on how that should be managed?
Thomas: At this point, we’re in good shape. From a volume perspective, from a capacity perspective, we’re in very good shape. I don’t see this having any impact on our elective procedures at this point. Now, certainly patients have to make their own decisions about whether that’s something they want to do. And we’re working with them to help them understand; we have a back to work safe campaign where we’re helping local companies around the region make sure they’ve got an environment that’s safe for folks to go back to work. We’ve got a safe and clean campaign that we’re showing our patients what we’re doing, showing our employees what we’re doing to make sure it’s a safe place for them to be.
We ask every week, how are people feeling about if it’s safe to come in for their clinic visits, for their ER visits, for procedures and in the hospitals. And we’ve seen our satisfaction levels increase as we’ve gone through this period of time, because we’re taking extra care in helping make sure people stay safe, and we’re doing an extra great job around communication. Our ability to communicate and to be very open and transparent with our employees, with our physicians, with our patients has been part of our success in seeing more folks come back to get services.
MH: Getting back to your workforce, do you expect to bring people back to an office setting once the pandemic subsides, or do you think remote work is here to stay?
Thomas: It’s going to be both. I do think you’re going to see more people come back into the office. Although, that’s slower than I would have anticipated frankly, if you’d asked me this three months ago. We do have some people who are back into some of our corporate areas that are on-site, but we have a very high percentage that are still working off-site.
This is going to fundamentally change the work that can be done outside of an office at home and folks’ ability to connect to work in remote areas. It’s a situation that will grow. We were looking at potentially building additional corporate or administrative space prior to COVID-19. We’ve stopped that project.
We are going to provide more opportunities for folks to work at home. The other real strength on this is it allows you to recruit in a different way and to a lot broader geographic region than you did previously. This is going to be a real plus in many ways.
How you engage people, how you communicate with people, how you create teams is different in a virtual environment. We’re going to have a lot to learn there, and to study as we go forward to make sure we create the right team environment (and) keep people connected.
