Health chief Echols describes city's tactics in coronavirus war

Health chief Echols describes city's tactics in coronavirus war

ST. LOUIS – Dr. Fredrick Echols, the director of the city’s health department, said Wednesday that the city now had 482 confirmed cases of the COVID-19 coronavirus.

Echols was a guest on Mayor Lyda Krewson’s livestreamed Facebook talk Wednesday afternoon.

He told listeners that more than 2,000 people in the region as a whole had tested positive.

In the city itself, Echols said, the health department has two special initiatives: one for elderly people, particularly those in longterm care centers; and the other for homeless people. Both groups are particularly vulnerable during this pandemic.

The city is providing education to workers at nursing homes about personal protection equipment, effective infection control measures, monitoring of residents and linking people with extra care they may need.

For people without homes, Echols said his department was working with the department of human services as well as housing agencies and groups specializing in serving homeless people.

Echols noted that the homeless are very susceptible to communicable diseases and very apt to spreading infection rapidly among themselves. He said that getting people into housing was critical, and that special federal waivers for housing were helping.

“Housing in itself is a prevention measure that is often underrated and underutilized,” he said.

Missouri has given city an extra rapid test machine and cartridges to screen people for the virus rapidly, so they can be either cleared or isolated.

The city is tracking contacts of potentially infectious people to let them know they too may have been exposed. This is not a new protocol, Echols said; it’s used for any infectious disease.

When asked if he knew how many people have contracted the coronavirus but have recovered, Echols had no exact figures but noted that worldwide, 85-90 percent recover.

He advised any residents with coronavirus-like symptoms to contact their medical provider first; or if they have none, to call the city department of health at 314-657-1499. Testing sites are scattered around the city, but some will test only people who are already patients. There is a map and list of sites on the city’s website, stlouis-mo.gov.

Echols said social distancing had been “bending the curve” – slowing the rate of new coronavirus cases. “The measures have allowed us to push the peak back a little further and protect our work force and public health force,” he said.

Data on new cases come continually from hospitals and other health care centers, as well as public and private labs. They are now mandated by Missouri to report testing results within three hours.

Will the city’s stay-at-home order be extended?

“The city of St. Louis Department of Health is adamant about implementing data-driven processes,” Echols said, explaining that all decisions would be made using facts.

“Based on what we’re currently seeing, with the increase in cases daily, as well as the increasing number of deaths daily, it’s likely that we will need to extend the order.”

The coronavirus hot spots are now the urban areas, but “as time moves forward, a ripple effect happens,” especially if people don’t continue social distancing.

A higher rate of infection has been seen among blacks, and Echols addressed that, saying it was a “huge issue.” He noted the long history of pre-existing inequities in health care and other resources.

“This is a priority for us because our community is only as strong as the weakest link,” he asserted. “It’s important that we tell the story about why African-Americans are being more heavily impacted.”

He mentioned the rich health expertise and resources of the St. Louis area and added, “Part of our job at the health department is to make sure every one know what resources are available.”

Echols described what happens if someone is identified as infected or potentially infected and is ordered to self-quarantine.

“We enroll them into our self-quarantine or self-isolation program,” he explained, saying it was important to distinguish between quarantine and isolation.

“Quarantine is if someone has been exposed but has not tested positive for COVID-19 or another ailment. For self-isolation, we know the cause of their illness. They’ve been ill, they tested positive, we know the cause of their illness.”

When the city enrolls people in the quarantine program, “at the very beginning we give them education so they understand why we need them to self-quarantine for the 14-day period,” he said. The city provides anything they need for self-care, for instance thermometers and hand sanitizer. “If they test positive within that 14-day period, we link them to medical resources and move them into the self-isolation part of the program.”

“Anyone who has the virus has to be medically cleared by a medical provider before returning to work or other activities outside the home,” he added

After Echols spoke, Krewson told listeners that she endorsed the United Food and Commercial Workers’ calls for grocery shoppers to wear a mask. She also asked residents to stretch apart their visits to the story as much as possible, and to go alone rather than taking anyone else alone.

“It’s safer for you and for workers in the grocery store,” she emphasized.

To help residents get access to online resources, she said, she has asked ATT, T-Mobile and Verizon to make internet access free during the pandemic.

“Telemedicine is a real thing … but you need access to the internet, and of course you also need a device,” she reminded listeners. It’s important to bridge the “digital divide” also for schoolchildren trying to learn remotely and for all of us to keep up with the coronavirus developments.

Krewson, like Echols, addressed the issue of homeless people and their special vulnerability.

Recently a tent city was erected along Market Street just northwest of City Hall. Homeless people and their advocates hope to call attention to their needs.

And they are getting some attention, but many don’t want what the city can offer.

“Yesterday we sent our outreach workers as well as my chief of staff out to talk to every single person who was there,” Krewson said. “There were only three people yesterday who were willing to be put on the list to go into shelter. That’s always a challenge, especially with the nice weather we’re having now.”

She implored everyone listening to the livestream to spread the word, not the virus: Social distancing is vital.

“Go out and tell five people who maybe don’t know – call them up on the phone – and just remind them how important this is.”

That includes other family members who are not in the same household. She sympathized with grandparents who can’t see their grandchildren, but was adamant about the risk.

“I know that’s very tough for people not to be able to see their family members during this time, but it is really for our own health that we don’t do that,” she warned.

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