Louisiana COVID-19: As Acadiana vaccine trial announced, doctors urge continued restrictions

William Taylor Potter
Lafayette Daily Advertiser
Four UH-60 Black Hawks from the Louisiana Army National Guard’s State Aviation Command fly over Lafayette General Medical Center hospital Wednesday to honor first responders and health care professionals who have been working the frontlines of the COVID-19 response. Wednesday, July 1, 2020.

A COVID-19 vaccine trial will begin in Acadiana in the coming weeks, but health care leaders warned a vaccine does not spell an immediate end to the pandemic and residents should follow restrictions to avoid a “dual pandemic” this the winter.

The chief medical officers for Lafayette General Health, Our Lady of Lourdes, and Acadian Companies spoke about the challenges health systems faced during the pandemic during a discussion held as part of Beacon Community Connection’s 2020 South Louisiana Community Health Summit.

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Dr. Amanda Logue, the chief medical officer for Lafayette General Health, said LGH would be beginning a Phase III trial for a COVID-19 vaccine in the coming weeks. She said more information will be released in the next few weeks.

Logue said the goal is to include a diverse group in the trial of a single-dose vaccine used, which differs from the two-dose vaccine used in other trials underway across the nation.

Dr. Amanda Logue, Chief Medical Officer for Lafayette General Health

A COVID-19 vaccine does not mean an end to the risk of the pandemic

The experts stressed that a vaccine does not mean an end to the pandemic. Dr. Henry Kaufman, chief medical officer for Our Lady of Lourdes, said there’s a good chance any vaccine released in the next year would not prevent many from contracting the virus, but might lessen the severity of symptoms for some.

“That’s going to change things, and it does reduce the severity, but that’s not going to be the effect in everybody,” Kaufman said. “We know from the influenza vaccine that it’s not 100% effective.”

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Typically, vaccines are not rolled out quickly. Logue said there are numerous check marks that vaccines have to meet during the phases to ensure they are safe and address potential biases that might skew data.

Logue said a Phase III trial, like the one that LGH will be involved in, usually has the largest and most diverse group possible. With COVID-19 affecting some populations disproportionately, it’s important to make sure groups are represented.

“We want to make sure that all of those patients are well represented in a trial, so that when...it’s all concluded and if it’s successful and able to go to market, that you can honestly step back and say that it was a diverse population that got it and you can feel good about the outcomes that you see in each one of those,” Logue said. 

Could Louisiana see a 'dual pandemic'?

In addition to concerns about vaccines, the experts said there is a possibility the region sees a “dual pandemic” involving COVID-19 and the flu, though they said there’s evidence that the COVID-19 restriction measures may curb cases of the flu as well.

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Dr. Charles Burnell, the chief medical officer for Acadian Companies, said he’s seen some examples in the southern hemisphere, which has opposite seasons from the northern hemisphere, that have shown mask mandates and isolation due to COVID-19 has reduced the flu’s impact.

“If we maintain the vigilance that we started with this thing, I think we’ll get through the winter influenza pandemic okay,” Burnell said. “That is a fear I think all of us share, and it is a reality if we’re not careful.”

Logue said she’s optimistic the overlap of symptoms between the two viruses will cause people who might have the flu to isolate themselves while they await test results, something people typically don’t do during a normal flu season.

Still, it’s possible to have the dual pandemic if the public doesn’t continue with COVID-19 precautions, Kaufman said. The winter season is normally a busy one with hospitals, usually due to the flu and other respiratory illnesses. Adding COVID-19 to the mix could stretch a hospital’s capacity to care for patients.

Dr. Henry Kaufman of Our Lady of Lourdes

Kaufman said predictive models have shown the dual pandemic is a possibility for Louisiana.

“I think that COVID fatigue is a very real thing,” Kaufman said. “This is the time when we need to maintain our awareness and our health and to keep doing what we’re doing until hopefully we can get some successful vaccines in place.”

Hospitals adapt to COVID-19 

In addition to vaccines and the flu season, the experts discussed how COVID-19 has changed operations for health care systems — including communication and the disruption of elective surgeries.

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Logue said one of the challenges COVID-19 presented to health care providers is the lack of data and reliable information. In normal times, health systems don’t have a great system for disseminating information quickly, particularly with other hospital systems.

But Logue said LGH, Acadian and Lourdes were in regular contact, sharing information about best practices and successes in combating the virus.

“We got together rather quickly,” Logue said. “We could take that information and disseminate it in our facilities to our employees or to wherever we needed to.”

Burnell said another challenge was ensuring employees didn’t get information from unreliable sources, such as social media. He said he began making short videos to share vetted information about the virus with the workforce.

“It became apparent very, very quickly because of the media and a lot of things that were going on that we really had a need to get accurate information, to get the information out quickly,” Burnell said. “If we didn’t, people would fill those...information vacuums or gaps with whatever they could find on the news media or on social media.”

Kaufman spoke at length about the issues hospitals faced after Gov. John Bel Edwards shut down elective procedures, a move he called a “reasonable and sound thing to do at the time.”

Kaufman said Louisiana officials had seen what could happen when the health care system becomes overwhelmed in other countries and even in states like New York that saw COVID spread rapidly.

“The curious thing about when we shut down elective surgeries was how quiet the hospitals were,” Kaufman said. “Even though a quarter of our hospital capacity locally...was occupied by COVID patients, because we weren’t doing elective surgeries, because of the fear in the community and the public of going to the hospital, the hospitals were very quiet.”

But the decision had negative effects. People suffering from heart attacks and strokes delayed going to emergency rooms out of fear. Patients who needed surgeries for things like spinal injuries or early-stage breast or colon cancer had to delay treatment.

The state’s restriction was lifted when the state passed its “first wave,” and hospital systems were able to make the call for themselves. Kaufman said when Lourdes saw the height of the pandemic this summer, it allowed no inpatient surgeries that would require a bed. Now, it has unrestricted operating room access. 

Kaufman said the systems saw an “immediate decrease” in cases after the mask mandate was put into place.

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“The clear evidence amongst multiple communities that have put masking in is that as soon as the masking goes into place and social distancing is that you do see a decrease in the number of cases,” Kaufman said.

The state is currently seeing low numbers of new cases statewide, but the hospital leaders said they are staying prepared.

“We still have a long ways to go,” Logue said.