We’re Number 1

Good morning!

Mississippi is Number 1 again, and like so many lists on which we’re at or near the top, it’s not good. 

According to several reports, during the last week, we led the nation in COVID-19 test positivity rate at 23.3 percent. That's an indicator of the extent of spread in the community. And even though case counts have moderated over the last few days, the state also has one of the highest rates of cases per capita and the highest rate of deaths.

In early June, the average number of cases reported per week was about 2,000.  Since then, that number has risen to somewhere between 8,000 and 9,000.  And as new cases are reported, hospitalizations and deaths will eventually follow on a similar trajectory. 

All of this makes Mississippi a hot spot – maybe even the hottest spot – for COVID-19 in the United States.

Not surprisingly, the national media have turned their attention toward Mississippi.  And I, along with other leaders of our pandemic response team, have been eager to speak out. 

Just in the last week, I’ve been interviewed by NBC News, MSNBC, CBS News, National Public Radio, CNN, VICE News, ABC News, the BBC and The Washington Post, and a handful of interviews with local media outlets. 

I am happy to speak to the media to share the reality of what we are experiencing here at UMMC and in Mississippi, and my concern about our front line staff’s ability to handle a tidal wave of COVID-19 cases.

Our ICUs have been at full capacity virtually every day for several weeks – actually beyond capacity, because we almost always have patients boarded in other units awaiting an ICU bed.

As many of you know, I have advocated for a statewide mask mandate, which is now in place, thank goodness.  I’ve also been vocal about my view that K-12 schools should delay reopening until after Labor Day.  That will give us the rest of August for these additional restrictions – masks in public, limits on public and private gatherings, activity in bars, and other measures – to take hold. 

My tweets and other public remarks have prompted a number of comments and questions.  Some have been supportive and others have been critical.  That’s fair.  All of these issues are complex.

One particular question gave me pause.  Since I have advocated for a delay in the return to school for K-12, the question was posed about UMMC students returning to school.  Specifically, why are we starting our new classes of health professions students when I am pushing for a delay in the start of K-12?

First, I want to clearly state that I am very much in favor of children and teenagers returning to school in person.  While not an expert on the subject, I can think of a dozen reasons why it is a good thing.  I believe children and teens should be in school for the delivery of educational content in a consistent manner, for the social interaction, for the structure that in-person school affords, for school lunches and, for some children with special needs, for the specialized care they can receive.  It’s also true that access to the Internet and to computer resources are uneven across the state and from one household to another. 

I also believe strongly that children should return to school when it is safe to do so.  Corinth schools started in July and they have had COVID-19 outbreaks. As of yesterday, 116 students have been sent home to quarantine.

My position on school reopening aligns with other physicians', notably the Mississippi chapter of the American Academy of Pediatrics and the Mississippi State Medical Association. 

Restarting a hybrid educational model – part online, part in-person – at UMMC is a different matter.  Our students are an older and more mature population.  We have been enforcing mask wearing and appropriate spacing for some time.  We have ready access to appropriate testing and personal protective equipment.  Since the outset of the pandemic, we’ve had an excellent track record internally of providing a safe environment, with minimal numbers of employee exposures despite having large numbers of COVID-19 patients in our hospitals.

It is important for clinical students, in particular, to learn to care for ALL patients.  Very soon, we will need them in the workforce.  At this time, the decision to remove our clinical students from the clinical learning environment would be made only if our supplies of PPE become so critically low that we have to reserve it exclusively for front line staff.