STHS chief medical officer talks the future of COVID in St. Tammany Parish

'It’s really extraordinary to think about the first case being in December 2019, and here we are four months later and how much we know about this virus,' said Dr. Patrick Torcson, chief medical officer at STHS, in a recent interview on The Lake 94.7-FM. (Photo by Tim San Fillippo / STHS)

By Mike Scott, mscott@stph.org

It’s been nearly two months since St. Tammany Health System’s first COVID-positive patient showed up at its Covington Emergency Department. Since then, the people of western St. Tammany Parish have been hunkering down, social distancing and doing everything they can to stop the spread of the virus.

Meanwhile, the doctors and nurses at STHS – just like medical professionals around the world -- have been learning.

They’ve been learning what makes the virus that causes COVID-19 tick, how it spreads and how best to defeat it.

“It’s really extraordinary to think about the first case being in December 2019, and here we are four months later and how much we know about this virus,” said Dr. Patrick Torcson, chief medical officer at STHS, in a recent interview on The Lake 94.7-FM. “Chinese scientists had sequenced the RNA of this virus back by mid-January. We already had tests available in February and are now developing treatments. So it is really pretty extraordinary what’s been accomplished thus far.”

As the hospital continues its ramp-up to normal operations, Torcson said all that knowledge has made the hospital staff better equipped than it was before to care for the community. 

“We are going to stay vigilant and stay prepared,” Torcson said. “And I think that all that preparation and planning has made this a stronger and more higher-performing organization than we were even before the pandemic. We are open for business to take care of patients that have non-COVID 19 issues and (are) perfectly capable to continue to be in a position to take care of COVID-19.”

Below, find an edited transcript of Torcson’s full interview with The Lake’s Charles Dowdy, in which he covers such topics as the hospital’s response to the crisis and his expectations of what the outbreak will mean for the community, and the hospital, in coming weeks and months.

Tell us a little about yourself.

I am the chief medical officer here at St. Tammany Health System. I have been a member of the medical staff for 30 years, practicing internal medicine and as a hospitalist. For the last year and a half, I’ve been in the role of the CMO, and in that position I bring the physician’s perspective to the executive management in the administration of the hospital, including strategic, operational and financial issues. I also work very closely with our medical staff on quality of care and patient safety. We have over 400 physicians on our medical staff and 35 different specialties, and just having that delivery system working at such a high level is part of my role here at St. Tammany.

Obviously we’ve got to talk about COVID-19 just a bit. I would assume this is something that will be talked about, dealt with and reacted to for years to come as hospitals and medical institutions try to understand what happened and better ways to deal with it.  

You are so right. From a generational standpoint, I think there is a generation that remembers where they were on Dec. 7, 1941, for Pearl Harbor -- and then, for my generation, when we first heard President John Kennedy had been assassinated. I think many of us are going to remember the first time we heard about Wuhan, China, and the COVID-19 pandemic. 

I remember first hearing about it back in December 2019 and just being relieved to hear that all the cases were associated with that one market in Wuhan, China, and that we didn’t think there was any person-to-person transmission -- that is, it could only be caught from an animal. And then certainly things changed over the next several months. The epidemic spread throughout China and then (we got) the first cases in the U.S. in January and that led up to where we are now. 

Things changed at St. Tammany Health System here in Covington, Mandeville around March 10, which is roughly just two weeks after Mardi Gras. So being on the edge of a hot-spot region like New Orleans, we were just a little bit behind them in terms of when COVID-19 landed in our community, and the thing that I will reflect on, and one of the stories that we’ll tell, is when we had the first case here at St. Tammany Health System. We were not caught off guard, and were not surprised. The first patient that showed up in our Emergency Room, they were caught outside the door, they had a mask on. Everybody in the Emergency Department at the hospital had a mask on. We presumed and assumed that this patient was going to be positive. They went right into an isolation room. Everything was done correctly even with that first admission on March 10, and I think that just set the stage for a lot of heroic activity by our staff that followed after that. 

We are starting to see a little bit of a light at the end of the tunnel.  In your mind, what do you see happening in the near future as far as what’s going to happen with COVID-19 on the North Shore?

I think we are not going to make any specific predictions, but we are planning and preparing for any possible scenario. No question, in looking at the data, we are seeing a downward trend in the number of cases. I think that is a result of the social distancing, and all the measures that have been put into place.  So we think that is very positive. I think that there will continue to be this downward trend as we move toward getting back to normal, but I just want to reassure all the listeners: Here at the hospital, we are the safety net and we are the front line for taking care of patients that do become infected with COVID-19. So we are going to stay vigilant and stay prepared, and I think that all that preparation and planning has made this a stronger and more higher-performing organization than we were even before the pandemic. We are open for business to take care of patients that have non-COVID 19 issues and (are) perfectly capable to continue to be in a position to take care of COVID-19.

If we can pivot just a little bit, I think one of the keys to moving forward and getting back to normal is going to be the availability of testing for COVID-19. That is something I have put a lot of focus on and have a very special interest in. That is part of my responsibility here. 

Do you think there will be a relapse in the fall?

Yes, and – again, trying to stay away from predictions -- but definitely preparing and planning for it should it happen, I think that is just the responsible thing to do.

There is a part of me that does hope it just burns itself out over time like other pandemic viruses – you know: SARS, MERS, Ebola, the different things we have had to deal with in the past.  So hopefully that’s going to be one potential scenario that we are going to see. But definitely preparing and planning -- I think particularly when schools start up again in September, we just have to be prepared that those social gatherings and people being together there could (trigger) a resurgence. 

So would testing be a big part of how we deal with this in the fall? Aren’t they kind of linked in terms of knowing where the problems are? 

Yes, you are exactly right. I think that we have had a really complete evolution in how we thought about testing. The more testing we do and the right kind of testing and doing the right actions with the results that we get from the testing is going to be key over the summer. 

You may even remember, even six weeks ago we were telling people, ‘Look, don’t worry about getting testing. Stay home and eat some chicken soup. There is nothing you can do even if you have COVID 19.’  We know one of the key ways to contain this virus is to know every person that is infected or is a carrier or was exposed, and being able to quarantine and to isolate and use the right social distancing and personal hygiene factors that are going to keep this from resurging. So we were actually the first ones to start doing drive-by testing here in the parish. Early on in the pandemic, we knew that is was going to be much better to fight this virus in the outpatient setting, away from the hospital, and not waiting for people to get really sick and have to be admitted to the intensive care unit. So we have been very aggressive about testing here at St. Tammany and are going to continue to be in that mode. 

The listeners may know there are several different testing options and so having the right guidance from a knowledgeable professional about what test to get and how to interpret it is going to be key. 

Is what’s happening right now kind of what we are going to deal with in the future?  Are these viruses going to evolve and become more powerful? How do we prepare for that and what do you think is going to happen?

That’s a great question. Just a little historical perspective: I was doing some reading, (and) in 1853 8,000 people died in New Orleans from yellow fever, and if you think about it, the population was much smaller. What an incredible disruption and epidemic that was.

So, in some ways, this is part of the course of human history -- the Plague, Ebola, SARS. I was in medical school during the HIV days, so I think there has been some of this going on in the background throughout history. But with the internet-enabled age and instant rate of information and sort of the globalization, I think that has really just heightened everybody’s awareness.

It’s really extraordinary to think about the first case being in December 2019 and here we are four months later and how much we know about this virus. Chinese scientists had sequenced the RNA of this virus back by mid-January. We already had tests available in February and are now developing treatments. So it is really pretty extraordinary what’s been accomplished thus far. 

I think probably for most of the listeners the questions are going to be, ‘Should I get tested and where can I get a test?’ I will just answer the second question first: We have all of the approved and most validated testing methods here at St. Tammany, and if you call 898-4001 we can walk you through what the options are and how to get tested. Basically, it comes down to two options right now. One is to do the nasal swab we have all heard about that tests for the COVID-19 or coronavirus in the back of the throat. That is a pretty specific test that is fairly accurate. Secondly, we have the blood test or the antibody test.

If anybody has symptoms of fever or cough or is concerned that they may have an active infection, it is the nasal swab test that you want to get done. We have tried to make that very easily available to our patients, to our neighbors, to the residents of the community, to our listeners.

Anybody that’s been through this past several weeks that is curious whether they had COVID-19 or may have had it (should) have the blood test done. What that does is to test for the antibodies to COVID-19 to know if you have been exposed. There are a lot of questions that go with that, but the only way we are going to be able to answer those questions is to get more information by testing people and getting more data and information so we can make informed decisions about the results of those tests.    

So which of those two would be more important as we are going through the next year, two, three and -- short of getting a vaccine or something that solves this -- do we want to know more about the antibodies or active cases, or do we want to know both?

For the short term, while we are still dealing with a lot of active cases and patients are still coming to the emergency room, it’s the virus test, the nasal swab, is the test we want to be doing, testing directly for the viral particle.

At the same time, as we sort of move on to the next stage of this in containing the virus and hoping it doesn’t resurge, the antibody testing is going to very important, just to see what the prevalence of it is in the community, to see how many people were exposed. And then, here’s the really important question that I don’t have the answer to: Does having the antibodies protect you from future infection? 

I think we all know from the old chicken pox story, once you had chicken pox … our parents would expose every kid on the block to the chicken pox so you would get it and be immune the rest of your life. Does having the COVID-19 antibodies offer protection against future infection?

And, again, because of our experience only being four months with this virus, we just don’t know the answer to that yet. But we are going to get the answer if we can do enough testing and get enough data. 

We are talking about people starting to open back up again. So what does it look like at the hospital? In terms of what you guys are doing.  Are you moving back to more normal operations, or no?

We have remained open serving the community throughout the pandemic. We are, if you want to say, ‘reopened’ now and always prepared and ready to provide care to non-COVID patients. We’ve got staff, we have done well with all the supplies. We have safety protocols in place (and) we are in a very good position to continue to serve the public moving toward, getting back to normal, being fully accessible to people that need any type of care -- and really in a stronger position than we were before the pandemic because of the success we have had in dealing with it and all the lessons that we’ve learned. 

I see a lot of healthcare heroes here at St. Tammany Health System, and I think that they really should be commended. 

I know there are people out there who probably needed some type of procedure who were saying to themselves, ‘I’m going to wait until I know what’s going on with this pandemic.’ What do you say to them right now?

I think, again, because of what we learned about COVID-19, we’re safer in many respects than we were before the pandemic in terms of knowing how to isolate, test and (institute) different infection control measures. So, for patients that need care, you can feel safe about coming to our hospital.

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Visit STPH.org/COVID-19  for the latest information on coronavirus in St. Tammany Parish.