HJNO Sep/Oct 2020

44 SEP / OCT 2020 I  HEALTHCARE JOURNAL OF NEW ORLEANS LDH CORNER In the beginning, we were only testing sick people, and in the weeks after the first COVID-19 test came back positive on March 9, most testing was taking place solely in our public health lab. Since then, the OPH Lab has transformed itself into a 16-hour per day facility that is now able to turn around near- ly all of the 1,000+ COVID-19 tests received daily, in 24 hours or less, providing a life- line to facilities that have an outbreak and need results quickly. Meanwhile, thanks to the OPH Lab, the OPH Bureau of Epidemi- ology, the public health regional teams, our emergency response partners, our nurs- ing home partners, the Louisiana National Guard, our federal partners, private and pub- lic labs, and the TAC, we made testing one of the state’s success stories, ramping up testing from 200,000 in May, to 400,000 in June, to more than 500,000 in July. We could not have done this without the dedication and innovation of the network partners and the people who fanned out across our state to testing sites to adminis- ter the tests, not to mention the army of cou- riers and lab workers who ensured people got their results. It started with our collaborative mapping regional testing needs with regional laboratories to find efficient routes to trans- port tests. Together, we explored the capaci- ty of private and public labs across the state to discover how to support widespread test- ing, and when it finally rolled out, we tack- led problems like supply line disruptions and long turnaround times, working together to find solutions. While we solved many of the problems we encountered together, we also realized some were simply too big for Louisiana to solve on its own. When White House Coronavirus Task Force Coordinator Dr. Deb- orah Birx met with us inmid-July about Lou- isiana’s testing capacity, she told us the Unit- ed States was already consuming so much in the way of testing supplies, it was unlike- ly we could tap into global markets to find more supply. But even this problem didn’t hold us back from finding solutions. The collaborative has since studied pool testing, which we piloted with the Department of Health and Human Services at a Baton Rouge testing site. We have also studied the implications of doing more targeted testing, taking a lesson from our past work to prioritize testing. It is diffi- cult to imagine assembling a team of high- er caliber, with more sense of purpose, than those who joined the TAC. The relationships we built, the systems we’ve adopted, and the ideas we’ve seen become a reality will serve our state for a long time to come. Other important relationships built during this crisis include partnerships with the 280 nursing homes across the state that serve our most medically fragile residents. When we began to see high mortality rates in nurs- ing homes across the state, the department took an all-hands-on-deck approach that required a high degree of collaboration and coordination between the private and pub- lic sector, in addition to the hard work of our federal partners. When the crisis began, we deployed infection control experts—both our own fromhigher education, and from the fed- eral government—to ensure nursing homes had everything they needed, from cleaning supplies to PPE. We followed with a sharing platform, which allowed us to communicate with nursing homes in a highly interactive way, providing staff with both formal training ses- sions, and open-ended forums where they could ask our subject matter experts ques- tions. In June, we tested every nursing home resident in the state, and in July, began on- going weekly testing of staff and residents in facilities with COVID-19 cases. None of this could have been done as quickly or effectively, had we not emphasized the simple principle of working together to solve problems, and learning lessons from what didn’t work in the past. It also wouldn’t have happened without Louisiana’s health care providers, compassionate nursing home operators and staff, and public health pro- fessionals who hail from sectors across the spectrum. These two small examples are emblematic of the dedication that has been demonstrated; people from all walks of life bringing heart to this crisis, from National Guardsman to lab specimen couriers. I am mindful that as we continue to respond to this horrible disease, we will never be able to get back what we lost, but the lining of this dark cloak of disaster is silver, and it will outshine the darkness of the times. The silver lining, as in previous di- sasters, will provide a higher level of under- standing, and the promise of brighter days. n Melinda “Mendy” Richard is an executive leader with responsibility for several bureaus within the Louisiana Department of Health’s Office of Pub- lic Health. One of those areas is the State Public Health Lab. As a certified Master Black Belt in Lean Six Sigma, she combines her medical technology degree with her efficiency training to oversee the Department of Health’s Continuous Quality Im- provement efforts. Her experience has poised her to be uniquely qualified to lead the state’s COVID testing efforts. “The public has learned the importance of personal protection, proper test collection, and that different tests can give you different information about a disease process.”