Wiltz to serve on Covid-19 equity task force

Teche Action Clinic CEO Dr. Gary Wiltz M.D. was recently selected by Governor John Bel Edwards to serve on the newly-developed, 17-member, statewide COVID-19 Health Equity Task Force.
Wiltz is no rookie to being selected by Louisiana’s governors for special service on state task forces, but even so, he said he is honored to have been among those chosen for the COVID-19 HETF.
He said it is his understanding that the HETF will be charged with addressing the disproportionate effects of COVID-19 on the communities of minority populations state-wide, and how to address and/or narrow the gaps of those discrepancies. He stated that he thinks the HETF needs to come up with a set of implementations and initiatives that will stay in place, no matter who the governor may be.
“I really think you need to break the unit down,” he said. “Every parish has a set of metrics and indicators that breaks down by parish, just as they break down by state. We are ranked from one to 64, and each parish is told why its rank is what it is, and what they can do to improve it. So, I think the only way we are going to be able to do what we have to do, is to treat it as if we are eating an elephant, one bite at a time.”
“It’s almost Darwinian,” he continued, “Survival of the fittest. If your population is not fit, as a baseline, when you get hit with something like this (COVID-19 pandemic), then it really uncovers and exacerbates the disparity that exists.
“So, I think that is our main charge, to find out why these inequities exist. We’ve known for a long time the underpinnings of how these inequities and disparities are playing out, when you are dealing with a population who has had lack of access to healthcare—that’s one factor. The other is educational attainment. If the population isn’t given access to educational opportunities, they will wind up in more contact-service-oriented jobs that put them at risk. That’s why you are seeing workers in the service industries experiencing a much higher rate of infection, and subsequently not doing as well.”
Wiltz said he wasn’t certain of when the idea for the HETF was conceived, but ventured that it was most likely when the state was provided racial infection statistics at the beginning of the month.
During a press conference on April 6, Edwards said, “Of the 512 coronavirus deaths so far, more than 70 percent were African American patients.”
The plan, according to Wiltz, should be to look at parish statistics of things like smoking rate, obesity rate, and diabetes rate, and couple that with what he called “a resource inventory,” which he likened to knowing what weaponry you are going to war with. Once that’s done, one can then ask the people of the affected communities what they are ready to do to try and help themselves, and provide them the resources they need based on their needs.
“I’m hoping that out of this crisis, some long-term interventions can be put into place,” Wiltz said. “But, it won’t happen in one generation. It is going to take a long time to get us there. I’m hoping I can come up with some recommendations that can be implemented, and then carried out on a more practical basis to be implemented by the people of the communities.”
As for his TAC’s front-line workers, Wiltz said that when the crisis initially hit, he convened what he calls a “war room,” and his team inventoried their equipment. He said they had personal protection equipment (PPE) and “things available from the Ebola crisis a few years back”… reserves in stock.
And with 16 sites, he assigned a manager to collect the assets to fight the virus, centralize them, and then notified their suppliers right away. After that, it was a matter of putting protocols in place, bracing for impact, and holding the line.
He added that TAC is set to petition the St. Mary Parish School Board at their next meeting to let TAC open their school clinics back up, and activate their mobile unit to give access and treatment to the kids in the communities and elementary schools TAC usually treats.
TAC is also offering telehealth and telepsych visits, as well as free pharmacy deliveries in Franklin, with Morgan City soon to follow. They are also installing personal protective shields at their campuses, around intake and reception areas.
When asked how he was personally holding up, Wiltz said, “I trained at ‘Big Charity’ (Charity Hospital) in New Orleans, and we had seen some volume come in, but nothing like six or seven codes (cardiopulmonary arrests) per shift like they are seeing now in New Orleans and New York. It’s got to be tough.
“One thing we are taught to do in Medicine, is to compartmentalize. So, even with all you have to deal with, you focus on the needs of the patient at hand and the circumstance you are dealing with, particularly in the emergency room.
“You get into a zone where you just keep going and going and going, and I’ve done that before, but never on the level that these folks are having to do it. So, I really feel for them. Because even though we practice compartmentalization, we are not robots. And I can tell you as a physician, that once you’ve done all you can do, and the time has come, and the patient cannot be with their family to say goodbye, we (healthcare workers) have to facilitate that. And I know that is taking its toll on physicians everywhere.”
Wiltz closed by voicing his concern on the potential public relaxation of social distancing standards set in place by the governor at the beginning of the month, saying, “The social distancing has worked. It has blunted the edge and flattened the curve, but if you practice premature relaxation of those standards, I am concerned that we will see a second wave. Let’s follow the science, follow the data, and make sure that we are giving ourselves the best chance to get ahead of this. It’s not enough to flatten the curve, we need to see it on a down-slope.”
He also advocated for more testing; and valid, timely testing, which he said he thinks would prove to be a good benchmark for progress going forward.