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Insights

This spring, we watched in collective shock and horror as New York City and a handful of other major cities in the U.S. — and dozens of COVID-19 hotspots internationally — struggled to contain outbreaks. Those were desperate days, and the tools were too few. Today, as the disease transmission rates climb and hospital capacity plummets, the image of localized hotspots increasingly has been supplanted by the equivalent of a forest fire running amuck.

This week, hospitals’ physician leaders joined in a public statement urging all Missourians — including Gov. Mike Parson — in the strongest possible terms to become more resolute in their adherence to public health guidance. That message was followed by a strong endorsement from the MHA Board of Trustees for a statewide mask mandate. It is critical that all leaders provide a full-throated endorsement of personal responsibility and public engagement in COVID-19 mitigation, and we got that message this week from hospital chief medical officers and the MHA board.

Hospital adult ICU capacity has dropped to approximately 25% statewide, but locally, we know that some hospitals have little to no room for COVID-19 care. Worse yet, this is occurring at the beginning of flu season — where normally we would expect a utilization spike — and at the beginning of the holiday season, where COVID-19 and culture could clash.

If this was a forest fire, fire jumpers would be around the blaze building fire breaks, clearing undergrowth and using their tools on the ground to box in the spread. The tankers would fly over and drop fire retardant to reduce the blaze, and help shape and contain the conflagration.

The public health efforts to control COVID-19 have been similar, with mixed results. As with the wind in a forest fire, human behavior can influence the ability to control a pandemic. As long as a fire has fuel, it will burn. And, an ember blowing in the wind can expand the range of the damage.

Populationwide distribution of a COVID-19 vaccine is months away. In the long run, it will act like the strong rains that often check an uncontrolled forest fire. However, what we do now will influence the damage done to our communities and our health care system. We won’t be rescued from afar. Without significant change, we can expect hospitals to be overwhelmed in the weeks and months ahead.

Missourians must reduce their chances of exposure. They must modify their behaviors — whether mandated or not — to reduce the person-to-person spread of the virus. The mitigation tools are the same as they were in the spring, but the stakes of failure now are much higher.

“The cavalry is coming,” Dr. Anthony Fauci said this week when he was describing the effort to gear up for the largest vaccination effort in U.S. history. But until those vaccines arrive, we must double down on public health precautions. Missourians and health care workers sacrificed greatly to get us to today. Now is not the time to tread lightly with the severe strain on the health care system leading us to contemplate crisis levels of care. Failure to redouble our efforts means lives will be lost as our ability to provide care becomes overwhelmed. That’s what the state’s leading physicians and the MHA board are telling us.

To protect hospital capacity, we need fewer embers in the wind.

Let me know what you think.

Herb B. Kuhn
MHA President and CEO

In This Issue

Richardson Updates Medicaid Oversight Committee On State’s Expansion Planning Effort
Medicaid Caseload Continues Its Steady Growth
MLN Connects Provider eNews Available