Limiting the spread of COVID-19


AUGUSTA, Ga. (WJBF) – Dr. Phillip Coule joined Brad Means to try to clear up the confusion of COVID-19.

Brad Means: Dr. Coule, you work nonstop, thank you for being with us for these few minutes.

Dr. Phillip Coule: It’s my pleasure. And although I’m working hard, we have entire team of people that are working incredibly hard to battle the COVID-19 crisis.

Brad Means: That’s so true. Dr. Coule, as of this broadcast, we’ve seen new restrictions put into place especially shelter in place, are we doing enough?

Dr. Phillip Coule: I think we are doing a lot. There are certainly some things that we could do better. I applaud the governor for giving the shelter in place order I think it is needed. There are a lot of people that got the message, that’ve gotten the message of social distancing. But there unfortunately are still a lot of people that do not understand the importance of social distancing and do not understand the importance of limiting contact with other people. And so ratcheting this up a level, hopefully helps convey the message of how important this is, in order to prevent the healthcare system from becoming completely overloaded.

Brad Means: That’s what I was going to ask you. I wanted to ask what happens to the virus if we stay home? But I guess the better question is, what happens to the hospital capacity if we stay home?

Dr. Phillip Coule: So the whole purpose of measures like this is to limit the spread of the infection to the point that the healthcare system can handle the capacity. Because as the healthcare system becomes overloaded, and we’re not yet, but certainly other places in Georgia are being overwhelmed. As they become overwhelmed, then the quality of care could decline, for example to the point where we don’t have enough resources, or people are stretched too thin. And although we’re in pretty good shape here locally right now, it’s very important that we keep this under control and stay that way. For example, we’re already having patients transferred from Albany, up to Augusta to our facility because they just don’t have the capacity to care for them anymore. With some of the areas near here that have not heeded warnings to not have large gatherings, et cetera, for example, in some cases churches and funerals, that has a tremendous impact potentially on the spread of the infection and needs to be avoided.

Brad Means: Are you worried? Do you wake up stressed?

Dr. Phillip Coule: I tell people I get paid to be paranoid. We’ve been proactive and a bit paranoid about this since we saw it unfolding in China. And actually our entire team started preparing as this was still confined to China. We began beefing up our supply of ventilators. We began beefing up our testing capability and trying to acquire the ability to test for this, ordering numerous supplies, doing training, et cetera. Paranoia has paid off thus far. I continue to remain concerned. The other thing I’d like to say is that I like to plan for the worst and hope for the best. We’re taking that approach. We are certainly planning for the worst case scenario. I’m hoping that doesn’t happen, but we’ll continue to hope and pray for the best outcome.

Brad Means: I want to get you to address something that we’re struggling with in our household and I suspect others are as well. What should we prepare for as far as a timeline. I know that’s unknown. But at first I thought it would be a matter of weeks before we got ahead of this. Dr. Coule, should we picture months at least now?

Dr. Phillip Coule: The best models, and in this modeling you have to use a little bit of caution because there’s only so many variables that you can factor into this. But the model would seem to predict a peak in Georgia around the 21st to 23rd of April. That is looking at the state of Georgia as a whole and not our local area. Thus far, the cases that we have seen here locally have lagged slightly behind other cases within the state. So it’s possible that our peak may actually occur a week or two later than other locations within the state and that we might be on the downhill side of that peak if we look at it for the state as a whole. I am saying that hopefully things get back to normal by summer, I plan to go SCUBA diving when this is all over. I’m hoping that I can do that this summer. If we happen to get over the peak, and things get normal before that, then I’ll be very happy with the better outcome.

Brad Means: I’d love if that happens. What are we doing better in Augusta compared to other parts of the state and the country? Is it a credit to your team and others here in our medical community?

Dr. Phillip Coule: I certainly can’t take the credit for that. We do have some capabilities here that have put us in a much better position. And that is, being able to test and identify cases early is critical in order to communicate the risk. And I’ve said this other times. There’s a different message that someone receives when you say, you have this disease, you need to be extremely careful about who you come into contact with. If their mother calls them and needs something, maybe they don’t go deliver that in person and potentially expose their mother. As opposed to, you might have this illness, you should be careful. But then when some issue comes up that person goes, oh I probably don’t have it. I’ve just got the flu, or I’ve just got allergies or whatever it is. And then goes and exposes someone else. I think that testing plays a big role in this. Our team has been very aggressive in that, in partnership with the Georgia Department of Public Health, Dr. Goggans and the East Central Georgia Health District has been incredibly supportive of our efforts and we’ve worked very closely with them on our drive up testing location. And then the other advantage that I would say that we have had is that, really we have pioneered telemedicine screening for this. We have an entire group of people that are just great innovators. And the ability to do that telemedicine screening allows us to focus in on higher risk individuals and make sure that they get diagnosed, and if necessary, get the treatment that they need. And that’s been a distinct advantage, and I think a model that other locations in the country have started to follow.

Brad Means: Yeah I think telemedicine has been proven, and in many aspects, perfected during this crisis. It’s gonna be a good way to visit your doctor in the future, don’t you think?

Dr. Phillip Coule: Absolutely, in fact, we have started rolling out telemedicine visits for routine visits, for what would be a normal visit to your physician’s office can now be done via the telemedicine in an arranged, scheduled fashion which provides some protection to patients that don’t have COVID-19, and we’re on a stay at home order. It allows them to stay home to complete that visit yet still get the consultation and the care they need.

Brad Means: How do you get approved for a test? We’ve hammered this over and over again, you have to get screened, then you get an appointment, then you get the drive through testing. Some say though, that they are told, “Look, just go home and monitor your symptoms, goodbye.” With no test, how do you get that test?

Dr. Phillip Coule: We are constantly adjusting our testing protocol and guidance on who is tested. And that is, trying to follow the latest guidance from the Georgia Department of Public Health in partnership with them, and then also the CDC guidance about who is at risk. Although we have some fairly sophisticated testing capability, it’s not unlimited. And so we have to make sure that we’re being good stewards of the resources both for the local area as well for the state of Georgia. So we’re now serving as a reference lab for other hospitals within the state to take samples from those locations. For example, say down in Albany or at other facilities within the state. So we’re having to factor all of that into our management of our testing capability. So because of that, we’re constantly adjusting that protocol and trying to make the best use of our resources and the best use of our testing capability. We have an incredible lab of people working incredibly hard at maximum capacity. I can’t say enough about them, as well as our entire team that is innovating in so many ways whether it’s telemedicine or lab testing capability, microbiology, the lab staff, our GEM lab staff, our leadership team. Everybody’s just working incredibly hard and doing an amazing job.

Brad Means: Dr. Coule, a couple more quick questions. Do you think we’ll have college football? Do you think that AU students, and college kids across the country will be back on campus in the fall?

Dr. Phillip Coule: I think so. My best prediction is that we’re gonna get over this crisis. That we will develop what’s called herd immunity to this. There’s some encouraging evidence that the immunity from this, unlike other coronaviruses may actually be long-lasting. In which case, that is very encouraging news. And eventually we’ll see the development of a vaccine. Right now I’m cautiously optimistic that football season is intact and I’m looking forward to it very much.

Brad Means: Me too, boy that was beautiful to hear you say that. We have about 30 seconds, and I just want to know how you’re doing, and how the other front line people are doing, and if you need anything more from any of us watching.

Dr. Phillip Coule: I’ll tell ya, we’ve had an incredible outpouring of support from the community, as you know, the donation from the Augusta National was incredibly impactful to us and our efforts. We have had donations of personal protective equipment. Our pastoral care staff, along with our patient and family centered care has helped coordinate some of the community support efforts that have occurred. WAFJ, the local Christian radio station organized a parking lot prayer last night that just encouraged our staff, and continued to support them in this effort. And that was very meaningful for our staff to see that support. Overall, staff morale is doing great. Up on our COVID ward, every two hours or so they put on some music and everybody stops and cleans all the surfaces. Again, we’ve got some great leaders leading that effort. But overall, morale is high and our team is doing fantastic.

Brad Means: Well, we are so grateful to you Dr. Coule, God bless you and your team, and thank you for what you’re doing for us, we appreciate it.

Dr. Phillip Coule: And thank you for getting the word out about the correct information.

Brad Means: Absolutely, Dr. Phillip Coule, Chief Medical Officer at Augusta University Health System.

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