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April 27, 2020

4.24.2020 Update from St. John’s Health CEO, Dr. Paul Beaupré

Updates

 

First, I want to say how saddened I was to learn on Wednesday about the passing of our first Teton County resident from COVID-19 complications. Later, when I read Robyn Vincent’s thoughtful KHOL profile of this gentleman, I felt even more emotional about it. Although our daily reports focus on numbers so that we can monitor the impacts of this insidious disease, please know that when you receive care at St. John’s, you aren’t a number to us. Each patient is a unique and special individual. Our hearts go out to the families and friends of all who have lost a loved one to this disease.

Stabilization Phase: Last week I reported that St. John’s Health had reached a plateau on the COVID-19 trajectory, with stabilization of the number of patients needing medical treatment for COVID-related illness. The trend continued throughout this week, and the Teton County Health Department confirmed it appears we are entering the Stabilization Phase. Governor Mark Gordon and public health officials have presented outlines of how the community may begin easing into a fuller level of social and business activity while minimizing the risk of a new wave of infections. The go-aheads for increasing activity will rely on people continuing to follow health recommendations and will be tied to health metrics, including the number of patient admissions and hospital bed availability. We are actively participating in these discussions.

Hospital Services and Clinics: As we enter the Stabilization Phase, it’s important for the health of Teton County that St. John’s returns to providing the full range of health and medical services that our community needs. Seeing your doctor and visiting the hospital for necessary tests, screenings, and procedures is very important and, in many cases, life-saving. Our physician offices and clinics have begun reaching out to our chronic disease patients to address their ongoing health needs. With our telehealth program and the extensive safety precautions now in place, the greatest risk you may be facing is not seeing your provider or in hesitating to come to the Emergency Department. As we slowly begin to offer more of the services that are needed, patient and staff safety are the top priority.

Antibody Testing: Based on a recommendation from my volunteer expert Antibody Advisory Panel, I will be consulting with hospital and medical staff leaders about how best to deploy the antibody testing platform just released by Abbott Laboratories for a study of our front-line healthcare workers and first responders. The Abbott platform was recommended by the advisory panel based on its credible, publicly available validation data from a well-credentialed source, the secure availability of lab testing supplies, and our ability to perform rapid, reliable, high-volume test processing at St. John’s.

What could we learn by studying this high-risk group? We could obtain our first reliable measurements of the penetration of the outbreak to date, and learn to what extent front-line workers may have been infected but remained asymptomatic. This is one kind of data that will help us make smart decisions as we navigate through this pandemic.

In order to get genuinely useful information from this type of testing, we must use a reliably validated platform and a systematic data-collection protocol with repeated testing over time of representative samples of this group to determine the significance of the presence of antibodies.

For individuals, however, it is critical at this time that you do not rely on antibody testing to relax your compliance with the hygiene and physical distancing guidelines and orders. If you have been reading about new local antibody testing options and have questions about their value, I implore you to become educated about their risks and limitations. First, a positive antibody test result may suggest to you that you have immunity to coronavirus when, in fact, there is a high risk you are still vulnerable AND able to infect loved ones and others. This is due to a high rate of false positives in the currently available tests. For example, when speaking about the Cellex testing platform, one of the antibody tests being offered by private providers in Jackson Hole, infectious disease expert Dr. Michael Osterholm told the New York Times this week that in a community where 5 percent of people have had the virus, there would be as many false positives as true ones. Obviously, a scenario of multiple hundreds of false positives in our community would be a very dangerous situation.

There are also risks associated with true positives. Though we presume that the presence of antibodies marks immunity to infection by the virus, that has not yet been established conclusively. We also do not know how strong any immunity may be, what the chances of reinfection truly are, how severe reinfection may be, or how long any immunity may last.

Based on these limitations, you simply must not rely on a positive antibody test result to inform your personal decisions about how to avoid contracting COVID-19 or spreading it to others.

Community generosity: On behalf of St. John’s, we are grateful for the generous support of Teton County residents to the St. John’s Health Foundation COVID-19 Response Fund, and the food, materials, and supplies that have been provided by community members. Thank you, again, for being thoughtful about decisions you make and compassionate about how they may impact the lives of our friends and neighbors.


Paul Beaupré MD, CEO
St. John’s Health

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