Documenting COVID-19

Overview:

New Orleans has gone through two waves of coronavirus infections, one shortly after the weekslong Mardi Gras celebrations ended in late March and the other in mid-July, as the U.S. struggled with a new round of community spread. Here are several of the key findings from internal records from the city's Health Department:

• A read-out of a July 7 Zoom call between Dr. Anthony Fauci and the directors of some of the largest health departments in the country, from Los Angeles, D.C., New York, Chicago and New Orleans, shows that Fauci took a dire tone on reopening issues and several health directors decried issues with contact tracing, testing supplies and school reopening plans. These semi-regular calls are arranged by David Barr, a New York-area AIDS activist who has known Fauci for more than 30 years. Another call from April 27 shows that Fauci and city health directors discussed the "criteria that must be met in order to begin re-opening businesses and services, where you are in terms of meeting that criteria and what plans are being made for a step-wise approach."
• On May 5, as New Orleans began planning for reopening, the Health and Economic Development departments agreed that there would be a "watch and wait" period for case increases over 3 weeks. "But if they go up substantially, we need to decide how to move backwards and when," wrote Dr. Jennifer Avengo. In another exchange, the New Orleans health director says she "got some intel today that what the state reports could be days-weeks old, depending on hospitals & mainly coroner's office," and they could be expecting a death surge.
• On April 25, Tony Robinson, the regional administrator for FEMA, wrote to his other federal colleagues. He wanted more info on New Orleans' walk-up testing program, which was now being asked for by other states. This comes on the heels of the federal pilot drive-through program, which failed to capture many of the city's poor, black and Hispanic populations. Dr. Avengo wrote, "Just thought you would appreciate this email string from the Region 6 FMA head and HHS about our 'best practice' program. The Adm. Schwartz he references is the HHS higher-up in charge of all of the federal drive through testing programs. I can't believe she didn't throw me in the brig during that project as I really let her have it over the difficulty with lab tests, call center etc ... but apparently she recognizes what a good thing we are all collectively doing."
• A New Orleans health provider, Ochsner, wanted to do a prevalence study in the hardest-hit black communities in the city. The Health Department responded, saying this belied historically disproportionate services to Black residents in New Orleans. Avegno tells this Ochsner hospital leader, Dr. Leonardo Seoane, that unless they treated poor black patients like real patients and not "then in reality creating quotas or barriers for meaningful access to the system," then "we would have a hard time supporting efforts to come into a vulnerable neighborhood previously ignored by many health care institutions and test, but not provide the opportunity for a long-term patient-provider relationship."
• Roche Diagnostics USA initially promised LCMC Health, the New Orleans hospital system, approximately 3,500 testing kits (more than 7 testing kits per hospital each week) but had to cut that number down to 1,322 at the beginning of July. With this cut, it would force the closure of community testing sites. As a result, New Orleans put in an emergency online order with Louisiana state but they responded that they were unable to fill it. Roche told Sen. Bill Cassidy's office that with nationwide demand, they will not be able to ensure additional tests through the end of 2020. New Orleans then used an outside consulting firm — Sabiston Consulting — to pressure Roche through its congressional delegation
• Late July email exchanges between Mayor LaToya Cantrell, the New Orleans Police Department and the Health Department discusses issues with tourists from Georgia, Texas and elsewhere overwhelming the French Quarter, and specifically Bourbon Street, in mid-July, along with young people flouting mask guidelines by way of party buses. This exchange ultimately led to the mayor closing all New Orleans bars in late July.