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Tampa General executive warns against COVID complacency

Margie Manning



Demonstators walk along Beach Drive in St. Petersburg last spring. Photo by Epiphany Summers.

A spike in new cases of COVID-19 in recent days has renewed concerns about community spread of the illness, including among large gatherings of protestors.

To slow or stop the spread of COVID-19, a top Tampa General Hospital physician leader is urging protestors to wear a face covering and practice social distancing.

Dr. Peter Chang (Photo credit: Tampa General Hospital)

“What a powerful message it would be if everyone had a mask on and was six to eight feet apart. That would make my heart happy to see that, because I would know that they are really caring about and for one another and the message they are trying to send,” said Dr. Peter Chang, vice president, care transitions, and chief medical informatics officer at Tampa General Hospital. “Wearing a mask sends a message that I care more about you than I do the way I look or the inconvenience of wearing a mask.”

Chang talked with the St. Pete Catalyst Tuesday, after several days of large groups nationally and locally gathering to protest racial inequities, spurred by the death of George Floyd, a black man in Minneapolis who died while in police custody.

Scott Gottlieb, former commissioner of the Food and Drug Administration, warned Sunday on CBS’ Face the Nation that the protests could lead to a rise in COVID-19 cases, just as cities and states begin easing restrictions, and the Pinellas County Board of County Commissioners touched on the topic as well during its Tuesday meeting.

“There is no social distancing happening in those protests anywhere in the United States,” said Pinellas County Commissioner Ken Welch. “Are we geared up for a surge that might occur?”

Dr. Ulyee Choe, director of the Florida Department of Health-Pinellas County, and Dr. Angus Jameson, medical director of Pinellas County Emergency Medical Services, said they shared Welch’s concerns.

“The CDC [Centers for Disease Control] recommends, especially in areas where you can’t socially distance, wearing a cloth mask. That’s some of the messaging we want to continue, not only for the protests going on, but any mass gathering events,” Choe said.

Phase One reopening

At Tampa General, Chang studies daily updates on the number of new COVID-19 cases and the hospitalizations and deaths that result.

Since the outbreak began, both Hillsborough and Pinellas counties have seen spikes in the numbers of cases that were largely associated with outbreaks in skilled nursing facilities that primarily care for older people with significant medical needs.

But in Hillsborough County in the last week there’s been a big increase in cases not associated with long-term care facilities, including 81 new cases May 30.

“We saw on Saturday the biggest spike since the onset of the pandemic in Hillsborough County as it relates to the number of new cases a day,” Chang said. “What we’re seeing now is a result of behaviors and activities that occurred two to three weeks ago. That’s right when there was the Phase One reopening. We are seeing the results of that.”

Under Gov. Ron DeSantis’ full Phase One reopening, which took effect May 18, retailers and restaurants that previously had to limit their operations for weeks to slow the spread of COVID-19 now can operate at 50 percent indoor capacity, as long as crowds are no larger than 10 people and as long as they maintain a six-foot distance. Other businesses that were closed, such as gyms and personal care service providers, also were allowed to reopen.

Increased availability of testing for COVID-19 accounts for some, but not all, of the increase in confirmed cases, Chang said.

While Pinellas County is reporting fewer cases than Hillsborough County, there also has been an increase in recent days in Pinellas, state reports show. In the past week, from May 27 to June 2, there were 139 total new cases in Pinellas County, according to Florida Department of Health reports. Those new cases in the past week account for 10.4 percent of the total 1,335 cases in Pinellas County.

While Chang did not have detailed information about the nature of the cases in Pinellas, he said in Hillsborough the new cases are largely occurring in people who have no symptoms or few symptoms, which means they could spread COVID-19 unwittingly to others, including vulnerable seniors or people with chronic conditions such as diabetes, high blood pressure or obesity.

“When we see these large gatherings of individuals in our community that are not practicing appropriate physical distancing, and the majority do not have a mask on, those two things are only going to increase the degree and the amount of community spread,” Chang said. “Where I worry is if one of those individuals works in a grocery store in Sun City Center or works at one of our skilled nursing facilities, and is asymptomatic to their knowledge, walks in and although they are OK, is able to spread the virus to the most vulnerable population in our community.”

It is the most vulnerable — seniors and people with chronic health conditions – that are most likely to be hospitalized, straining the resources of all the hospitals in the area, Chang said. Older people are also the most likely to die from COVID-19.

“To see these folks pass away is heartbreaking because yes they have a high level of skilled need, that’s why they’re in a nursing home, but their life is no less significant than anyone else,” he said.

Movement science

Face coverings have been shown to be effective in preventing spread, Chang said, citing initiatives underway at Tampa General Hospital, where he said there have been no cases of transmission between a patient and a health care worker. That means the protocols the hospital has in place are working, including wearing masks and testing every patient who walks through the door, provided they agree to a test.

Tampa General also is working with University of South Florida on projects based on movement science to help prevent COVID-19 outbreaks.

Those projects are different than contact tracing, Chang said.

Contact tracing involves identifying people who may have come in contact with an infected person, and collecting information about those contacts.

In contrast, movement science looks at how large groups of people are moving around, including from areas with a high predominance of positive cases to areas that have low numbers of cases.

“We’re saying we don’t know who these people are, we just know that they are moving, and moving in groups from areas that are not positive to positive areas or vice versa. What I would like to gain from that is coming up with a targeted testing strategy to prevent outbreaks before they occur,” Chang said.

Testing that is free, easily accessible and provides quick results is key, he said.

“That’s the only way to prevent this from getting worse, rather than reacting to something that’s happening, because by the time it reaches the hospital it’s too late.”

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