‘Demanding transparency’: Local health officials frustrated with state’s messaging

By:  Janice Francis-Smith The Journal Record April 1, 2020

OKLAHOMA CITY – Oklahoma’s death rate for COVID-19 may be twice that of the national average, data compiled by the Oklahoma City-County Health Department would indicate.

But at a time when accurate messaging to the public is the most critical tool health officials have in the effort to curb the spread of the disease, members of the Oklahoma City-County Health Department’s board on Wednesday voiced some frustration with the inconsistent messaging coming from the state level.

As of Wednesday morning when the board met, Oklahoma County had reported 192 positive test results for the coronavirus, and 10 deaths.

“Which puts that at an approximately 5%, 4.7%, case fatality rate, which is quite a bit higher than the national average, which is running at just 2% or under 2%,” said board chair Gary Raskob. “And if we take the broader Oklahoma data, 719 cases with 30 deaths, that’s about a 4% case fatality. I think that’s where we will be, about 4%.”

States with similar demographics, such as Arkansas, Alabama and Louisiana, are experiencing a similar fatality rate, said Raskob.

“Ours is not likely to be at 2%, it’s likely to be up at 4% because of the unhealthy nature of our population,” said Raskob, “and of course this impacts people who are vulnerable and disadvantaged more significantly.”

Raskob and other board members have been studying the information coming from other states and within Oklahoma regarding COVID-19, and learning more every day about the disease. Some stricken with COVID-19 develop pneumonia and succumb to respiratory distress. Now it is becoming clear that some afflicted with COVID-19 experience sudden cardiac deaths, though it is uncertain as to whether the virus is directly affecting the heart or the decline in oxygen results in a heart rhythm disturbance.

“This is a very bad, nasty thing that just to read the descriptions from the emergency doctors were really just wrenching,” said Raskob. “To the point of all that is we’ve just got to keep advocating for the most aggressive public health measures. … We don’t have a drug yet, we don’t have a vaccine. The solution to this is not treatment of the condition; the solution to this is reducing the number of cases by the public health measures we’re taking. And we have to do that to the maximum extent we can.”

The board provided a recommendation requested by Oklahoma County Commissioner Carrie Blumert that Oklahoma County adopt a resolution modeled after those that Oklahoma City Mayor David Holt has issued for the Oklahoma City. Holt’s order uses the term “shelter in place” in keeping with language used by federal health agencies that makes clear what measures are being put into place to shut down businesses and activities that pose a threat to the public health.

On Wednesday afternoon, Gov. Kevin Stitt issued another amendment to his order regarding COVID-19 in Oklahoma to now close nonessential businesses in all 77 counties – not just in counties with confirmed cases of COVID-19 as the previous order had stipulated. Stitt’s order also uses the term “safer at home” in requesting older Oklahomans stay at home, a term that has led to some questions regarding what activities are prescribed under the order.

During Stitt’s press conference on Wednesday, when asked about what specific business activities are permitted, he encouraged Oklahomans to use their best judgement while practicing social distancing.

“Ultimately it comes back to personal responsibility,” said Stitt.

“I think you’re quite right that there is less than optimal coordination and efficiency of communication at the state level between different groups,” said Raskob, adding that Holt, Tulsa Mayor G.T. Bynum and Norman Mayor Breea Clark have been “leading and being proactive” with the resolutions they have put forward in recent weeks to curb the spread of COVID-19 in their municipalities.

“I’ve gotten calls from constituents saying you know we’re confused by the governor saying one thing and the news is saying another thing,” said Blumert. “I think the mayor wanted to be as explicit as possible and I wanted to follow suit. I just felt in order to keep everything as consistent as possible for everyone living in the county that we extend those orders to people that don’t live within the bounds of the city.”

About 22,000 people living in Oklahoma County live outside the boundaries of a municipality, said Blumert. Oklahoma County commissioners will hold an emergency meeting within the next week to consider the recommendation.

Several OCCHD board members said they’ve fielded calls from constituents and the media that frequently confuse the Oklahoma City-County Health Department with the Oklahoma State Health Department, and they have found themselves in the uncomfortable situation of trying to provide the best information they have without appearing to contradict information coming from the state level. Though in the past the state and local health agencies have worked hand in hand on messaging, the current crisis has resulted in a disconnect between the organizations.

“I’m not trying to get political, I’m not trying to say that we’re not supporting the state, but at the same time I think that we’re responsible to our Oklahoma County constituents and they are demanding transparency,” said board member Erika Lucas, adding that it appears the governor’s office is “choosing not to contradict what’s being said at the White House.”

Testing has been a major issue of confusion among the public, with the state declaring that Oklahoma has 10,000 testing kits but not clarifying that many of those tests may not include all of the components required to administer the test – leaving true testing capacity at close to zero.

OCCHD is leading the state in testing at this time, said CEO Patrick McGough. At the state fairgrounds in Oklahoma City, more than 150 people a day are being tested.

“Those people are being processed through every 10 to 15 minutes,” said McGough. “We are seeing a 12-15% positive rate among the samples that we’re testing at that site.” McGough said he was concerned that quickly and significantly ramping up testing at the site may outpace the personal protective equipment on hand for testers.

Oklahoma County stands out for having a high number of positive cases – accounting for 26.7% of the state’s total positives – but that may be because the county is doing more testing than anywhere else in the state, said McGough.

“We are also partnering with Anne Barnes from OU Health Sciences Center on what will be needed when high-volume testing is available,” said McGough. “This will be a collaboration between OCCHD and OU and this will be the potential to test 1,000 people per day.”