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RGV COVID19 Physician Task Force Recommendations April 2020

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April 22, 2020

To: Judge Richard Cortez,

We are the Covid-19 Medical Provider Rio Grande Valley Task Force and are comprised of over 200 multidisciplinary health care providers in the Rio Grande Valley. Many of us are primary-care providers that have outpatient clinics throughout the Rio Grande Valley while many of us are also hospital providers. Our sole purpose is to benefit the overall healthcare of our community. We are very appreciative of the measures that have been put in place until now. However, our concern is that relaxing our shelter in place order and reopening businesses too quickly will move us into a territory where we will encounter many problems.

If we move forward too quickly, primary care providers are concerned that more people will inevitably become infected with Covid-19. In our current situation, we have had difficulty getting our patients tested due to both availability and cost. To date, Hidalgo county has only tested 0.03% of the population. We are very worried that any surge in new cases of Covid-19 would go undetected due to the current difficulty the county is having in testing our citizens. To make matters worse, we don’t have enough personal protective equipment (PPE) to protect ourselves and our staff when these patients come to our offices. The hospitals are rightfully referring concerned patients back to their primary care providers and we have not been given the support we need to provide the medical care that our community will require.

It is for these reasons, as well as those provided below, that The Covid-19 Medical Provider Rio Grande Valley Task Force is standing in support of the Rio Grande Valley ICU Task Force. We urge you to take their recommendations seriously and to act accordingly for the best of our community.

The Covid-19 Medical Provider Rio Grande Valley Task Force

Re: Recommendations from The Rio Grande Valley ICU TASK Force COVID-19

As a reminder, we are the group of local physicians ( Cameron, Willacy, Hidalgo, and Star Counties) that are directly involved in the treatment of the acutely ill COVID-19 patients in the Rio Grande Valley. This physician association includes all 28 intensivists (ICU) physicians and additional consultants in multiple specialties that these critically-ill patients require.
In view of the most recent recommendations emanating from both the state and federal authorities, there is a move towards reopening businesses and relaxing social distancing. It is with great concern that we reach out to you as our elected top county official, to urge you to not proceed in this direction at this time.
In a collective and unanimous opinion we are concerned that this may lead to a second wave of increased infections.
Criteria that other metropolitan areas have utilized to conclude that the time to loosen restrictions is at hand, have evolved in higher population density areas. In those high density areas, a rapid and accelerated spread rate is expected. However, statistical spread in a more dispersed area such as the RGV, probably results in a slower spread rate. Our cases vs time curve has not flattened (squished), instead it has continued in a low amplitude but widened chronological extension. In other words, case increases have stayed about the same but continuous and not dropping. Therefore, there has not been a downward slope yet, creating a potential for a second wave if we relax social distancing.
Based on the above we believe that in the RGV there will not be a significant change from April into mid-May. Hopefully at that time the picture will be more transparent with more data and hopefully more extensive testing.
Our population should be congratulated and reminded that because of their social isolation, use of ppe, etc, they have been responsible for keeping our numbers lower than what had been expected. Your Emergency Orders and their compliance have worked!
Our community and those lay people who advocate a more permissive approach do not appear to understand the potential cataclysmic scenario if a second wave of infections is allowed to ensue. Their belief is easy to understand as this new virus and its minimally asymptomatic presentation in up to 70% of cases and a 10% hospital admission rate has lured many on the Global stage to bring their guard down. Our recent increase in traffic and shipping while ignoring previous successful practices concern us that the public is becoming more complacent and less concerned at the most critical time.
It is our responsibility as the local medical experts, with your assistance, to create the most conducible environment to abate this pandemic.
We are encouraged that in the past you have valued and accepted our recommendations. Because of this, we are emboldened again to ask you to heed our advice again. We strongly urge you to maintain the status quo until we have a more reliable measure of the decrease in incidence and acuity of COVID-19 cases.
There will be a clearer picture specific to our community in several weeks that can better guide us in our mitigation strategies.
Rio Grande Valley ICU TASK Force COVID-19.
Co-signed and fully supported by the Covid-19 Medical Provider Rio Grande Valley Task Force

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