Dr. John Raymond Sr. has served as president and CEO of the Milwaukee-based Medical College of Wisconsin since July 2010. It’s the nation’s third-largest private medical school, and its more than 1,600 faculty physicians constitute one of the largest medical groups in a state where COVID-19 cases have surged in recent weeks. Raymond talked with Assistant Managing Editor David May about lessons learned during the pandemic and priorities for the months ahead. The following is an edited transcript.
MH: Can you talk about Wisconsin’s COVID-19 caseload? It’s recently been one of the nation’s hot spots for surges in new cases.
Raymond: Like many parts of the Midwest, Wisconsin is experiencing rapid community spread of COVID-19, especially in the north central and northeastern regions of the state. In addition to a surge of new cases, the positivity rates and the reproductive numbers and measures of contagiousness are very unfavorable. So this indicates a large and growing burden of disease. Data posted (on Sept. 30) by the Wisconsin Department of Health Services showed that every county of the state had either a high or very high burden of disease. And more than half of the counties had a trajectory that was unfavorable.
And this has also been exacerbated by the need to quarantine healthcare staff, who either have active infections or who have confirmed exposure. In many cases, especially in rural parts of states, the staff is the bottleneck. You can create surge capacity for ventilators, ICU beds and hospital beds, but if you don’t have enough staff to take care of the patients, that’s a real problem.
MH: Initial reporting was that the universities were a part the problem, but what about the rural areas? Is there a general theory about what’s happening?
Raymond: We had well over 100,000 students, returning to school; most of the universities in Wisconsin had some form of in-person classroom activity that began in early September and late August. So for the first week in September, when the surge really was beginning to be apparent in Wisconsin, most of the cases were associated with young people in the 18-24 range. There was a very, very significant spike in cases. What was interesting though, is the spike wasn’t limited just to counties that had a large university; we were seeing community spread in addition to the return of thousands of students. And we believe that was in part due to long-term (pandemic) fatigue, some skepticism about the utility of wearing a masks and a lot of gatherings and relaxation of social distancing around the Labor Day holidays.
MH: Given all that’s transpired, what have your doctors and affiliated hospitals learned during this pandemic?
Raymond: Like other parts of the country, we now know much better how to triage and provide supportive care for patients with COVID-19. And there are some moderately effective therapeutics that we can strategically deploy to help us. Just the level of comfort in taking care of novel coronavirus has increased significantly.