Within a week of statewide pandemic shutdowns, Tracy Antee of Healthy St. Landry Alliance found herself at the hub of a parishwide health support system that she’d never have predicted would become so important so fast. The alliance, a consortium of local groups partnering to address community health across the Parish, had just completed a two-year process compiling a resource directory and partnering with around 40 local governmental and nonprofit groups when March 2020 rolled around.
As hospitals throughout Acadiana began to fill with Covid patients, Antee mobilized the network. She facilitated daily virtual meetings, sometimes two hours long, attended by state representatives, police chiefs, hospital personnel and business owners. They were open to the general public, as well, and attended by upwards of 75 people per session. By the time vaccines became available in spring 2021, the focus of these calls shifted to answering questions from the community — including those about side effects, eligibility and where in the parish to get the shot.
Compared with other rural communities in the state, St. Landry Parish mounted a better pandemic response and has fared comparably against wealthier, urban peers. It has the second highest vaccination rate in Acadiana, sneaking up just behind Lafayette Parish. During the fourth surge, total Covid deaths climbed 25% in St. Landry, a tragic figure, but still below the 30% increase in Lafayette Parish. Because the lines of communication, resource access and institutional interdependence were in place before the crisis, St. Landry Parish was able to react nimbly and deploy its resources more effectively.
That preparation paid off.
Early on, St. Landry Parish suffered high COVID-19 mortality rates, particularly in its nursing home population. But leaders there credit the alliance’s communications-centric response for their more recent successes in getting vaccination rates up, notably during the height of this summer’s fourth wave.
“We don’t have a radio station, a TV station, any kind of mass media that’s located within the parish,” Antee says. “We needed a way to get information out to the community about what was going on locally. What did our numbers look like? What resources were available?”
Antee made sure leaders from municipalities across the parish were present for each Zoom call. After representatives from Opelousas General presented the latest information — number of new local cases, updated guidance from the CDC — members of the general public could ask questions. Restaurant owners asked how to best communicate the latest restrictions to their patrons. Homebound residents asked for help with transportation questions. Sometimes, hospital authorities would answer, but sometimes it was the parish president, a school board member or representative from the Office of Public Health who had the best information.
“I needed the mayor of the town as much as I needed that town’s community member or faith-based organization,” says Antee, who also directs the Opelousas General Health System Foundation. “Whatever was the hub of that small town, I needed to have them on the call.”
St. Landry’s population is poor economically and in terms of healthcare resources and, at 41%, has Acadiana’s largest proportion of Black residents — all factors that would tend to predict lower rates of vaccination. But in the past month its completed vaccinations have surpassed Region 4’s average to settle at 44.4%, just behind Lafayette Parish, the region’s wealthiest jurisdiction and its medical hub, which reported 45% as of this week.
|Parish (LDH Region 4)
Voluntary weekly testing sites on school campuses, coordinated by the Louisiana Department of Health’s Safer Smarter Schools program, may also contribute to keeping these numbers down. St. Landry Parish is one of only 10 school districts in the state participating in this program.
“We reached out deep into the community,” says Sylvia Brown, lead nurse for the St. Landry Parish School Board. “And into different communities to help to vaccinate — to medical providers, pharmacies in Eunice, in Sunset, trying to cover all of our bases.”
Across the nation, rural communities have lagged in Covid vaccination rates compared to their urban counterparts. Some researchers trace this gap to the increased prevalence of social vulnerability factors like poverty, disability, lower educational attainment and more crowded households.
Working against widespread misinformation has made efforts like this even tougher. St. Landry’s two-way, open channel of communication between local authorities and the general public did more than just aid in circulating information. The transparent way leaders engaged with their community’s questions and concerns throughout the pandemic helped to build trust, which proved crucial when it came time to talk about the vaccine.
“Leaders definitely set the tempo and the pace for trust in vaccines,” says Rep. Dustin Miller, who represents St. Landry Parish. Miller, who is also a nurse practitioner, was present for many of the calls himself. “Your chief of police, your mayor — I mean, everyone is encouraging the vaccines. That is a big deal.”
Of course, St. Landry’s success in vaccinating its population is only relative to the rest of rural parishes in the state — which, overall, is performing poorly. As of mid-September, the average vaccination rate in rural parishes in Louisiana was 33.9%. Nationwide, around 70% of Americans are vaccinated.
Nonetheless, the efforts of the Healthy St. Landry Alliance garnered recognition from the American Hospital Association in May 2020. In the AHA’s case study on the alliance’s response, the organization described it as the parish’s “go-to community liaison for pandemic response efforts, establishing a feedback loop with community members by building on its network of partners.”
This feedback loop, says Antee, allowed local leaders to really understand the informational needs of the community. She was often surprised, in the beginning of the pandemic, how many people had basic questions about symptoms. “It was the same thing with the vaccines,” she says. “A lot of people just wanted to know when different groups were eligible. What did all of those requirements mean?”
Since late July, when the fourth surge hit, the calls — which had gone from daily to weekly and finally paused altogether in the early summer — resumed. According to Antee, there were increasingly more members of the general public in attendance. The number of email addresses on the associated mailing list doubled.
If the recent uptick in vaccinations and dip in new Covid infections in St. Landry Parish is any indication, the strategy’s working. Over the past two weeks, test positivity throughout the parish fell at a rate more than twice that of Lafayette Parish.
Their success may also be traceable to Healthy St. Landry’s focus on ease of access when it comes to getting resources to community members. Early in the pandemic, Antee printed hard-copy versions of the parishwide resource directory (also available online). In cooperation with the school board, the directories were distributed directly to students to bring home to their parents and caretakers.
It all goes back to communication, coordination and collaboration. Listening in helped ensure everyone in the parish was on the same page, and having representatives from so many different corners of the community ensured that no matter the question, someone in the room had an answer.
“It was really positive for us to see how much collaborating really worked,” Antee says.
Head nurse Brown concurs. “We gained a lot of partnership on the journey during this pandemic,” she says. “And I think that’s made us a stronger St. Landry.”