Q&A With Dr. Philip Huang, Director, Dallas County Health and Human Services

On Wednesday, March 25, our team interviewed Dr. Philip Huang, Director of Dallas County Health and Human Services (DCHHS) and a 2020 Leadership Dallas class member. Dr. Huang shared the latest county projections, recommendations for the business community, and the personal side of the fight against COVID-19.

For many people, this is their first experience with a public health crisis. Can you share the methodology behind identifying, assessing, and managing a public health crisis?

One of the things about public health is when we’re doing our job, you don’t know anything about it and things are quiet. We’re monitoring diseases and other issues of concern every day, whether it’s influenza every year, or TB, or sexually transmitted infections, things like that.

We work with the health care system and providers, we get lab reports of new illnesses. Flu is something that every season we are monitoring how bad it is, trying to implement interventions like vaccines. We have had other types of outbreaks that have gotten a lot of attention; most recently perhaps Zika, where we get the reports either perhaps it might be something that was occurring in another country. You start seeing the reports of what’s going on, you monitor that. Then you start to see how that spreads to this country, and we start getting reports and assessing and learning about the disease. When it’s a new disease, we don’t know a lot about how easily it’s transmitted, how lethal it is. We work and communicate with our state health partners, the CDC, also the international partners, as in this case, just to see what is being learned about it. We work with our health care systems to report, here’s what the symptoms of this problem are, are you seeing any of that? As lab testing is available and developed, then we start to gain data from those sorts of testing results. But you know these things progress – usually it’s not as big as this.

But every day, we deal with different infectious disease outbreaks, be it a foodborne outbreak at a local restaurant or something more like this. As it progresses, we’re working with the state and federal partners, and it escalates as it becomes an issue of higher concern where the World Health Organization declares it either a pandemic or something like a public health emergency. At different levels, you get those designations. Certainly, having Judge Jenkins here in our county with the leadership is done in prior events like this, whether Ebola and West Nile virus, or now, this, helps bring together all of the partners. Certainly, the business community is one; health care; schools; and universities. We’re working with homeless shelters, long-term care facilities. Everyone in a situation like this is really a partner and we try to keep those communication channels or emergency responders inspired, EMS all of them. We try to keep in very close communication and coordinate things as they develop.

Please talk about the impact of COVID-19 on the residents of Dallas County.

[Statistics as of midday Wednesday, March 25, 2020]

Yesterday (March 24), we had 78 new cases that were identified. That brings our total case count in Dallas County to 247, and we’ve had our six death. We’re early in this outbreak.  What’s been concerning in particular is how we’ve seen how fast it spreads, how it overwhelmed some of the health care systems in China, in South Korea, and in Italy. Now we are seeing on the West Coast and East Coast some of those numbers that that are very concerning. We’ve done some of the math regarding potential for this and there are two populations in particular we are trying to protect, some of the vulnerable populations; some of the older population, and those with chronic health conditions of any age. We’re also trying to protect health care workers and our health care system from being overrun. Because then if the health care system becomes overrun, we can’t even take care of other people who have COVID-19, or any other health care conditions that will be going on.

Currently, the (Dallas County) judge has issued the orders on social distancing, and the stay home/stay safe day type of policy. The goal of that is to slow this down, to keep the spread of the infection manageable, keep the prevalence of this low and only 2% of the population being infected. If you do the straight math, 2% of Dallas County’s 2.5 million population, would be about 51,000 persons having infection, about 681 deaths would occur. We have about 4,000 hospital beds in the area, and roughly another 400 ICU beds. If you get a 2% prevalence (of COVID-19 infection), 51,000 Dallas County residents would be infected. And if we say of those persons infected, let’s say 7% need hospitalization and multiply by 51,000 persons infected. You have about little less than 4,000 persons that need hospitalization and that’s manageable within our system. But the problem is, and this is where the concern (lies). If you raise it and instead say 20% in Dallas County get infected, that means 517,000 out of our 2.5 million have infection, and based on ratios, you’d get about 6,800 deaths. In terms of number of hospital beds that would be needed, it would be like 37,000 beds, compared to the 4,000 we currently we have. Thinking of the magnitude of our health care system, we got about 4,000 beds available, we’re down about 33,000 beds (in this scenario). You can see how that could potentially influence and impact our health care system – and that’s only with the 20% prevalence. Certainly, if you don’t do anything, this can get to even to 70% of the population being infected. This is why it is so important to be acting quickly and to be acting very strongly on trying to do the social distancing efforts and slow down the spread of this infection.

Why is it important to take a regional approach in fighting COVID-19?

“We are all part of the same region. The (Dallas County) judge mentioned that if we have a really strong policy and say people can’t go to restaurants and bars, or can only get take-out from restaurants. But then if the bars in one of our neighboring counties are open and people who live in Dallas County go to these other bars, get the infection, spread it, and then come back home, that really undermines the effect of some of the social distancing to try to slow down and prevent the spread. That’s why it is really important that these policies affect the whole region.

Do you have a story of hope you can share with the group?

What is encouraging is how the community always comes together for these situations. I’ve been heartened by hearing how community members have really been trying to do all they can to get PPE (personal protective equipment), and make and sew PPE, and mobilize to make ventilators and stuff like that. This is everyone pulling together to address this and recognize how important it is. It’s going to take everyone to work together.

You’re a Dallas native. Can you talk about the personal side of this fight for you?

This where I grew up. I have so many friends from childhood and this is my community. I went to medical school here. This is our community and (I want) to protect the health of everyone who’s here.

On a personal level, my daughter is not right in the community, but she’s in her second year of an OB residency. I am hearing her stories of how frightening it is to be on the very front lines, working in hospitals with a lack of personal protective equipment and masks and other things that are needed to protect our health care workforce. It is scary, and that’s why is it so important for all of us to pull together at the protect everyone in this community. When you look at some of the potential numbers of what this could be, it’s huge. Our family members and all of us make an impact.

Any final recommendations for how this group of business leaders can help?

We’re all in this together, and that’s how were going to successfully get through this. We will get through it. And I appreciate all the support that the business community has given to us during this. I know is that it’s not easy at all, but we will get through it.

Our next virtual town hall will be a conversation with Texas Commissioner of Education Mike Morath. He will share his insights on how COVID-19 has impacted public schools, students, educators and care givers. Learn what his recommendations are for parents, business and our elected officials during his conversation with Drexell Owusu, the Senior Vice President of Education & Workforce at the DRC.