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Deeply conservative hospital CEO predicts where Tennessee's health crisis is headed next

210819 alan levine with bush family.jpg
Alan Levine Facebook Page
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Ballad CEO Alan Levine, and wife Laura, with former President George W. Bush, former First Lady Laura Bush, and former Florida Gov. Jeb Bush

(Mike Osborne) -- A deeply conservative Republican hospital executive on Wednesday released grim predictions for where Tennessee’s pandemic is headed next.

Alan Levine is the CEO of Ballad Health. The company operates 21 hospitals in East Tennessee, Kentucky, North Carolina and Virginia.

Levine describes himself as a “freedom loving, 2nd amendment supporting, federalist Republican.” Photos on his Facebook page show Levine in the company of GOP stalwarts, including President George H. W. Bush, President George W. Bush and former Florida Gov. Jeb Bush.

In a lengthy Facebook post Wednesday, Levine asserted there will be dire consequences if personal freedom is prioritized over public health in the fight against COVID-19.

He expressed special concern for children’s hospitals, which he noted are already being stretched to capacity.

You can read Levin’s complete post copied below. The original post can be found on both the Ballad Health Facebook page and Levine’s personal Facebook page.

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Ballad Health CEO Alan Levine post dated Aug. 17, 2021.

"To all parents, caregivers and guardians, we encourage you to take the time and read these personal thoughts of Ballad Health Chairman and CEO, Alan Levine, posted Aug. 18:

SOME THOUGHTS FOR TODAY, AND ADVICE FOR PARENTS:

I have served in Senior roles as Health Secretary for two of America's most conservative Republican governors during consequential times - through 10 major hurricanes making destructive landfall, the H1N1 Pandemic, Deepwater Horizon Oil Spill off the coast of Louisiana, and the mental health crisis in New Orleans revealed after Hurricane Katrina after the terrible murder of a police officer, Nicola Cotton, by a man named Bernell Johnson. In every single instance, Governor Bush and Governor Jindal gave me clear direction - respect local government's role, and lean in to help them prepare and respond with all my resources. Our nation's entire emergency response system is built on this model - local, then state, then federal. It is based on the premise that locally elected leaders are closest to the people they are elected to serve, and they have a better perspective of what the local needs are, and they can balance the needs against the tolerance of their communities for the assistance.

Combined with leaning in to help local government prepare and respond, we also saw it as our role to over-communicate with the public. Not opinions or speculation, but just the facts. Both Governors knew they had the platform to deliver information, and both used it assertively to keep the citizens well-informed with trusted information. Even during the H1N1 pandemic, as CDC guidance shifted, Governor Jindal and I methodically shared the guidance with the public and tried to be a resource for local school systems who had kids that were getting very sick, and even dying. When we had to evacuate hospitals during massive hurricanes, Governor Bush insisted we track the whereabouts of every patient, and ensure their families were notified of their status. There were certainly things only the state could do, but we did it in concert with local officials.

So, I am definitely puzzled by where we are now, where our nation's institutions designed to guide us through this have been made into political targets, and freelance, self-appointed experts are having as much influence over our local and state responses as our well-trained and experienced public health medical experts. Our system is simply not being permitted to work as designed, and I do think there are consequences to this.

So, what do I think we need to expect from here?

Since we are here, where simple mitigation like masking has now become political, or perhaps a symbol for freedom and liberty for some, it is important that I say I respect that people's strong feelings about this are genuine. I'm a freedom loving, 2nd amendment supporting, federalist Republican, and while I strongly disagree with those who feel masking is an infringement on liberty, I do understand where these follks are coming from. THAT HAVING BEEN SAID: political choices come with tradeoffs. Choosing individual liberty and freedom is a legitimate position to take, but what comes with that is to ensure you have a clear-eyed understanding of what the tradeoff is for yourself and for your fellow citizens.

And here's where we are: Thousands upon thousands of children are now being exposed to the virus in their schools without the full range of mitigation at our disposal. So, there are some things we all need to be prepared for:

1. As these kids bring the virus home with them from school, their family, if unvaccinated, will be exposed. This will increase hospitalizations in the coming near term for those who have severe symptoms. In many parts of the country, hospital capacity is being stretched, with some hospitals now setting up tents and using military or FEMA support staff. We are in the midst of a national shortage of nurses, which compounds the problem.

2. More children and teens will be hospitalized. Besides my obvious concern for the health and well being of children and teens who are exposed to COVID, and who may have symptoms severe enough for hospitalization, I am also concerned by the fact that our system of health care for children is not built for this kind of surge. So, other kids, who have other medical needs, may find it challenging to get the care they need. Already, in Broward County Florida, there are Zero pediatric beds available. Similar is true in other places. Ballad Health only has 10 PICU beds, with two currently occupied by teenagers on ventilators. Thankfully, we have not yet begun to see increased inpatients, but we believe that is coming. Our advocacy for full mitigation measures in the schools is, in part, based upon our concern that if there are no mitigation efforts, our hospital for children will be overwhelmed, and unable to serve kids with COVID AND kids with other health conditions or traumatic injury. Children generally do not require serious hospitalization, so the infrastructure for children is much, much smaller than for adults. Tennessee only has 5 legitimate children's hospitals.

3. IMPORTANT: Parents, you need to familarize yourself with a condition called Multisystem Inflammatory Syndrome in Children - or MIS-C. This condition seems to accompany the virus which causes COVID, although science is still trying to understand how it happens. MIS-C leads to inflammation of the heart, lungs, brain, eyes, skin or gastrointestinal system (or many of these at once). Children who present with MIS-C generally either had the COVID virus or had been around someone with COVID-19. MIS-C can be deadly, but timely medical care is proving to be effective. Generally, children with MIS-C will need to be hospitalized. What's critically important to know is that, right now, our children's hospitals are seeing huge surges in COVID cases through testing, and increasingly, in the ER, most of which are not being admitted to the hospital. And yet, around the country, children's hospitals are filling up. So, think about this...and you will understand my concern: Children's hospitals are filling up due primarily to COVID, which follows high levels of transmission of the virus. And yet, the rate of hospital admissions for children is low. Said another way, the population of kids who need to be hospitalized is low, but the infrastructure is already being tested.

With MIS-C looming, and which generally occurs 6 or so weeks after exposure to the virus, or to people who had the virus, kids end up getting MIS-C who never had any COVID symptoms. As yet, we do not know how big the denominator is - meaning, the population of kids who will end up with MIS-C is yet unknown, but it is not limited only to kids who had symptoms of COVID. The denominator is MUCH larger, thus the population potentially presenting with MIS-C will likely be significant.

What should parents look for? A fever AND any of the following signs/symptoms: Abdominal Pain, bloodshot eyes, chest tightness/pain, diarrhea, feeling extra tired, headache, low blood pressure, neck pain, rash, vomiting. YOU SHOULD SEEK EMERGENCY CARE IMMEDIATELY FOR YOUR CHILD IF THEY EXPERIENCE TROUBLE BREATHING, PERSISTENT PAIN OR PRESSURE IN THE CHEST, NEW CONFUSION, INABILITY TO AWAKEN OR STAY AWAKE, PALE, GRAY OR BLUE COLORED SKIN, LIPS OR NAIL BEDS.

If your child is in a school now, and there is no masking, it is highly likely your child is being exposed, even if they are asymptomatic. Keep in mind that the CDC goes out of its way to say that "We do not know what causes MIS-C. However, we know that many children with MIS-C had the virus that causes COVID-19, OR HAD BEEN AROUND SOMEONE WITH COVID-19 (emphasis mine)". Notably, they do not say MIS-C has only impacted kids who had COVID, but also those who were around others who had it. Well, in the schools, that's happening now.

SO, as COVID spreads through the schools, particularly in schools where there are no, or limited, mitigation efforts underway, the die is already being cast for what is to come in the coming months.

ONE MORE THING: the coming months also bring the flu season, which is expected to be more significant this year. We are headed into a period which is going to be very challenging for our system of care for children, and children will feel the impact of this.

To me, the most important thing our institutions are supposed to do is protect those who are vulnerable any way possible while also preserving our liberty. Regardless of how individual parents feel, our laws require vaccinations in schools, car seats for infants and toddlers, seat belts for kids, and we don't let parents decide not to do these things because their freedom is being infringed upon (there may be some valid reasons for not vaccinating certain children for medical or religious reasons, and society has accepted this). Society, and our legislatures, and our governors, have decided that the tradeoff is worth it because the evidence shows that doing these things protects our kids and our families from what might be devastating decisions by some to put their individual liberty first.

I hold many of our leaders and others who disagree with me in very high regard, and so my comments here are not intended to imply that I have a broad disagreement with them. But on this issue, I am concerned for where this is taking us, and I worry about it."