Health Official Explains COVID-19 Procedures-Brevard NC
Last updated 4/6/2020 at 5:28pm
Editor's Note: Tara Rybka, Transylvania County Public Health's public information officer, was asked to explain the procedures Public Health officials take once someone is confirmed to have contracted COVID-19.
The following is Rybka's response.
Our typical contact tracing process follows guidance set by the state and the Centers for Disease Control (CDC) for each disease. Physicians or laboratories that diagnose certain diseases are required by law to notify the local public health department.
On Feb. 3, the N.C. Department of Health and Human Services added the 2019 novel coronavirus (now known as COVID-19) as a reportable disease, requiring clinicians to report suspected or confirmed cases to the local health director in their county or district.
Once we have been notified of a reportable disease, our communicable disease nurse will contact the patient to complete a questionnaire that asks about their possible exposures to the disease.
With COVID-19, the nurse would ask them to remember their activities for the past two weeks: if they had recent travel to an area where an outbreak is occurring, if they have had close contact (within 6 feet for 10 minutes or more) with someone diagnosed with COVID-19, or if they had close contact with anyone who had a fever, cough or shortness of breath.
This helps to identify where the case may have gotten exposed to the disease. The nurse will advise the case that they should be in isolation, which includes staying at home, limiting visitors to the home and other close contacts, and wearing a mask around others.
Ideally, they would limit contact with other household members by staying in a separate room and bathroom if possible.
She will tell them when they can stop isolation, which is at least seven days since symptoms first started and at least three days without fever and no fever-reducing medications, and when other symptoms have improved.
The communicable disease nurse will ask about other people who may have been exposed to the case.
For COVID-19, this includes any close contacts from 48 hours before symptoms first started until they are released from isolation.
The nurse will gather information about any household members, visitors to the home, group gatherings, or other times when they were within 6 feet of another person for more than 10 minutes.
She will attempt to speak with all of these people to inform them that they are contacts of a known case of COVID-19 and should self-quarantine for 14 days after the last time they were around the case (this means that household members will need to stay at home for 2 weeks after the sick person has recovered).
She will tell them that this includes staying home, maintaining at least 6 feet of distance from other people at all times, self-monitoring for symptoms by checking temperature twice a day and watching for fever, cough, or shortness of breath.
She will also remind them to avoid contact with people at higher risk for severe illness unless they live in the same home and had same exposure. The nurse may inform people individually, or if there was an exposure to a group of people, she may rely on the group organizer to share this information with the attendees or group members.
Obviously, contact tracing is limited by the information we get from people. For those who go out and interact with a lot of other people, it can be hard to identify all of those potential contacts. And some people may be unwilling to tell us about all of their contacts.
The value of contact tracing becomes less important once we have widespread community transmission of a disease, or when we know that people without symptoms can spread the illness to others. Because of this, N.C. Department of Health and Human Services is no longer requiring local health departments to do contact tracing for COVID-19 at this time. As more and more cases are identified, our nurses will still reach out to lab-confirmed cases and their household contacts, but may not be able to identify all contacts throughout the community.