COVID-19 Briefing - Tuesday, July 14th

Today’s Recap:

• Delays in getting test results are negatively impacting staffing and operations nearly everywhere. 
  

• For weeks, we’ve been struggling with COVID results reporting.  Some come by fax, some by email, some by phone.  One major hospital is sending via fax (twice) and by email so the results need to be collated and sorted for duplication.  And the formats are all different so even our experienced team has difficulty deciding if a positive is a positive.
  

• Our good friend, Dr. LJ Tan, from Immunize.org and Director of the CDC/AMA National Flu Summit, did this interview for the BBC on what to expect this flu season.  A good listen: Double threat of Covid-19 and flu
  
  
• The impact of Fourth of July weekend parties is peaking.  One example: a high school party near Belton, MO with 300 attendees now has multiple confirmed positives impacting businesses across the area.
  
  
• Outside dining isn’t easy.  From the expense involved in purchasing outside furnishings, to a shortage of umbrellas and tents, and on to afternoon thunderstorms, operating al fresco has its challenges.  
  
  
• There seems to be a very widespread lack of understanding about what someone should do after being notified of close contact with someone with COVID (that requires they be excluded from work).  It means that they should self-quarantine for 14 days from their exposure. We’re hearing about people who use that time to travel, go on vacation, host parties at their homes, attend parties.

Best Questions:

An employee was diagnosed with Strep Throat, Bronchitis, Pneumonia or something else with COVID-like symptoms. Can we return them to work?

For any other diagnosis with COVID-like symptoms, we recommend that you require a doctor’s note and 3 days fever-free without fever-reducing medication to return someone with COVID-like symptoms earlier than 10 days from symptom onset. If they can’t get a doctor’s note with a diagnosis AND clearing them to work, keep them out for the full 10 days just to be safe. 

We excluded an employee 14 days due to a family member having fever and body aches. Neither of them were tested. The 14 days are up and now one of their kids have fever and diarrhea. What does exclusion look like?

Unfortunately, we’ll need to put this person out for another 14 days. This is a tough one to swallow, but the CDC guidance is clear. Especially if the employee hasn’t developed symptoms or gotten tested, we need to exclude them every time they are exposed to someone with COVID symptoms in their household, or within 6ft for 15+ consecutive minutes to anyone with confirmed COVID.

If someone has close contact but also has symptoms, do we put them out for 10 or 14 days?

Symptoms trump exposure. If they have COVID symptoms, we will exclude that employee for 10 days from the date that their symptoms started. 

An employee thinks they have close contact, but it was 3-4 days before the person’s symptoms started. Do they need to be excluded from work?

This is a common one that we are seeing. Employees think that they had close contact, but it doesn’t always match our criteria. What we are looking for when deciding who to exclude is: 

1) Was the contact within 6ft for 15+ consecutive minutes? 

2) Was that interaction when the COVID+ person was already sick, or in the 48 hours before the person became symptomatic (or tested positive if asymptomatic)?

In order to exclude someone, the answer to both questions must be yes before we consider it a true close contact. 

An employee believes they had COVID previously, but was never tested or treated by a doctor. She’s now been exposed to a confirmed COVID case. Do we exclude her?  

Yes, unfortunately. Unless we know that someone had lab-confirmed COVID, we need to exclude them every time they are exposed. Perhaps eventually antibody testing will be consistent enough and we’ll know enough about immunity to change this recommendation, but given what we know now, we recommend excluding every time someone is exposed if they don’t have a lab-confirmed COVID positive result. 

Best Read:  

While we wait for a vaccine and COVID surges in many parts of the country, many wonder which will come first: a vaccine or herd immunity.  This Atlantic article does a great job of explaining how we’d achieve Herd Immunity.

How Herd Immunity Happens

Best Laugh:

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