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COVID-19 Briefing - Tuesday, June 30th

Astronomical case count estimates, employee anxiety, HIPAA waivers, and more.

July 1, 2020


Today’s Recap:

Well - it’s been quite the few days since our last Exec Summary on Friday.  Since then:


  • Case counts exploded all over the place.  Your hotspots aren’t just the states all over the news (FL, TX, AZ, CA).  They include MI, MN, UT, OR, and SC.


  • Bars closed in multiple states. Rumors abound re: more closings or restaurant closings.


  • Testing availability has maxed out in many of the states with surges and testing turnaround time has slowed to a crawl.


  • Employee anxiety and fear continues to rise. Definitely the issue of the week.


  • The CDC reports that 1 in 2 patients with COVID can’t tell you who they came into close contact with who had COVID. 


  • A local high school graduation in Chappaqua, NY  appears to have set off a second round of community transmission just north of New York City, just a few miles from where the first community transmission occurred in New Rochelle, NY at the start of this. 









Best Questions of the Day:

How do we know that a lab report actually shows us a result  is positive?  

They’re not always clear and every lab has their own lab report format.  LabCorp’s will say Detected: Abnormal.  Others say:  Detected.  We wish there was a single format for lab reports, but between rapid tests, varying labs, many technologies - there just isn’t.  Even our team is sometimes confused and we need to double check with one another.  

Along the same lines, how do we tell if a positive result is for a COVID test or for COVID antibodies?

Good question.  The answer is that the COVID antibody test will say Ab or Antibodies or COVID Immunity Test.   And the best result on that test is “Positive”.  If someone has Antibodies or is AB + or Immunity Detected, that’s great.  They can work and more importantly, don’t need to be excluded if exposed to a positive co-worker or close contact outside of work.

An employee tested positive and was excluded for ten days, and now has been exposed to a close contact who has tested positive.  Do they need to be excluded again?

No.  We are still operating under the assumption that one can currently only get COVID once.  So if someone has tested positive and was excluded, then they do not need to be excluded again if they are exposed to someone with COVID. 


If an employee was excluded for close contact for fourteen days and then developed symptoms, what should their additional exclusion be?

That employee may actually end up with a shorter exclusion.  If someone was excluded for 14 days due to close contact and becomes symptomatic on day 2, they can return to work 10 days after their symptom onset, if they’ve been fever free without fever reducing medications and have resolved respiratory symptoms.  If they become symptomatic later than day 4, then their exclusion will need to be extended to at least ten days from their symptom onset. 


How do we know when we should close because of positives or illness?

Well - that’s a complicated question and there is not a single answer.  Very few businesses need to close for a single positive or even several.  Most of you say that decision is driven by your ability to safely staff and your ability to have managers who are cleared to work. 


We’re concerned about the information we are handling and discussing and HIPAA.  We’d heard that there is currently a  HIPAA Waiver related to COVID.  Is that true?

Although we always advise to maintain confidentiality and not identify who has tested positive, who is experiencing symptoms, or who has been excluded for self-quarantine due to exposure, the Department of Health and Human Services announced that they would not be enforcing HIPAA violations related to COVID response.  Here’s a link to their initial guidance, and there is more guidance on this on the CDC website.

We always recommend reviewing your documentation procedures with your legal counsel. 


A guest or customer called to tell us that they tested positive or developed symptoms after visiting us.  What should we do?

We would: Thank them for calling, tell them you hope they feel better soon and assure them that you are following the best practices for minimizing contact, sanitizing and keeping employees informed as needed.  Since best practices ensure that your team members aren’t within six feet for fifteen straight minutes or more with any customers/guests (and ideally each other!),  there is no reason to exclude anyone or inform them if a guest tests positive.


A customer called and wanted to know if we’d had any positives before they visited us.  How would you recommend we handle that one?

Another good question… and a bit of a challenging one.  Our first guess is that really is either a reporter or a disgruntled employee rather than a customer.  We wouldn’t  recommend sharing that information with anyone outside of your organization (other than the Health Dept. when required).  I’d outline the steps you’re  taking to ensure no one works sick (wellness checks), the regular and thorough sanitizing you’re doing, and your use of outside clinical consultants (us) while politely saying that medical privacy guidelines prevent you from discussing results or tests. If anyone has a better answer to this question, please share it and we’ll include it in the next Exec Summary.


An employee says they tested positive but can’t or won’t produce their lab result.  Can we force them to?  Do we take action and exclude co-workers who worked within six feet for 15 straight minutes or more based on their word?

You’ve asked this question a lot over the last several days. While a few weeks ago getting a lab result could be challenging, they’re much easier to get today. And many employees are finding they’ve tested positive from an email with the result they can forward.  

Your legal counsel can give you the best advice on whether or not you can require the result.  It may depend on whether or not you're providing COVID pay.  Your employee may prefer to give the results to our clinical team. Results can be emailed to covid@zerohourhealth.com and we’ll confirm to you that we received it. 


 

Best Read of the Day:  

There are ways to stop this virus.  This is an excellent read about how we can turn the tide.

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How to Stop Coronavirus Surges from Winning the War

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Best Guidance and Best Laugh of the Day:  

The variability in mask usage is dramatic and likely, together with reduced social distancing,  plays a large part in some regions’ very high case counts.  There has been a lot of emotional discussion about masks in stores, restaurants, offices and families.  Here’s something to make you think about wearing one... and something to make you laugh about them, also. 


COVID-19: Considerations for Wearing Cloth Face Coverings