Howell County Health Department Director Chris Gilliam states that he feels it is important to clarify some of the information related to the COVID-19 testing and reporting that the Howell County Health Department is providing to the public. Gilliam acknowledges that he is aware of frustrations in the community on both sides of the COVID-19 argument. “Some have expressed that we are guilty of overreach or stoking fears while others argue that the Department isn’t doing enough in our response to the outbreak,” He states that he hopes that if residents have a greater understanding of the Department’s response efforts to contain each COVID-19 case identified, that concerns can be reduced.
The use of unfamiliar terms used in public health surveillance has likely contributed to some of the uncertainty that has been generated. Contact tracing is a term often used in case reporting. Contact tracing is used by health departments to prevent the spread of infectious diseases, like COVID-19. In general, contact tracing involves identifying people who have an infectious disease, as well as their contacts or people who may have been exposed. Public health works with each case and contact in an effort to interrupt or slow disease transmission. For COVID-19, this includes asking cases to isolate and contacts to quarantine at home.
Contact tracing for COVID-19 typically involves:
- Interviewing people with COVID-19 to identify everyone with whom they had contact during the time they may have been infectious, especially close contacts.
- Notifying close contacts of their potential exposure.
- Monitoring close contacts for signs and symptoms of COVID-19.
- Referring close contacts for testing.
Close contacts with COVID-19 are defined by the CDC as being “anyone who was within 6 feet of an infected person for at least 15 minutes.” Individuals that do not meet these criteria are deemed to be at low risk of infection, even if they are at the same location at the same time as a COVID-19 infected individual. Gilliam adds, “We have received considerable outcry for the Department to report out each location every positive case has visited while they were contagious.” Adding that, “This information is often of limited use in containment measures.” He fears that this data can give a false sense of security, as some will get the idea that if they avoid any identified business that has been visited by a COVID-19 case, they can avoid the risks of exposure. When in truth, we all face potential exposure each time we go out in public, even if the businesses we visit have not been identified as a potential exposure location.
Contact tracing investigations are designed to ascertain a complete list of all close contacts to each new case identified. Each contact on the list is contacted by the Health Department and notified of their exposure. To prevent the further spread of disease, COVID-19 contacts are notified that they should stay at home and self-quarantine for 14 days, starting from the last day you were possibly exposed to COVID-19. The contact tracer will help identify the dates of your self-quarantine. Contacts should monitor themselves by checking their temperature twice daily and watching for symptoms of COVID-19. The contact tracer can also provide resources about COVID-19 testing in your area.
- Self-quarantine means staying home, monitoring your health, and maintaining social distancing (at least 6 feet) from others at all times.
- If you need to be around other people or animals in or outside of the home, wear a cloth face covering. This will help protect the people around you.
If you have been around someone who was identified as a close contact to a person with COVID-19, you should closely monitor yourself for any symptoms of COVID-19. You do not need to self-quarantine.
A common term utilized in the contact tracing process and reporting is the epi-linked, which is short for an epidemiologically linked case or a case in which the patient has had contact with one or more persons who either have/had COVID-19. The contact tracing conducted on the spread of the SARS-CoV-2 virus determines if the spread is from community exposure or if it has been epi-Linked. Cases, at times, are also found to be travel related, meaning the individual was exposed while on out of area travel. Community exposure or spread means that people have been infected with the virus in an area, including some who are not sure how or where they became infected. Each of the cases of COVID-19 identified within the county since May 27 2020, have been Epi-linked to a known case, except for two that have been determined to have been related to out of state travel.
It is a greater concern for public health when newly identified cases are community spread.
Community spread viruses are considerably more difficult for public health to combat as the source of the infection is unknown. Gilliam states, “We have been fortunate in Howell County in that nearly all of our cases since the end of May have been epi-linked and not community spread.”
