County health departments across the state are struggling to keep up with the demands placed upon them by the COVID-19 pandemic. Health departments have worked tirelessly to contact positive cases as well as all close contacts, however, cases continue to rise, and that practice is becoming unsustainable.
With widespread community transmission of COVID-19, health department contact tracing is no longer effective in determining where a case may have been exposed to COVID-19 or in determining all potential exposures to others from the case during their communicable period.
As COVID-19 testing expands and cases increase across the state, there is often a delay in the process of contact tracing through local health departments. This delay is caused by a variety of factors. It can take several days for local health department to receive positive results; not all lab results are received; not all lab results have the correct contact information and many do not have contact information at all; many people avoid answering the phone or do not give complete information; an increasing number of positive cases are declining to disclose their direct contacts and instead report that they will notify their contacts on their own; and an increasing number of contacts believe they are incorrectly being named as direct contacts by cases and would rather be contacted by the person they know than a public health professional.
Moving forward, the Crawford County Health Department (CCHD) will be focusing its efforts on case investigations and household contact quarantine. The health department will be prioritizing case investigation to vulnerable populations and those aged three to 21 years. CCHD will continue to assist places where outbreaks are more likely to occur, such as schools, businesses and long-term care facilities. Cases at local schools will continue to be contact traced and identified close contacts will be quarantined if needed.
After exploring expedited contact tracing and community mitigation strategies, CCHD, in conjunction with other area health departments, is shifting to a modified approach to contact tracing for the majority of individual cases. This will allow positive cases to immediately notify their contacts as soon as they receive positive lab results instead of waiting for the health department to do so.
Individuals do not need to wait for instructions or information from their respective health department. Those that test positive for COVID-19 should refer to the “COVID Patient Guidance Tool” that can be found at the end of this story, Missouri Baptist Sullivan Hospital’s website, or an emailed copy can be requested by calling the Crawford County Health Department at 573-775-2555.
CCHD will no longer be calling close contacts of all positive cases—instead, all positive cases will be expected to notify their own contacts. This will eliminate the wait time and, hopefully, stop people from unknowingly spreading the virus. The health department is also hopeful that people will feel more comfortable telling their contacts about their positive result versus a stranger on the phone. There may still be situations when the health department directly reaches out to contacts, as well.
Anyone who receives a call from their doctor with a positive result needs to take immediate action to slow the spread of the virus within their friends, family and coworkers by following the outlined steps in the “COVID Patient Guidance Tool” document. They should not wait for a call from the health department to implement their own contact tracing.
The positive case will need to notify everyone with whom they have had close contact. A close contact is anyone who has been within six feet for at least 15 minutes starting two days prior to becoming symptomatic, regardless of face coverings. It’s important to consider how many people that would be and to take action now to reduce that number on a daily basis. Keeping distance from those outside of a household is important in limiting the spread of COVID-19.
The Crawford County Health Department has discovered clusters of positive cases at office buildings, group gatherings and long-term care facilities. There have also been numerous cases from household exposures to a known case.
The health department urges everyone to continue to take responsibility for their own health and to protect others. Please reconsider hosting or attending gatherings that bring people together that are outside of normal interactions, especially if physical distancing cannot be maintained. These activities are high risk for transmission of the virus. Please adhere to physical distancing recommendations and limit contact with others outside of a household.
In addition to limiting social interactions, the Crawford County Health Department is still strongly recommending that everyone take the following precautionary measures to reduce the spread of the virus:
• Stay home if you are sick.
• Adhere to all social distancing recommendations and do not be within six feet of others outside of your household for 15 minutes or more.
• Wash hands often with soap and water for at least 20 seconds, especially before eating. If not available, use hand sanitizer. Avoid touching your eyes, nose, or mouth with unwashed hands.
• Wear face coverings when in contact with someone outside of your household within six feet for more than 15 minutes. Cloth face coverings offer some degree of protection against large infectious droplets—such as mucus or saliva—when speaking, sneezing, or coughing. This particularly protects those around the person wearing the face covering. It also helps those who are unknowingly infectious from spreading it to others.
However, it should be noted that cloth face coverings are not considered an acceptable substitute for social distancing. Interactions within six feet of a positive case for at least 15 minutes will be considered exposure regardless if either person is wearing a cloth face covering.
Cloth face coverings should be washed after each use. Cloth face coverings should also be replaced frequently as consistent washing will degrade the fabric and decrease the effectiveness. It is important to always remove face coverings correctly and wash your hands after handling or touching a used face covering. For more information, visit: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html
For more information, please consult a factual source, such as http://www.CDC.gov or www.health.mo.gov/coronavirus. The community can also call Missouri Department of Health and Senior Services hotline (877) 435-8411 to address questions or concerns related to COVID-19.