COVID Q&A: Vaccine, flu vs. COVID-19, and counting rapid antigen tests

How is Idaho preparing for a COVID-19 vaccine, and will the state be ready when a vaccine is available?

The Department of Health and Welfare has a pandemic plan for vaccine deployment and distribution that will be updated when we know which vaccines will be available and what the priority groups for vaccination will be.

Idaho, like all other states, is still waiting on information from the Centers for Disease Control and Prevention (CDC), U.S. Food and Drug Administration (FDA), and the White House Task Force before the plan can be adjusted to fit this pandemic. The plan includes Idaho’s Immunization Information System having the appropriate functionality to both recall patients for their second dose of COVID-19 vaccine and to track any potential adverse events from the vaccine.

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From DHW Director Dave Jeppesen: A Reminder to Get Your Flu Shot and Recognizing Suicide Prevention and Recovery Month

Each year, the Department of Health and Welfare (DHW) reminds Idahoans to get their flu shots in preparation for the flu season. This year, the stakes are even higher. Even if you normally get your flu shot in October, the time to start thinking about it (and getting it) is now. Flu shots are available at your local pharmacies, supermarkets, and primary care clinics (an appointment is usually not necessary). Please call your primary care physician if you have questions.

Why is the flu shot so important in 2020?

Both the flu and COVID-19 are respiratory illnesses affecting your lungs and breathing and can be spread to others. Adding the flu to the ongoing COVID-19 pandemic could overburden our healthcare system and strain our testing capacity.

Getting your flu shot is a safe, inexpensive way to stay healthy and protect those most vulnerable from the flu, our elderly residents and those with underlying health conditions.

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Enjoy Your Labor Day Weekend Safely and Responsibly: A Reminder from DHW Director Dave Jeppesen

As we approach this Labor Day weekend, I want to remind all Idahoans to minimize the risk of COVID-19 “transmissible moments” by wearing masks or cloth face coverings, washing your hands often, and keeping a physical distance of six feet when outside your home.

I know that holiday weekends are often a time for family or community gatherings, but I am encouraging you to celebrate safely. According to the Centers for Disease Control and Prevention (CDC), our risk for COVID-19 increases at events and in-person gatherings as follows:

  • Lowest risk: Virtual-only activities, events, and gatherings.
  • More risk: Smaller outdoor and in-person gatherings in which individuals from different households remain spaced at least six feet apart, wear masks, do not share objects, and come from the same local area (e.g., community, town, city, or county).
  • Higher risk: Medium-sized in-person gatherings that are adapted to allow individuals to remain spaced at least six feet apart and with attendees coming from outside the local area.
  • Highest risk: Large in-person gatherings where it is difficult for individuals to remain spaced at least six feet apart and attendees travel from outside the local area.
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COVID Q&A: Percent positivity, how COVID-19 deaths are counted, carbon filters in masks, tests vs. cases

Q: Is it possible we’ve had a steady amount of cases in the state for many months, but we are testing more which makes it seem like our cases are rising, but in reality the infection rate hasn’t changed?

A: Comparing the number of tests with the number of cases doesn’t tell us the whole story. It makes sense that as more tests are done, more infections might be identified. For this reason, we also look at the percentage of the tests that are positive to determine if the increase in cases is a result of increased testing OR the increase in cases is because more virus is circulating. This measure, called “percent positivity,” is one way to determine how widespread infection is in the area where testing is being done.

A high percent positivity indicates high coronavirus infection rates. Even as our testing increased during June, the percent positivity increased at a higher rate because the virus was circulating in a higher percent of the population than it had been before June. When percent positivity remains unchanged, we know the new cases identified are likely a result of additional testing. Unfortunately, that was not the situation for Idaho in June and July as percent positivity rose from 2.7percent to a high of 14.85 percent. However, our percent positivity has been decreasing during August, which is a sign less virus may be circulating. Our current percent positivity is 8.3 percent.

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DHW is here to support the most vulnerable Idaho residents: A reminder from DHW Director Dave Jeppesen

At the Department of Health and Welfare, our mission is to strengthen the health, safety, and independence of Idahoans. As you might guess, the positive impact we have on individuals and their families is ongoing and significant. We help people in crisis: struggling families needing a safe place to raise their children; people in the midst of a physical or mental health crisis; and families who need temporary public assistance to feed themselves and their children. These are just a few examples of how we serve those in need.

Now, add a global, devastating pandemic to the mix. The impact of COVID-19 on the United States is immeasurable. Here, in our home state, Idahoans have lost their jobs, closed the doors to their small businesses, or contracted COVID-19.

Now, what we do and how we do it, is more important than ever to the people of Idaho. We do not take this responsibility lightly. We spend many hours each day developing plans and removing barriers to better serve Idahoans. It’s not easy, but we want to always be there for Idahoans during dark days and difficult times. We want to create paths to healthier futures and more self-reliant Idahoans. Our goal is always to help Idahoans be as independent as possible and live their best lives.

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COVID-19 Q&A: Out-of-state residents, symptoms of COVID-19, flu, and UVC lamps

Why don’t the state or local health districts count out-of-state residents who test positive for COVID-19 in Idaho?

Public health departments at the state and local levels often don’t receive test results for out-of-state residents. The lab that performs the test sends the result to the address given by the person tested. If test results are received in Idaho and it is determined that person isn’t a resident of Idaho, the results are sent to that person’s state of residence for investigation and follow-up. This is common and consistent public health practice throughout the United States – public health authority to have personal health information applies to residents in their states.

However, DHW staff are working with universities to see if and how we can get summary information on their student populations, many of whom may list an out of state legal residence when they are tested.

Do asymptomatic carriers of the virus that causes COVID-19 have a fever or increased temperature?

No – since they are asymptomatic, that would mean they are not experiencing symptoms of COVID-19, which would include a fever. However, some people who are asymptomatic initially may develop symptoms the following day, or a few days later.

The symptoms of COVID-19 can vary from none at all to very severe. This is why following the recommended guidelines – and especially wearing a face covering in public, maintaining 6-feet of physical distance, and staying home if you feel sick — is so important. It’s possible to spread the disease without knowing it.

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For those raising children when the parents are unable to do so: A thank you from DHW Director Dave Jeppesen

I am asking all Idahoans to join me in celebrating and honoring Idaho’s kinship families. Kinship care is when significant adults (e.g. grandparents, Godparents, aunts and uncles, etc.) in the lives of children take on the responsibility of parenting when the child’s parents are unable to take care of them. I am guessing that some of you are parenting and nurturing your grandchildren, or maybe your nephew or niece, and to you, I send my sincerest appreciation.

According to the Annie E. Casey Foundation, 1 in 11 children live with a relative or significant adult at some point before turning 18. In 2018 in Idaho, there were 10,574 grandparents responsible for their grandchildren under 18 years old. This does not count for the thousands of children living with relatives informally. In the State Fiscal Year 2020 (July 1, 2019, to June 30, 2020), 2,934 children in Idaho were in foster care. Of those, approximately one-third were placed with either relatives or with a person who had a significant relationship with the child.

The department is actively working to create resources and support for caregivers. We know that the majority of caregivers are not receiving the support or assistance they are eligible for today. In an effort to provide further support to kinship caregivers and families, Idaho applied for and received a federal kinship navigation grant. Our goal for the grant funding is to identify kinship families and provide individualized supports to prevent children from entering formal foster care by supporting placements that promote family stability, safety, and well-being. We have applied for a second federal grant, which will serve as a continuation of our current grant activities. 

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COVID Q&A: hydroxychloroquine, deaths, and dangerous hand sanitizers

Is hydroxychloroquine considered an effective treatment for COVID-19?

Hydroxychloroquine and chloroquine have not been shown to be safe and effective for treating or preventing COVID-19, according to the FDA, citing reports of serious heart rhythm problems in patients with COVID-19 treated with hydroxychloroquine or chloroquine.

Anyone considering using hydroxychloroquine should consult with a medical professional before beginning to use it. The U.S. National Institutes of Health recommends against using hydroxychloroquine except for people in clinical trials due to lack of evidence of clinical benefit and increased risk for abnormal heart rhythms and other side effects with the use of this medicine.

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From DHW Director Jeppesen: We remain focused on our mission to serve Idahoans. You can track our progress in our Strategic Plan and Performance Reports.

Although COVID-19 has changed the way we work for the past five months, it hasn’t changed the need to serve Idaho’s most vulnerable residents. We want all Idahoans to be able to live their best lives.

The impact we have on those we serve is often immeasurable. We work with struggling families to make sure they have a safe place to raise their children. We assist people in crisis – whether it is a physical or behavioral health crisis. We also help people who need public assistance, while always keeping the path to self-reliance in our sight.

We are focused on our mission: Dedicated to strengthening the health, safety, and independence of Idahoans, and we keep track of our progress through our Strategic Plan. Our 2021-2025 Strategic Plan outlines our strategies to:

  • Address state and community issues (e.g. affordable, available healthcare)
  • Focus on public health issues and responses (e.g. COVID-19)
  • Protect children, youth, and vulnerable adults (e.g. reunification of families and behavioral health services)
  • Help Idahoans become as healthy and self-sufficient as possible (e.g. reduce Idaho’s suicide rates)
  • Strengthen the public’s trust in confidence in DHW (e.g. prevent accumulation of ineffective, outdated regulations)

We invite you to review our Strategic Plan and Performance Reports. As we continue with our plan, we will be able to show a positive influence on Idaho’s health and human services system.

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In our endless desire to make sure Idahoans have accurate, current, and relevant information about COVID-19, we’re continuing to answer questions we have received through the Department of Health and Welfare’s (DHW) social media accounts, in emails, and in our daily lives as we all live with the coronavirus in our communities. Here are some we’ve collected recently.

Q: I’ve heard that hospitals make more money treating COVID-19 patients, so they are labeling more patients as COVID-positive than they are actually treating for COVID-19. Is this true?

A: This is not true. There is a false rumor circulating that hospitals are misrepresenting COVID patient data to increase federal reimbursements for patient care. It is true that the Coronavirus Aid, Relief, and Economic Security (CARES) Act increased reimbursements to hospitals for Medicare patients with COVID-19 due to the high cost of COVID-19 patient care.

However, it is not true that healthcare providers have an incentive to misrepresent a patient’s COVID-19 status. To begin with, a misrepresentation of a patient’s COVID-19 status would be fraudulent, exposing the provider to civil and even criminal liability. 

Second, the clinicians who decide whether to diagnose patients with COVID-19 have no economic incentive to do so. The way physicians in hospital systems are compensated for the services they provide is not based on what Medicare or other payers reimburse the hospital system for the care. A diagnosing physician is paid the same amount for services provided to a patient with or without a COVID-19 diagnosis. 

Third, Medicare’s increased reimbursements typically do not cover the increased costs of providing care to COVID-positive patients. COVID-positive patients often suffer more intense symptoms and potential complications than non-COVID patients. These patients often require a combination of medications and sometimes a ventilator for many days to support breathing. Even COVID-19 patients whose disease does not become more severe require more expensive care, including increased use of personal protective equipment, seclusion, and more rigorous disinfection routines. The modest increase in Medicare reimbursement does not come close to covering the cost of care. 

Finally, Medicare is the only payer that has increased hospital reimbursement for COVID-positive patients. Therefore, for the vast majority of patients under age 65, there is no increase in funding for hospitalized COVID-19 patients.

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