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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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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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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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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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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Face coverings are protective, research shows

We have received several questions about whether face coverings actually protect us from the virus that causes COVID-19.

The evidence from many different sources is clear – face coverings are protective, especially when they’re used with the other recommended guidelines of keeping 6 feet between you and everyone else in public, washing or sanitizing your hands frequently, and staying home if you’re sick. Here’s a list of articles and studies and reports that have slight variations on the same theme — #MaskUpIdaho.

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COVID-19: Facts vs. Fiction

There is a lot of COVID-19 information available through social media and other communications channels. Some of it is helpful and factual, and some of it is opinion or speculation. And some is just plain false. We want to help you separate the COVID-19 facts from fiction as you navigate through this pandemic.

Is wearing a mask or cloth face covering really helpful? The evidence is clear — cloth face coverings reduce the spread of COVID-19. They serve two purposes: to protect the public from those who may be infected with COVID-19 and to protect those infected with COVID-19 from spreading the disease to others.

Wearing a mask is most effective when everyone does it, and it also shows respect and concern for your neighbors and community. Masks are appropriate when physical distancing of at least six feet is not possible.

Cloth face coverings should not be placed on young children under the age of 2, anyone with difficulty breathing, anyone who is unconscious, incapacitated, or unable to remove the covering without assistance.

Does COVID-19 more severely affect older adults? Yes. According to the Centers for Disease Control and Prevention, as you get older, your risk for severe illness from COVID-19 increases. For example, people in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, are at higher risk for severe illness than people in their 50s. The greatest risk for severe illness from COVID-19 is among those aged 85 or older.

There are also other factors that can increase your risk for severe illness, such as underlying medical conditions. By understanding the factors that put you at an increased risk, you can make decisions about what kind of precautions you should take in your daily life.

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Public Health staff, programs work hard to keep Idahoans safe and healthy. We need your support during COVID-19.

Public Health employees take their jobs to protect the health and safety of Idahoans very seriously, even when Idaho isn’t in the middle of a deadly pandemic.

Public health practitioners look after our health and safety in Idaho through a range of services that include, but are not limited to, maternal and child health, immunizations, chronic and communicable diseases surveillance and intervention, food safety regulation, environmental health, emergency medical services licensing, vital records administration (including birth and death records), rural healthcare provider recruitment, laboratory services, and bioterrorism preparedness. They also record and compile health statistics, so we have some historical context for what makes us sick or unwell.

Public health programs and services promote healthy lifestyles and prevention activities while monitoring and intervening in disease transmission and health risks as a safeguard for Idahoans. Public health activities largely go unnoticed until there is a crisis like this COVID-19 pandemic.

I am very proud of the work we are doing at the state and local levels to help keep Idaho healthy and safe, for both COVID-19 response and non-COVID activities.

During the COVID-19 pandemic, state and local public health have been working collaboratively to respond. Public health at the state level works with and supports the locals as they manage the pandemic response. When the state issues guidelines and protocols, they have been developed in close coordination with the health districts.

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DHW Director Dave Jeppesen: Stage 4 pause means it’s more important than ever to follow the guidelines

Gov. Brad Little announced Thursday that Idaho did not meet the metrics needed to move out of the final stage of the Idaho Rebounds plan. Idaho will stay in the final stage of the Idaho Rebounds plan for at least another two weeks.

Idaho did not meet the epidemiologic and healthcare criteria to advance past Stage 4:

  • The number of reported cases from June 10-25 trended upward instead of downward.
  • The percent of positive tests from June 8-21 trended upward instead of downward.
  • The average percent positive for the prior 14-day period was greater than 5-percent at 5.12-percent.
  • The number of healthcare workers reported with COVID-19 from June 10-23 trended upward, and the average number of healthcare workers reported having COVID-19 per day was greater than the standard of 2.

He also announced that the state’s COVID-19 response will transition to a more regional approach as the number of cases in some counties has increased significantly, but several others have had no reports of COVID-19 cases. The seven local public health districts across the state are continually evaluating the criteria at the local level and will announce any changes in moving forward.

What this all means is that it remains critical for everyone – especially those who are 18-29 years old — to follow the recommended guidelines and stay home if you’re sick, wear a face covering and keep six feet apart in public, and wash your hands frequently. It’s also a good idea to avoid large gatherings of people to help reduce your personal risk of getting COVID-19.

The ultimate goal is to slow the spread of COVID-19 and keep us within the capacity of our healthcare system so people who do need hospital-level care can get it when they need it.

Idaho’s success depends on us all.

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Businesses are uniquely challenged in this pandemic, but they can help slow the spread of COVID-19

Trying to operate any business in Idaho in this time of COVID-19 is a challenge. The number of COVID-19 cases are increasing, face coverings are divisive, staying on top of cleaning is difficult, staffing is an issue, and some people aren’t following the guidelines recommended by public health officials, potentially causing the numbers to rise even higher.

Operating a bar in this environment is even more difficult. Customers are drinking alcohol, which dulls the ability to make good decisions, and the bars are packed with people who are tired of staying home. That is risky behavior in a pandemic; and the evidence bears that out as we saw with a cluster of cases that started in bars in downtown Boise two weeks ago and grew in the locations and types of businesses impacted.

While Ada County has now moved back to Stage 3 from the Idaho Rebounds plan and bars have been ordered to close, it is an opportunity to learn about the devastating impact COVID-19 can have if businesses and people are not socially responsible and creating environments where people can stay healthy and businesses can stay open. 

The following is a list of actions that businesses and patrons can take to help keep the doors open:

  • Staff consistently wear face coverings.
  • Customers wear face coverings.
  • Physical distancing and occupancy restrictions are in place and practiced.
  • Public health and business owners educate the public on responsible socializing while COVID-19 is circulating.
  • Local public health districts can assist establishments in an on-site technical review of operational plans for increased safety and sanitation.
  • Customers can let businesses know they appreciate being kept safe and visit establishments that provide for that safety.

These are great examples of how businesses should protect their customers by making it easier for them to adhere to the guidelines by having their employees adhere to them, and how they can do their part to keep Idaho open during this pandemic by reducing the risk of getting infected with COVID-19 in their establishments.

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