COVID-19 Q&A: Hospital capacity, getting tested, and Thanksgiving

Q: I keep hearing that hospital officials in Idaho are very concerned about capacity, and they might have to implement crisis standards of care. What does that mean? If I needed life-saving care, would a hospital really turn me away?

A: We have been emphasizing this since the start of the pandemic: Hospitals, including those in Idaho, have limited capacity. When they no longer have enough staff or beds or equipment to treat patients, they will have to divert patients to other hospitals, turn people away if other hospitals are not accepting diverted patients, and possibly set up field hospitals. Healthcare will have to be rationed. Idaho has a Crisis Standards of Care Plan that outlines what this looks like and what would trigger it to be implemented.

However, we don’t want to get to that point!  We can PREVENT it by following the recommended guidelines and wearing a mask when we’re around others who don’t live with us, keeping 6 feet between ourselves and others we don’t live with, washing or sanitizing our hands often, and staying home if we feel sick.

The Centers for Disease Control and Prevention (CDC) has published a scientific brief that says that mask-wearing protects others, but it also protects the person wearing it. That’s new, and worth remembering. It’s a very small sacrifice to wear a mask, and when most of us do, it lowers the risk of infection for all of us. That also helps our hospitals and healthcare workers. Fewer people get sick and require hospital-level care, which can be provided when it’s needed.

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COVID Q&A: Family gatherings are COVID-19 hotspots

Q: Where is Idaho seeing the most spread of COVID-19?

A: Public health officials are seeing the most spread in Idaho at smaller gatherings of families and friends, where people are not following the recommended guidelines. We understand — it feels weird to wear a mask around people you know and love. But the reality is that the virus doesn’t care how strange or uncomfortable it feels to stay 6 feet apart and to wear a mask around your friends and family. It will take advantage of the situation and spread among your loved ones if precautions are not taken.

Asymptomatic spread is the most complicated part of the coronavirus. Sometimes people just don’t know they have been infected and they unwittingly infect their friends and family. The solution is simple – everyone should wear face coverings and stay 6 feet apart. It’s very important to be diligent about those simple things to protect ourselves and our loved ones.

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COVID-19 Q&A: Testing and Idaho schools

Q: I have heard there are testing programs for teachers and staff in Idaho schools. What are they?

There are a couple of different things happening on the testing front for schools.

The Coronavirus Financial Advisory Committee, or CFAC, approved funding for the Department of Health and Welfare(DHW) to help expedite COVID-19 testing for teachers and school staff, specifically for those without insurance or if their insurance will not pay for the testing.

DHW is working very closely with Idaho’s local public health districts on subgrants to assist with agreements with testing entities, contact tracing, outbreaks in the school setting. One of the subgrant activities is for the local public health districts to implement agreements with testing facilities in their area. This helps to prioritize testing for teachers and school staff.

There are also funds in these subgrants to reimburse the testing facilities the PHDs have agreements with for the uninsured or underinsured teachers and school staff. DHW is also working on agreements with pharmacies, labs, and businesses to prioritize testing for teachers and school staff.

The agreements we’re implementing are for PCR tests (the gold standard for testing) that can be self-administered by teachers and school staff. The tests can be done at home and include a prepaid overnight shipping envelope to send to the contacted laboratories.

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COVID-19 Q&A: Counting cases associated with Idaho schools

Q: The state has started posting a weekly summary of the number COVID-19 cases that are reported in each school. How are those numbers compiled?

A: Gathering case counts associated with schools is not an easy process. Information is gathered by state public health epidemiologists from local public health reports, media stories, and school reporting, and are limited to available information.

Disease tracking is based on a person’s usual place of legal residence. Local public health districts don’t know what school a child attends until they do the case investigation, and the parent agrees to provide that information. Public health officials will know some basic demographic information such as age and sex of the child, but they won’t know the school a child attends until a case investigation is conducted and the information is provided. If a parent isn’t able to be contacted or doesn’t provide the name of the school their child attends, then public health won’t know that information.

The weekly summary is not complete, but it is the best information we can provide at the state level at a certain point in time to give parents and others an idea for how COVID-19 is affecting their schools. We continue to work to improve this system and provide as much information as possible so that parents, school officials, teachers, and others can use it to make informed decisions as the pandemic continues.

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COVID Q&A: Schools

As children go back to school, parents are confused about some of the guidelines, especially about when they should keep a child home from school. When should a child be kept home?

The school setting has a large influence on your child’s health and well-being. The school environment provides educational instruction, supports social and emotional skills, safety, speech, mental health, nutrition, and opportunities for physical activity. If your child is participating in in-person classes, they can attend unless they are sick with symptoms of COVID-19 or other illnesses or have been exposed to a positive case of COVID-19.

It is important to help your child promote behaviors that reduce the spread of infections including social distancing, washing hands, and wearing cloth face coverings.

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COVID Q&A: Vaccine safety, different rates of testing positivity, cases in schools, and fall predictions

How do we know that the vaccine will be safe since it’s being fast-tracked through the clinical trials?

Idaho Public Health officials are watching this issue very closely and are committed to providing safe and effective vaccines for Idahoans. In particular, we are reassured that:

  1. These are companies like Pfizer, Johnson & Johnson, and Merck that are in the health field for the long haul—they don’t want to risk their reputation with the American public by issuing a poor or unsafe vaccine.
  2. The FDA has pledged to give COVID-19 vaccines a full review and not be pressured to act more quickly than might be safe.
  3. The National Academy of Medicine recently announced a committee that will create an overarching framework to help policymakers plan for equitable allocation of vaccines. The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices, made up of independent researchers, doctors, scientists, and public health workers, will review the data and make recommendations for the use of the vaccine.
  4. Lastly, manufacturers have committed to full safety and efficacy reviews. Read the pledge: https://www.pfizer.com/health/coronavirus/pledge
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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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