COVID-19: A Q&A

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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DHW Director Dave Jeppesen: Please honor dads and granddads safely this weekend

The pandemic is not over. As states began to reopen, we are seeing increasing activity in Utah and Oregon, and in Idaho, we have seen the number of cases in our state increase over the past few days.

Because there is no vaccine or proven therapeutic interventions at this time, we have to take other precautions to slow the spread of COVID-19 in our state. It is up to each of us to protect our friends, families, neighbors, and community. You have heard these recommendations before, but they are worth repeating because they are more important than ever:

  • Keep at least six feet between you and others in public
  • Wear face coverings in public places (the Centers for Disease Control and Prevention advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus, and do not know it, from transmitting it to others)
  • Stay home if you are sick
  • Wash your hands often
  • Cover coughs and sneezes
  • Disinfect surfaces and objects regularly

Nationally, approximately 41 percent of cases are found in adults between the ages of 18 and 44. Several states are seeing a concerning recent trend with increasing cases among those under 40.

 In our own state, 49 percent of known cases are in Idahoans under the age of 40. Younger adults often feel invincible or have heard that having COVID-19 may not be a serious condition for them. It’s true that approximately 80 percent of cases are mild, but there are severe cases in all age ranges.

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Idaho needs your help: Even though we have entered Stage 4, the pandemic isn’t over

Idaho entered the fourth stage of its plan to reopen on Saturday. All Idaho businesses can open their doors and resume serving their customers, with recommended precautions in place. However, we are not out of the woods yet.

It is tempting to act as if life is back to normal, back to before COVID-19 was spreading in Idaho’s communities. Everyone is tired of staying home and wearing face coverings when we venture out in public, myself included.  

But we can’t go back to normal yet because COVID-19 is still here. It’s still circulating and making people sick.

As evidence, we have recent reports of more than 30 people who visited bars in Downtown Boise who later tested positive for COVID-19 or are considered probable cases because they have the symptoms and were in close contact with the people who tested positive.

We have reports of many people testing positive for COVID-19 after attending family reunions, family and community barbeques, graduation and birthday parties, and church gatherings. We even have a few reports of deaths for people who attended these kinds of gatherings.

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Idaho public health officials work closely with long-term care facilities to help slow the spread of COVID-19

Like other states around the country, Idaho has unfortunately had cases and deaths related to COVID-19 in long-term care facilities since the start of the pandemic in Idaho in mid-March.

The virus that causes COVID-19 is particularly dangerous for the vulnerable residents of those facilities, which include skilled nursing homes, assisted living and memory care, and intermediate care facilities. Idaho has about 400 of those facilities.

Public health officials at the state and local public health districts continue to work closely with long-term care facilities throughout the state to make sure they have access to testing, personal protective equipment (PPE), and the latest guidance for how to slow or stop transmission of COVID-19 for these highly vulnerable people. Much of this guidance has been posted at https://coronavirus.idaho.gov/ltc/.

But it has been challenging. The virus that causes COVID-19 is new, and the world is still learning how to treat and contain it. It is such a contagious virus that it can spread easily among vulnerable residents in congregate living facilities. A confirmed COVID-positive resident in a facility is not necessarily a reflection of the quality of care or the performance of that facility.

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DHW Director Dave Jeppesen: Staying Safe During Stage 3 and Contact Tracing

Thanks to all Idahoans, we are now halfway through Stage 3. Rebound.idaho.gov has numerous protocols available to help businesses reopen safely, including guidance for safe campgrounds, outfitting services, agricultural workers, indoor movie theatres, and much more.

Although it has been said many times, it’s important to remind everyone that the continued reopening of Idaho depends on you. Please follow the recommended precautions:

  • Keep at least six feet between you and others in public
  • Wear face coverings in public places (the Centers for Disease Control and Prevention advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus, and do not know it, from transmitting it to others)
  • Stay home if you are sick
  • Wash your hands often
  • Cover coughs and sneezes
  • Disinfect surfaces and objects regularly

With your support and commitment, we will be able to continue the reopening of Idaho.

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