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Several things have changed since the WHO officially declared a global pandemic on March 11, 2020.  Here in Baton Rouge, after the stay-at-home order was declared, we were able to slowly reduce the number of new cases and hospitalizations, eventually leading to Phase 1 re-opening, and most recently entering Phase 2.  However, with the transition into Phase 2, we have started to see a rise in the number of cases. There are still many things that we are learning about the virus and we have certainly come a long way from what we knew at the very beginning of the pandemic.

Understandably, many want to get back to life as it was before COVID-19, but that may only be possible if we give attention to the current need to take appropriate precautions now. SARS-CoV-2, the virus that causes COVID-19, has not gone away and we must remain vigilant in our efforts to reduce the spread of the virus and protect those that are the most vulnerable in our community.

Since early June, with the transition into Phase 2, social distancing measures have been relaxed and many have started to resume normal activities. As a result, outbreaks have occurred at local bars and restaurants, with the demographic of new cases changing dramatically from what it was earlier in the pandemic. Specifically, a shift toward younger age groups (notably those in their 20’s and 30’s) in the age distribution of COVID-19 patients has occurred. Part of this may be due to increased social interaction among younger age groups who are at lower risk for severe disease and death. While true in many cases, younger individuals can still develop severe disease and die due to COVID-19.  Still more concerning is that any increase in cases in the community increases transmission risk, including those individuals that are at higher risk. These young people can transmit the virus to their parents or grandparents, or even to children.  Many in this age group work as counselors in summer camps, as babysitters, or elsewhere where they may expose young children as well.  The concern is that this age group may more easily spread the virus to various populations.

 

What should we continue to do to decrease community spread?

  • Wear a mask.
    • A common misconception is that you wear a mask to protect yourself only.
    • By wearing a mask, you are actually protecting all those around you.
    • If you happen to be infected with the virus, wearing a mask contains the virus and prevents you from exposing others to it.
    • If everyone wore a mask when going out in public, we would minimize exposure to others in the community and potentially mitigate continued spread.
    • Wear your mask correctly; it should cover your nose and mouth and fit securely under your chin.
  • Continue to social distance.
    • Limit close contact with others outside your household in indoor and outdoor spaces.
    • In order to minimize continued exposures and potential spread, it is recommended that you avoid large gatherings.
    • If you are attending a gathering, it is recommended that you maintain at least 6 feet from each other and wear a mask.
  • Follow everyday health habits.
    • Avoid contact with people who are sick
    • Wash your hands often, with soap and water, for at least 20 seconds
    • Use hand sanitizer if soap and water are not available
    • Avoid touching your face
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There is a good chance that by now many of us have been exposed by someone that has tested positive for COVID-19 or some of us have even been infected by the virus. There are several updates to the recommendations regarding testing after exposure or returning to work after testing positive.

Here are some of the most commonly asked questions:

1. I have symptoms of COVID and need to get tested
  • Contact your primary care doctor to see about when and where you should be tested
  • If you do not have a rapid test performed, self-quarantine until the results of your test are available and presume a positive test until you get your results.
  • Stay at home.
  • Try to isolate from other household members as much as possible.
  • Perform good, frequent hand washing
  • Perform frequent cleaning of shared household surfaces.
2. I have tested positive, when can I return to work or school?

The CDC is recommending following a “symptom-based” approach:

If you were tested due to symptoms, once the following are met, you may return to work:

    • If you are Fever free for 72 hours without the use of fever-reducing medications
    • If at least 10 days have passed since the onset of symptoms

If tested due to exposure but no symptoms:

    • At least 10 days have passed from the date of the positive test
3. My employer says I need to have a negative test before I can return to work:

The CDC is no longer recommending a “test-based” approach for several reasons: below are some of the concerns (sorry for the super scientific explanation).

  • A virus capable of replicating has not been successfully cultured more than 9 days after symptoms have developed
  • Many people will continue to test positive (for RNA) for weeks (some as many as 6-8 weeks) after the initial positive test.
    • When looking at people that continue to have RNA detected, the ability to culture virus that is able of replicating cannot be found 3 or more days after recovery
  • So to simplify, although some patients will continue to test positive (RNA testing by PCR), if their initial symptoms have resolved, evidence suggests that there is a low chance that the virus is alive and able to infect others beyond 10 days.
4. I have been exposed to someone that has tested positive for COVID, what do I do?

Was it  high risk exposure or low risk exposure?

  • High-risk exposure is direct contact, >15 minutes, at <6 feet with neither person masked
  • Are you symptomatic? If yes, contact your PCP and get tested
            • If a positive result, help with contact tracing and inform those that you may have exposed directly.
            • Self-quarantine until fever-free for at least 72 hours and at least 10 days from the onset of symptoms.
            • If a negative result, you must still self-quarantine for 14 days.
  • If no symptoms, DO NOT get tested!
            • Self-quarantine for 14 days and monitor closely for symptoms.
            • Perform twice daily temperature checks and monitor for signs and symptoms of infection.
            • Why should I not be tested? If exposed but asymptomatic, a negative test does not exclude the possibility of infection and may give a false sense of security. Rather than having those exposed go back into the community and potentially expose others, it is recommended that you self quarantine for 14 days and monitor for symptoms.
5. Low-risk exposure is contact but both parties were masked

If no symptoms:

  • Simply self-monitor for 14 days, no need for self-quarantine.
  • Monitor twice daily temperatures, development of symptoms.
  • Seek care if symptoms develop.

If symptoms:

  • Seek care and get tested.