Submitted by Thurston County

Letter to the Community: September 1, 2020

Hello Thurston County! Labor Day weekend is coming up! While you are enjoying the long weekend and taking time to connect with family and loved ones, please remember to limit your gatherings to 10 people or less, meet outdoors where possible, keep at least 6 feet of distance between you and non-household members, and wear a face covering. These simple measures can help to slow the spread of COVID-19 in our community!

In July, we experienced a significant increase in our transmission rates and during our investigations, we found Fourth of July celebrations were a significant contributor to this rise. Continuing to be mindful about masking, distancing, and limiting outside household contacts is essential to bringing our transmission rates down and progressing to a safe return to public life. I sincerely hope we don’t see an increase in COVID-19 cases associated with gatherings over the Labor Day weekend.

I appreciate and have enjoyed the questions you have been submitting. This week, I have selected 3 more to answer.

Question 1: If I was diagnosed with COVID, how would contact tracking work in Thurston County? Do other counties in Washington do the same type of tracking?

Great question! Once a resident of Thurston County tests positive for COVID-19, the result is reported to Thurston County Public Health and Social Services (PHSS) and a COVID-19 Disease Investigation staff member begins a case investigation. The staff person will contact the individual who tested positive, inform them of their test result, and give them instructions to isolate for at least 10 days and remain fever-free for 24 hours without medications. The case investigator will also have everyone else in their household quarantine.

The case investigator will then conduct an interview to ask about high-risk exposure areas like travel, being in contact with someone who is sick, or attending events. Investigators will also ask the positive case who they spent more than 15 minutes with, at a distance of 6 feet or less during their infectious period, which is defined as 48 hours before symptoms start or 48 hours before a positive test for those who do not show symptoms. Each of those people would be considered a close contact.

Contact tracers call each identified close contact and instruct them to get tested for COVID-19 per Washington State Department of Health guidelines, even if they are asymptomatic. If they test negative, they are required to quarantine for 14 days. If they test positive, they must isolate for at least 10 days and remain fever-free for 24 hours, without medication, before they no longer need to isolate. All information obtained through case investigations and contact tracing remains confidential and the name of the individual is not shared with the contacts. If someone has tested positive, they have an obligation to notify their employer. PHSS will often ask for lists of individuals on shift at the same time as the person who tested positive to assist in contact tracing. This method of case investigation and contact tracing is similar across all counties in Washington State.

Question 2: How soon after exposure should I test? For example, if I step off a plane and immediately take a COVID-19 test, will it accurately show if I caught COVID-19 during that plane ride?

Thank you for bringing up this topic as it can be confusing. Let me first talk a little bit about the available tests.

  • Viral PCR test: These tests check for the genetic material of the virus. To perform this test a sample is taken from a patient’s nose, nasopharynx (end of the nasal passage), or throat. The lab then compares the genetic material on the swab with known genetic material from the SARS-CoV-2 virus and, if there is a match, the test result is positive. A person who tests positive for COVID-19 with a PCR test is a confirmed case.
  • Antigen test: These tests check for viral proteins. Although these tests have become more reliable over time, they are not as reliable as PCR tests and a positive antigen test is categorized as a probable case.
  • Saliva test: These are being developed, many of which use PCR to detect the virus.
  • Antibody test: These are blood tests and test for immune proteins that the body makes to fight off the virus. Antibody tests show if a person was exposed to the virus, but do not diagnose active infection or provide information about immunity status.

For Viral PCR and Antigen tests to work, a good specimen must be obtained and the patient being tested must be actively shedding the virus. The incubation period, or the period of time between when an individual gets infected and when they show symptoms, is between 2 and 14 days and viral shedding can take up to 5 days to occur after infection.

So, if you became infected while on a plane, you would most likely test negative at the end of the plane ride but would likely test positive 5 days later. This is why close contacts are asked to test for COVID-19 once they are identified and contacted. If close contacts test results are negative, they are instructed to quarantine for 14 days and retest if they develop symptoms.

Question 3: I’m wondering if we can know how COVID-19 is affecting teenagers and how they are recovering?

In Thurston County, as of August 30, 2020, there have been 72 cases in people between the ages of 12 and 19, 1 hospitalization, and 0 deaths. While hospitalization rates and death rates for teenagers are low both in Thurston County and nationwide, the CDC has reported teenagers who have died of COVID-19 mostly due to underlying health conditions. The CDC also reported people 18-34 years old who have had long-lasting symptoms, longer than 2-3 weeks after contracting the disease, despite not being sick enough to warrant hospitalization. Because COVID-19 is a new disease, we do not know the long-term impacts of infection. This is why we encourage people of all ages to observe physical distancing of at least 6 feet from non-household members, wear a mask, cover their cough, avoid social gatherings of greater than 10 people, and wash their hands frequently.

Thank you all so much for your great questions this week. I look forward to answering your public health questions next week. Please submit your questions to Stay safe this weekend!

Wishing you the best of health,

Dimyana Abdelmalek, MD, MPH

Thurston County Health Officer

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