How is the DPH handling COVID-19 contact tracing?

Health, News
DPH

BLAIRSVILLE, Ga – All of North Georgia now has at least one Georgia Department of Public Health (DPH) confirmed COVID-19 case. DPH is also responsible for notifying individuals who encountered COVID-19 patients so they can isolate or receive testing.

After a lab relays a positive test to DPH, “local epidemiologist or public health nurse will start a contact investigation by calling the person who tested positive for the disease,” explained Public Health District Two MPH, Dave Palmer. District Two included Union, Towns, Rabun, White, Lumpkin, Dawson, Habersham, Stephens, Hall, Hart, Banks, Franklin, and Forsyth.

DPH Districts throughout Georgia.

If an individual can’t answer or is a minor, then family members can answer the questions. The line of questioning includes how a person could have been exposed to the virus as well as who else might have been unknowingly subjected to COVID-19.

Currently, the only people being notified are those who had immediate and prolonged contact with a confirmed COVID-19 case. In other words, they came within six feet or less and had more than 10 minutes of interaction. Symptomatic individuals will be directed to isolate, and asymptomatic people will be asked to quarantine. As scientists and epidemiologists, learn more about the virus, these recommendations could change.

Fetch Your News (FYN) asked about tourists who visited North Georgia, and then test positive once returning home.

Palmer stated that DPH relies on information provided by patients about where they had been recently, and he reiterated that only individuals with prolonged exposure would be contacted by DPH epidemiologists.

Additionally, he said, “There should not be any tourism per the governor’s shelter in place order. There should be no public gatherings. People out in public should only be there for essential reasons, food, banking, etc. and should be practicing social distancing.”

DPH Administrative Order on Public Health Control Measures, issued on March 23, instructs:

“Each isolated person shall avoid unnecessary physical contact with any and all persons and shall comply fully with the Isolation Protocol attached to this Order, which may be updated from time to time based on guidance from the Centers from Disease Control and Prevention.”

See entire order here: administrative_order_of_commissioner_i_q_amended_3.23.20_003-01 (1) (2)

The Isolation Protocol, last updated on April 1, details best practices for positive individuals who treat themselves in the home. In short, these patients should do their best to separate from all inhabitants of the house, including pets, ensure surfaces remain clean, and don’t share commonly used household items.

According to DPH, isolation can end once:

  • The patient hasn’t had a fever for at least 72 hours (that is, three full days of no fever without the use of a fever-reducing medicine); AND
  • Other symptoms, such as cough and shortness of breath, have improved; AND
  • At least 7 days have passed since symptoms first appeared.

If placed under home isolation due to a laboratory-confirmed positive test result but have experienced no symptoms of COVID-19, patients may discontinue home isolation when at least 7 days have passed since the date of the first positive diagnostic test.

See entire isolation protocol here: covid-19_isolation_protocol_.revised_4.1.20_exhibit_to_ao (1)

Quarantined individuals or those identified as most likely to result in infection must remain in their homes for 14 days since last exposure to COVID-19. According to the DPH Administrative Order on Public Health Control Measures:

“During the period of quarantine, the quarantined person shall take his or her temperature twice per day and monitor any symptoms of respiratory illness. If at any time the quarantined person’s temperature is above 100.4 degrees Fahrenheit, or if the quarantined person experiences cough or shortness of breath, the quarantined person shall be considered a person with suspected COVID-19 and shall follow the requirements for isolation.”

FYN also asked if DPH would issue press releases or notify the public in some manner if a patient admitted to attending a public event. Palmer stated, “Because the virus is spreading, we are not issuing press releases about cases – they are reflected on the GDPH website.” He also added that no one should be attending public gatherings under the shelter in place order.

Georgia DPH adjusts COVID-19 models to include asymptomatic transmission

News, Police & Government, State & National
asymptomatic

BLAIRSVILLE, Ga – As of April 1, Georgia had 4,748 cases and 20,328 completed COVID-19 tests, but Georgia Department of Public Health (DPH) has only tested symptomatic and high-risk patients. As a result, some cases have gone undiagnosed across Georgia.

Currently, DPH is following CDC guidelines, which still states online that not everyone needs to be tested for COVID-19. Most people who contract the virus will recover and can care for themselves at home. CDC gave healthcare workers four priority categories to help decide who receives tests.

Asymptomatic individuals were ranked last, and those exhibiting mild symptoms or subjected to potential community spread should only be tested if resources are available.

White County Public Safety Director David Murphy went on record about the issue.

“Some people take care of themselves at home and never go to a doctor, especially those who have minor symptoms,” he explained. Murphy added that White County first responders have encountered a dozen or more patients with coronavirus symptoms in the last two weeks.

DPH guidance for healthcare facilities when it comes to testing lower priority potential cases is as follows:

Patients with mild illness who do not require medical care or who are not a DIRECT contact of a confirmed COVID-19 case (meaning the person has NOT been within 6 feet of a confirmed case for greater than 10 minutes, will not meet criteria to be tested at GPHL but can be tested at commercial labs—see below:

These patients should self-isolate at home until symptoms resolve. If respiratory symptoms worsen, they may need to be re-evaluated. Guidance for safe home care can be found at https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-homecare.html.

If you want to test these patients for COVID-19, commercial laboratory testing is the best option. Commercial laboratories are expected to conduct a substantial number of COVID-19 tests going forward. Currently, the primary source of testing is LabCorp, but we expect other laboratories will be testing in the near future as well, including Quest and ARUP. Neither LabCorp nor Quest will collect specimens at their facilities. Providers should contact LabCorp or Quest regarding supplies needed for testing.

DPH Commissioner Kathleen Toomey addressed that asymptomatic individuals in Georgia aren’t being tested but could be transmitting the virus to numerous Georgians. The state and DPH now believe the time is now appropriate to take “very aggressive measures.”

“We have not been testing everybody. We have only been testing those who have symptoms and those who are the most ill. And now, we recognize a game-changer, in how our strategy to fight COVID has unfolded. We realize now that individuals may be spreading the virus and not even realize they have an infection. As many as 1 in 4 people with coronavirus don’t realize they have the infection because they have no symptoms whatsoever,” explained Toomey.

“Finding out that this virus is now transmitting before they see signs,” remarked Gov. Brian Kemp. “Those individuals could have been infecting people before they ever felt bad.”

Kemp is expected to sign a shelter in place order on Thursday, April 2 to prevent people from ignoring self-quarantine recommendations. The details on the order are yet to be released.

Toomey further voiced that they knew asymptomatic community spread was possible due to the cruise ship cases. As of March 4, the CDC website also stated that asymptomatic spread is possible, but not as common as among individuals who are visibly sick.

Until the past 24-hours, all the DPH models relied on data solely from patients with symptoms.

“I think it’s a combination of recognizing not only that there are probably a large number of people out there who are infected who are asymptomatic, who never would have been recognized under our old models, but also seeing the community transmission that we’re seeing and now is the time to stop that transmission before the hospitals are overrun,” said Toomey.

How can Georgians prevent exposure/slow the spread?

Follow the CDC guidelines:

  • Wash hands for at least 20 seconds – wash often
  • Regularly clean and disinfect surfaces
  • Avoid social contact and stay home
  • Social distance if in public – stay six feet apart from each other
  • Avoid touching the face – mouth, nose, eyes
  • If sick, stay home
  • Cover coughs and sneezes with a tissue and throw it away
  • Wear a facemask if sick

By following these guidelines and Kemp’s shelter-in-place order, Georgian’s should be able to flatten the curve and hopefully protect themselves and loved ones.

Posted by Governor Brian Kemp on Wednesday, April 1, 2020

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