LCDHD COVID-19 Response: Why We Do What We Do

Why do we release the information that we release?

1. 1. Why do we keep repeating the message to: social distance, avoid crowds, cover your cough, stay home if you’re sick, wash your hands frequently and avoid touching your face?
      • Since COVID-19 is wide-spread and community-spread (you should assume people you meet have it), this is the absolute best message possible to keep as many people as safe as possible.
   2. Why don’t we release the names positive COVID-19 cases?
      • Patient information is protected by HIPAA to preserve individual health privacy.
   3. Why don’t we release the names of businesses where confirmed cases work?
      • We do reach out to every close contact of all confirmed cases to let them know about their increased risk and to provide guidance.
      • We do reach out to businesses who have had an employee who may have worked while contagious to provide instructions about sanitation and how to better assure staff and public safety.
      • Unless it is essential for the public’s protection, we do not otherwise release publicly the names of said businesses. Why?
        • Doing so may convey a false assumption the business did something wrong.
        • Doing so may result in the public having a false sense of security that if they avoid said businesses, they will be safe.
          • Since COVID-19 is wide-spread and community-spread it is far better if the public simply assumes others have COVID-19 and; therefore, take all appropriate social distancing steps.
        • Doing so might “push” more people to businesses that haven’t had a staff who has tested positive for COVID-19; thus, resulting in the unnecessary congregation at these “other” businesses.
        • Doing so may disrupt essential services such as grocery, gas, medical, pharmaceutical.

Why is the “Social Distancing” message the best information?

1. 1. Since COVID-19 is a community-spread, wide-spread pandemic, containment is not the strategy. Instead, mitigation (slowing and lessening the impact of COVID-19) is the strategy.

If we can’t contain COVID-19, why bother to complete case and contact investigations?

1. 1. Because isolating known cases and quarantining high-risk close contacts supports the mitigation strategy.

How does our internal COVID-19 Process Work?

1. 1. 1. Lab notifies provider > provider notifies patient & health department > health department conducts case and contact investigations > then the health department released to the public positive case counts.
         • Public notification happens after contact investigations so those who are high-risk exposures can receive information and medical advice from trained providers instead of the media/social media.
      2. Why do we not go public immediately when a case is confirmed?
         • We must first fully assess and understand the scope of the situation.
         • As a matter of basic human decency, we must allow time for health department staff to reach out to those who have been closely exposed to the disease so that they are receiving the information first from a qualified provider who can calm them and give them good medical advice.
      3. Why would we wait until the following day to release publicly exposures within a nursing home or other long-term care facility?
         • To provide accurate information and to allow time for critical response actions to occur:
           • in a complicated scenario such as this, it takes time to fully assess the situation,
           • it takes time to notify the individuals and families of those impacted about the situation and to provide guidance,
           • and, it takes time to determine the: 1) immediate, 2) 24-hour, and 3) the post-24-hour plans and to mobilize the appropriate responses.
         • In these situations, it is important that the responders be actively engaged in the response itself, instead of taking critical time out of the response activities to respond to public inquiries.

Why do we not immediately report COVID-19 related deaths?

1. 1. As a matter of basic human decency, we try to provide at least a few hours for family members to be contacted and to begin the grieving process.

Why would we suggest that health care providers wear surgical instead of N-95 masks?

1. 1. Ideally, N-95 masks would be in abundant supply and routinely utilized by healthcare personnel when treating COVID-19 patients.
   2. Healthcare personnel should implement all conservation strategies for their supply of N-95 masks (see: https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Frespirator-supply-strategies.html).
   3. In a world where the availability of N-95 respirator masks are in extremely limited supply and when N-95 mask inventory is running critically low, more common medical masks are encouraged for most non-high-risk COVID-19 services.