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Public Health Essentials

A place to highlight the work of the Snohomish Health District as well as share health-related information and tips. Have an idea or question? Drop us a line at SHDInfo@snohd.org.

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Feb 29

Coronavirus update: Addressing questions about a presumptive positive case in an adolescent

Posted on February 29, 2020 at 5:51 PM by Kari Bray

On February 28, the Snohomish Health District announced a new presumptive positive case of the novel coronavirus (COVID-19) in Snohomish County. The individual is an adolescent who is a student at Jackson High School. 

The Health District has been coordinating closely with Everett Public Schools on this case. The school district also announced that Jackson High School will be closed over the weekend and on Monday to allow for a thorough cleaning and disinfecting. This is out of an abundance of caution on the part of the school district. The student was out of school most of the week and was on campus briefly on the morning of February 28 before returning home. 

The Health District has interviewed the student and is getting in touch with anyone who was in close contact. Those people will be asked to stay home and away from others while they monitor for any symptoms, and Health District staff are checking in with them.

This is the second known case of coronavirus in Snohomish County. The first was announced on January 21 and that individual has since fully recovered. There was also a lot of news earlier this week about a person under investigation connected to Bothell High School. Those test results came back negative on February 28. 

While we understand that this recent news is alarming, as is the increasing number of COVID-19 cases internationally, we want to encourage people to remain calm, prepared, and informed.
 

The health and safety of the people in Snohomish County remains our top priority. We need people to help prevent the spread of illness and to support the response to this outbreak by staying informed and sharing reliable information.

Below are answers to common questions we have received about this case:

Presumptive positive?
Washington state recently began testing for COVID-19 at the Public Health Laboratories in Shoreline. Previously, tests were routed through the CDC in Atlanta. Having in-state testing improves our capacity and response times. At this time, positive tests through the state lab are considered “presumptive positive.” This means they are treated just as a confirmed case but specimens are also sent to the CDC lab for confirmation.

Why was the student at school if they were sick and knew they were being tested?
Here’s the interesting thing: the family didn’t know their son was being tested for COVID-19. He became ill on Monday, with fever, body aches, and a headache. Like most people, they assumed it was the flu. They did all the right things. They kept him home from school. His symptoms weren’t getting better, so they visited a clinic to be tested for the flu. The rapid tests came back negative, and since the symptoms were relatively mild, they returned home. 

On Friday morning, he was feeling better and had been fever-free for 48 hours, so he went to school. He was on campus for approximately 5 minutes. That’s when he received a call to come home immediately. 

However, during that time, the original sample had also been shared with the Seattle Flu Study as part of its ongoing research partnership with Seattle Children’s. The research sample was tested for a range of infectious pathogens, including recently approved protocols to test for COVID19. The Seattle Flu Study immediately notified Seattle Children’s and public health officials who were able to communicate with the family. As we mentioned, the family immediately called their son and had him return home. An additional specimen was run at the State Public Health Lab in Shoreline, and results again came back with a presumptive positive.

What about community transmission?
While most previous cases in the U.S. have been linked to travel, this new case does not appear to have travel history that would explain exposure. The Snohomish Health District team is continuing to work on the details of this case, including identifying the potential exposure. However, it is realistic to expect that we now are seeing this illness within the community, not just through travel. This is the case in multiple locations elsewhere in the country, as well.
 

What about the coronavirus death in Washington?
Public Health – Seattle & King County and the Washington State Department of Health on February 29 announced the first death due to the novel coronavirus in a resident of King County. Additional details are available from Public Health – Seattle & King County   

What about the Bothell High School closure?
The individual associated with the closure of Bothell High School, who was under investigation for coronavirus (COVID-19) in Snohomish County, has tested negative. This individual was a close contact of someone from Bothell High School and the school closed out of an abundance of caution and at its own discretion.

Should I go in for testing if I think I may have been exposed?
People who are not ill should not go to a clinic, hospital or the Health District seeking coronavirus testing. It is creating a strain for our healthcare partners, and you will not be seen.
 

If you are ill, and you have been to one of the impacted travel areas or have had close contact with a known coronavirus case, call ahead to your healthcare provider to discuss further steps. If testing is needed, the providers will coordinate directly with the Health District.

Those who are close contacts of the presumptive positive case have been contacted by public health staff for further instruction. If you have not been contacted by the Health District, please assume that you are not impacted and that your risk of acquiring COVID-19 is not higher than the general population. 

People who are ill only with mild cold symptoms also should NOT immediately go to a clinic, hospital or the Health District seeking coronavirus testing. Doing so displaces other patients who truly need urgent care and increases the risk of spread of respiratory infections in health care settings. Furthermore, there is little personal health value in pursuing COVID-19 testing of patients who are not severely ill or part of a public health investigation.  Testing for COVID-19 remains finite in capacity and is triaged toward patients who are severely ill, are health care providers, or who are part of a public health investigation.  

What are you doing to stop COVID-19?
While COVID-19 is a new illness, it is also a respiratory illness. Just like influenza and other respiratory illnesses, neither public health nor healthcare providers can stop them from happening. What we can do is work to reduce the number of illnesses, as well as working to ensure EMS and providers are ready to treat patients if the illness becomes severe. 

As the situation changes, additional actions may be taken, such as school closures or event cancellations. These decisions are made in coordination between public health officials and the affected organization(s). Public health officials are adjusting response efforts, and we are encouraging people to be prepared and take illness prevention steps.

We also have tried-and-true methods of reducing the spread of respiratory illnesses.

You mean the same illness prevention steps you keep repeating?
Yes, those steps. And we’re going to reiterate them again. We cannot emphasize this enough: Standard methods of preventing respiratory illness are key in this response.

That doesn’t mean we aren’t considering additional steps. We are, and the Health District is in communication with our partners in the community to plan for and, if needed, implement steps like event cancellations or school closures. However, those additional steps will not be nearly as effective if people are not practicing illness prevention.
  • Wash hands often with warm water and soap for at least 20 seconds. Hand sanitizer is good in a pinch, but doesn’t replace handwashing with soap and water.
  • Keep hands away from mouth, nose or eyes to avoid transferring germs.
  • Clean and disinfect frequently used surfaces like counters, light switches, doorknobs, and remotes.
  • Cover coughs and sneezes with a tissue, then throw the tissue away and wash your hands.
  • If you feel sick, stay home from work, school or other activities.
  • Avoid close contact with others.
  • Have plans in place in case school closures, workplace closures, or other social distancing measures occur. (See next question for preparedness tips.)
Please note that masks are not recommended as a prevention strategy for people who are well in the general public. Medical providers have specific guidance on masks and personal protective equipment and should follow that guidance.

How should people prepare?
Take many of the same steps to prepare for an outbreak as you would to prepare for other emergencies.
  • Make an emergency plan of action with your household members, relatives, and friends. 
  • Know your workplace’s sick leave policies and whether you can work remotely. We are encouraging employers who can allow telecommuting to do so or make plans to do so.
  • Decide who will pick up and watch children if schools or child cares are closed, or if children get sick. Make sure schools and child cares have updated contact information and emergency contacts for your children.
  • Have emergency supplies like nonperishable food, water, personal hygiene supplies, and medicine or other medical supplies in an accessible emergency kit – enough to last your household for at least 14 days. Include a list of emergency contacts as well as a list of medical conditions and medications for household members.
  • If the disease spreads in your community, public events, school, or other gatherings may be canceled. Please respect these decisions. This is known as social distancing, which helps reduce the spread of illness.
  • Set up a separate room in the household for someone who is sick and clean the room regularly. Clean, disposable facemasks may be useful for the individual who is sick, not for the well members of the household.
  • Know your neighbors or friends in the area and be ready to support each other during an emergency. Check in on those who live alone or have underlying health conditions and may need extra support. If you live alone, talk to your friends and family members about who would be available to check in on you if you become sick.
Through all of this, remember to stay calm, prepared and informed. Check reliable sources for updates and follow the advice of public health professionals.

Where can I find more information?
Snohomish Health District: www.snohd.org/ncov2019
Washington State Department of Health: www.doh.wa.gov/coronavirus
Centers for Disease Control and Prevention: www.cdc.gov/coronavirus
World Health Organization: www.who.int/emergencies/diseases/novel-coronavirus-2019 
Statewide hot line: 1-800-525-0127, then press #

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