Powder River Examiner -

By PR Public Health Nurse Darlynn Williams

There have been many changes in how we deal with COVID-19 recently.

The Association of State and Territorial Health Officials (ASTHO) and the Council of State and Territorial Epidemiologists (CSTE) have released a statement jointly supporting state, local, territorial, and tribal health departments in transitioning away from universal case investigation and contact tracing at this point in the COVID-19 pandemic. The rationale behind the transition is based on several scientific factors that reduce the utility and feasibility of universal case investigation and contact tracing for each COVID-19 case.

These factors include:

• The availability of safe and effective vaccines

• The large number of asymptomatic and mild cases resulting from changes in the virus

• Many infections are never identified by public health agencies because of the large number of asymptomatic and mild cases in people who do not get tested, as well as the increasing use of “over the counter” home tests, which may not be reported to public health agencies

• The shorter incubation period of the Omicron variant

• The highest risk of transmission to others occurring prior to symptom onset and during the first few days of symptomatic illness (or immediately after first testing positive for those who remain asymptomatic)

In the future, universal case investigation and contract tracing may become an appropriate strategy once again, if the clinical and epidemiologic profile of COVID-19 changes (e.g., new variants emerge which change the incubation period, severity of disease, etc.).

As of late January, Powder River Public Health will only use contact tracing in specific high-risk settings such as congregate care settings (nursing homes, group homes, correctional facilities) and for high-risk individuals (e.g., immunocompromised individuals).

The recommended transition away from universal case investigation and contact tracing for COVID-19 does not suggest that such tools have limited value in the setting of many priority infectious diseases. Indeed, case investigation and contact tracing by public health officials remains a vital, well-established method for the control of other communicable diseases, such as measles, tuberculosis, hepatitis A, HIV and other sexually transmitted diseases, like syphilis and gonorrhea. Contact tracing will continue to be used in investigations of the aforementioned diseases.

In late January the White House announced that Americans will be able to order a test online at COVIDtests.gov - Free at-home COVID-19 tests. Tests will be mailed directly to households, while supplies last, and will typically ship within 7-12 days of ordering. Powder River Public Health and Powder River Medical Clinic will continue to provide testing with rapid antigen and PCR tests. They also have free home tests available, while supplies last.

If you test positive with a home test you can call the Public Health Department to report or you can log on to hometest .mt.gov and fill out a short form. Reports should be made as soon as possible. Quick reporting allows the ability to provide information on recommended isolation and ensuring individuals seek medical attention in a timely manner. Upon request, the Public Health office will send letters of excuse to your employer/school only if the home test is confirmed by professional collection of rapid antigen and/or PCR test by a clinic/health care facility.

The CDC recently updated recommendations for isolation and quarantine.

If you test positive you need to stay home for 5 days. After 5 days, IF you have no symptoms, or your symptoms are resolving AND you have no fever for 24 hours, you can leave isolation. Continue to wear a mask around others for 5 additional days.

If you are a close contact to a COVID-19 case, the actions you take will depend on your COVID-19 vaccine status. If you are up to date with your COVID-19 vaccine, you should wear a mask around others for 10 days. You should also test on day 5, if possible, or if you develop symptoms.

If you are unvaccinated or have not completed the COVID-19 vaccination series, stay home for 5 days then wear a mask when around others for an additional 5 days. If you can’t quarantine you must wear a mask for 10 days. Again, test on day 5, if possible, and if you develop symptoms.

Remember to take care of yourself and your community.