A conversation with Lincoln County communicable disease supervisor
In recent months, people have been deluged with information about COVID-19 from multiple sources. Because researchers and the medical community continue to learn about the disease, information continues to evolve. For a clear, local snapshot of what is known about virus transmission today, Mollie Vance, RN, supervisor of Lincoln County Public Health’s communicable disease division, participated in the following Q & A.
What do we know about transmission timelines? For instance, how long after someone comes into contact with the virus does it take before they are positive for COVID?
Everybody is going to be different, but we know incubation is up to 14 days. On average, it takes 2-5 days but that just depends upon your body. You are contagious when you start to shed the virus yourself. When you are symptomatic, you are shedding a higher viral load. The higher you shed, the more contagious you are, because the virus is replicating faster. But even people with no symptoms, people who are asymptomatic, they are still shedding the virus.
How long is someone contagious?
Definitely 10 days, minimum. If you are symptomatic, it can be much longer. That is why we tell people, if you test positive, isolate for 10 days and if you have any symptoms, you must continue to stay home until those symptoms have been resolved for three days. You must be three days clear of symptoms without medicine. (Note: Since COVID-19 is a new virus, health officials continue to learn. As of July 23, new guidelines allow that a fever must be resolved for only 24 hours without medication.)
What does it mean to be asymptomatic? Why is it an important distinction?
Asymptomatic people don’t feel sick. But even though you don’t feel sick, you can still have COVID-19. Asymptomatic people can test positive and be shedding the virus and that is why we need anyone who tests positive to isolate. But because testing is based mostly off symptoms, many asymptomatic people may not be tested. That’s why we wear a mask, wash our hands, and social distance. Because even when they aren’t coughing, people still produce spittle when they talk, and we know this is a droplet transmission disease.
Health officials sometimes characterize cases as community acquired. Why is that an important distinction?
If someone can say they were in contact with somebody known to have COVID, we can use epidemiology and mitigate the situation with contract tracing. If we don’t know where it has come from, then it is harder to manage and that is why it is such a concern. Sometimes we can interview five people with COVID and link them to one common denominator, but it is just a link. It can’t be pinpointed exactly, which is why we say community acquired cases are of unknown origin.
Sometimes it is difficult to distinguish between another ailment, say an allergy, and COVID symptoms. What is your recommendation when that happens?
Pay attention to your body and pay attention to your symptoms and isolate yourself for three days. If it is not resolved in three days, it might be something to have checked. There have been quite a few people thinking they have allergies or a stomach issue that was a byproduct of something else, but they had COVID.
Wearing a face covering is a state and local rule, but some people still seem confused by how that action can help.
If you are talking, or coughing, or sneezing here and there, the virus doesn’t jump out of the droplets you exhale. The more we can contain those droplets in our own mask, it’s going to help decrease the spread.
Washing your hands and using hand sanitizer is also something you promote. Why?
If someone has COVID and they do not know it and they touch something in a store and the next customer touches the same thing and then scratches their nose, there is a chance of transmission. That is why stores are wiping down equipment with alcohol pads or bleach wipes. It is a lower likelihood of transmission, but it is still possible.
What do you recommend when it comes to using shared spaces, say for instance a shared bathroom in an office setting? How can a person protect themselves?
Wiping things down is important because you can get COVID through feces. As far as any droplets in the air, I would recommend keeping a fan on in the bathroom. But in a work environment, it is really important that people talk to each other. Talk about any symptoms or concerns.
What happens when someone in household tests positive?
It is different in different scenarios. If people are able to isolate, we have seen situations where others in the house don’t get COVID. People in tightknit groups with multiple people using a small space have more difficulty. If you live in a household with a positive person, it’s important to wipe down all high touch surface areas, wear your mask, and be isolated from that person. Case investigators and contract tracers will offer a lot of information and resources to people in those scenarios.
If you have questions about COVID-19, please call the Lincoln County Public Health call center at 541-265-0621 or email LincolnCoCallCenter@co.lincoln.or.us.