Finally, we are seeing COVID-19 cases fall after the omicron surge, however our COVID-19 transmission rates still remain high. I wanted to share with you some of the recent guidance changes and the …
Finally, we are seeing COVID-19 cases fall after the omicron surge, however our COVID-19 transmission rates still remain high. I wanted to share with you some of the recent guidance changes and the reasons behind the updates.
Isolation Guidance: Isolation is for people who are experiencing COVID-19 symptoms or people who have tested positive for COVID-19. The isolation guidance has shortened to five days for at-home isolation for the general public provided they are not immunosuppressed, have not had severe disease, their symptoms greatly improve and fever has subsided for at least 24 hours without the use of fever reducing medications. Isolation is followed by five days of strict masking around others. This change in guidance reflects the science showing the majority of people who have mild disease are not infectious beyond day five.
Because a minority of people may still be infectious after day five even though they had symptomatic improvement, it is essential to continue to wear a well-fitted mask for an additional five days when around other people to prevent further spread. Individuals who have had severe disease and people who are moderate to severe immunocompromised have a greater risk of being infectious beyond 10 days and are required to isolate for at least 20 days. If you are wondering if this applies to you, please ask your primary care provider. More information can be found online at https://www.thurstoncountywa.gov/phss/phssdocuments/QI%20Guidance%20FINAL.pdf.
Quarantine Guidance: The quarantine guidance has been shortened as well for the general public. Quarantine is when a person who is exposed stays home because they may become infectious. The incubation period or the period between when a person is exposed and when they have symptoms is shorter. The Centers for Disease Control and Prevention reports that some studies have shown the incubation period for the omicron variant may be as short as two to four days. The five day at home quarantine includes this high-risk period.
Quarantine is followed by five days of strict masking because there is still a chance the incubation period may be longer in some people and wearing a well-fitted mask prevents further spread. Individuals who are up to date on their vaccine (have had all doses of the
COVID-19 vaccine that are available to them including booster doses) and remain asymptomatic are not required to quarantine at home but do have to wear a well-fitted mask when around others for 10 days. Testing for COVID-19 whether with antigen or PCR testing is recommended on or after day five from exposure. Everyone with symptoms of COVID-19 should stay home and get tested for COVID-19. More information is available online at https://www.thurstoncountywa.gov/phss/phssdocuments/QI%20Guidance%20FINAL.pdf.
Isolation and Quarantine Guidance in High-Risk Settings: In congregate settings the risk of a person being infectious beyond the five days and infecting other people is higher, so a 10 day isolation and quarantine are required in this setting.
There are some settings where there is sector specific guidance including guidance for health care workers, schools, daycares and others. Thurston County sector specific quarantine and isolation guidance can be found online at https://www.thurstoncountywa.gov/phss/phssdocuments/QI%20Guidance%20FINAL.pdf.
Case Investigation: The omicron surge resulted in a large number of cases to be investigated. When the number of cases exceeds our capacity to investigate all of them in a timely fashion, cases are prioritized based on risk of continued transmission and the risk of severe disease. We prioritize outbreak investigations, case investigations in congregate, high-risk settings like long-term care facilities, shelters, etc. as well as targeted case investigations among those at highest risk of more severe illness (older adults, homebound, etc.). We also prioritize schools and daycares as well. We attempt to make contact with everyone who tests positive via a phone call or through a letter providing them with instructions for isolation and information for their close contacts.
As Thurston County and Washington state recover from the omicron surge and as our hospital capacity becomes more manageable, we anticipate additional changes that relax mitigation measures. In the meantime, please continue to mask up to reduce disease transmission in Thurston County.
Dimyana Abdelmalek, MD, MPH, is the health officer for Thurston County.
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