Don’t get COVID-complacent, health experts urge | Premier


Don’t get COVID-complacent, health experts urge | Premier










COVID cases, hospitalizations and deaths in El Paso County have been decreasing since July. That’s encouraging news, health officials say, but it doesn’t mean we should get complacent.

“It’s reasonable to assume we’re going to have an increase in infections in the fall,” said Dr. Paul Mayer, co-medical director at El Paso County Public Health. “That’s been the pattern, and I think it’s reasonable to assume that will happen again.”

It’s also important to remember that the virus will continue to mutate.

“It is fairly likely that we’re going to see some new variants emerge over time,” Mayer said, adding that the best defense to avoid hospitalization and keep people from dying is to be up to date with vaccines and boosters.

Medical research is showing why it’s important not to get complacent, he said. Recent MRI studies have shown brain abnormalities and shrinkage after COVID, and investigators are looking at a possible link between COVID and dementia.

People who get repeat infections are at greater risk for complications, Mayer said.

“If you’ve had COVID more than once, your risk for stroke, heart attack, diabetes, cognitive impairment and kidney disease goes up each time you get it,” he said.

While the fall respiratory season, which also includes influenza, has in the past seen case numbers climb, “I also think there are some strengths this year,” said Dr. DeAnn Ryberg, deputy director of El Paso County Public Health. 

“The general community level of COVID-19 infection is low, and metrics in the community are trending down, which we haven’t been able to say every year,” Ryberg said. “There are also widespread resources available.”

Those resources include community-based testing, which remains available at The Citadel mall; vaccines for all school-age children; and treatments that have proven safe and effective.

“As we are talking about respiratory season and potential fall illness, this is the opportunity to think about what you can do to prevent the spread, whether it’s COVID or flu,” Ryberg said. “We will be encouraging people to get their flu vaccines as well.”

Businesses should continue to be vigilant and can help employees to know the signs and symptoms of COVID and what resources they can access if they are exposed or become ill.

NEW GUIDELINES

More than 13,700 Coloradans have died of COVID-19, but statewide, cases are trending down after hitting a peak in June, State Epidemiologist Dr. Rachel Herlihy said during an Aug. 18 briefing.

Positivity data — the proportion of tests that come back positive — also are declining and currently are down to 7.6 percent, she said.

The Omicron BA.5 variant is dominant in the state and nation.

“As these variants emerge, they tend to be more easily spread from person to person,” Herlihy said. “We also see a greater degree of immune escape, meaning that [in] individuals who have been previous infected or vaccinated, their immune system doesn’t recognize these new viruses quite as well.”

Gov. Jared Polis issued an executive order Aug. 18 extending the state’s COVID disaster emergency declaration.

“Our healthcare professionals continue to work tirelessly to ensure that COVID-19 patients are treated with the best medical care we can offer,” Polis wrote in the order.

The state has made progress in containing and treating the virus and distributing vaccines — more than 79 percent of Coloradans have received at least one dose, Polis said.

But the pandemic continues, and the new order will allow the state to maintain community recovery activities, facilitate vaccine distribution, improve economic recovery and retain access to federal recovery funding, he said.

The order does not impose any new restrictions but ensures the state can respond to changes due to variants and stressors on the health care system.

The Centers for Disease Control and Prevention have revised guidelines for COVID and moved toward “more of a traditional model of managing infectious disease,” Ryberg said.

“One of the most significant changes that we have in place is a shortened isolation period,” she said. “We are now at five days of isolation being the recommendation for individuals who have COVID, followed by five days in which they are encouraged to mask when in public and in contact with others.”

The five-day isolation count begins at the onset of symptoms or a positive COVID test, she said. After that, if symptoms are not improving and a patient continues to have a fever, “we would certainly recommend extending isolation until symptoms have improved and somebody is fever-free before they go out in public and start interacting with other people.”

Another significant change, Ryberg said, is that quarantine is no longer recommended after routine exposure. 

“We recommend that you wear a mask for 10 days after exposure,” she said, “and five days after exposure you would test yourself and see if you’re positive.”

There are some exceptions, however.

“We’re looking at a more targeted deployment of quarantine” — for example, to protect high-risk individuals, she said. “If you’re working around people who are immunocompromised, or you have somebody in your house who’s severely immunocompromised, that’s very different.”

If someone in your household tests positive for COVID, he or she should be considered contagious for 10 days, Mayer said. That means continuing

to wear a high-quality mask and to test for five days after that person is symptom-free.

At-home rapid tests are available for pickup at several sites in the community, which are located on a map at covid19.colorado.gov/testing. Pharmacies also identified on the map have low- or no-cost testing options. Free at-home tests also can be ordered at covid.gov/tests.

The at-home rapid tests are a bit less sensitive for new variants than the lab tests available at the community testing site and some pharmacies, but they are considered predictive, Mayer said. 

“If you get a negative at-home test and you have symptoms, you could go get a PCR [lab] test” at the community testing site or a pharmacy, he said. That’s important for people who work in a high-risk environment such as an assisted living center.

“We’ve been promoting this idea of having a plan to think through ahead of time” in case of a positive COVID test, Mayer said.

The plan begins with having at-home tests ready to go.

“The next part is to have prethought or prediscussed with your provider whether you are a candidate for one of the therapeutics that’s available,” he said. Those include Paxlovid, remdesivir and monoclonal antibodies.

These therapeutics “are very safe if taken appropriately, and you have to check some drug interactions,” Mayer said. A discussion with your health care provider will help to determine which treatment is appropriate.

After a positive test, an individual should contact his or her provider as soon as possible; the sooner treatment is started, the better.

“Ideally, you have to start these therapeutics within five days of symptom onset,” Mayer said.

People who don’t have a primary care provider can contact virtual urgent care facilities or hospital systems to get a prescription for medication, he said.

Tylenol is the safest option for relieving symptoms at home, he added.

“Ivermectin is very much discouraged,” he said. “It has toxicity that people need to be careful with.”

WHAT BUSINESSES CAN DO

“Many of our community businesses have done an outstanding job remaining flexible and responsive throughout the COVID pandemic,” Ryberg said. “Many of those same strategies remain in place.”

Businesses are encouraged to make sure sick leave policies allow employees to stay home when they’re sick.

“One of the things we know is important in controlling communicable disease is preventing the opportunity to transmit it to others, so looking at ways we can support the workforce in staying home when ill is an important consideration,” she said.

Businesses also can allow remote work, make rapid test kits available and make sure employees have information about where they can get vaccinated.

“As we approach respiratory season, these precautions remain important for a variety of respiratory infections,” she said. 

“I would encourage vaccination for employees,” Mayer said.

It’s also important to realize the importance of masks.

“Masks really do help prevent the spread of COVID,” he said. “If you’re having an outbreak at your work, I certainly do encourage mask use. I know it’s not tremendously popular, but it is a very useful intervention, and it’s overall relatively low cost.

“The better the mask, the more effective protection you’re going to get,” he said. 

Cloth masks “help a little bit, mostly to keep you from spreading it,” he said. “If you move up to a surgical mask, they’re a bit better at keeping you from spreading it. And if it’s fitted fairly well, they’re a little bit better at keeping you from getting it.”

The gold standard is a respirator-type mask — a KN95 or N95, he said.

“If those are well fit, they are quite effective both at preventing spread and keeping from getting it yourself,” he said. “But, as everybody knows, the more effective a mask is, the more burdensome it is and the more difficult it’s going to be for people to tolerate. So you have to balance that.”

However, any mask is better than no mask, he said. A cloth mask worn over a surgical mask is more effective than either alone and may be better tolerated. 

Ventilation and air filtration also can help.

“If you’re starting to see an uptick in cases, separating people for a bit can really help,” he said. Remote work is encouraged if that is a reasonable option.

“Our team here at Public Health remains available to consult with any businesses that have concerns about increasing illness in the workplace and would like to talk through mitigation strategies,” Ryberg said. “That is an area where we are always ready to support the business community.”




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