6/15/20: WCHD Health Alert COVID-19 Update – COVID-19 associated with recent large gatherings

| June 15, 2020
Doctor with a clipboard speaking to a man outside of a hospital

June 15, 2020

Whatcom County Health Department Communicable Disease & Epidemiology Division

COVID-19 associated with recent large gatherings

At least 15 COVID-19 cases have been diagnosed in Whatcom County over the past week linked to several large gatherings around Memorial Day and the first week of June, with secondary spread within households, among close friends, and coworkers who also socialized together. Those affected have been 19-25 years old. There have been no hospitalizations or deaths associated with the cases as of this date. Most have had mild symptoms, some had no symptoms. Cases have been instructed to isolate. Close contacts have been offered testing, instructed to quarantine and
monitor symptoms, and to isolate if symptoms develop.

Action requested:

  • Ask about exposures to large group gatherings and test for COVID-19 in patients so exposed and with compatible symptoms including fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and, diarrhea.
  • Participants should monitor their health for COVID-19 symptoms in the 14 days after attending any large group gathering and seek testing promptly if symptoms develop, even if mild.
  • Counsel patients that a negative test does not exclude COVID-19 unless the 14-day incubation period is past.
  • Clinicians should have a low threshold for testing persons participating in large group gatherings and use clinical judgement regarding testing of asymptomatic persons.
  • Reinforce the need for physical distancing, face covering when within 6 feet of non-household members (to reduce risk of the wearer infecting others), and of frequent hand washing or sanitizing to prevent self-inoculation of virus from hands to mucous membranes.
  • Educate patients that attending a large gathering with prolonged close contact carries a risk of acquiring COVID-19 and bringing it back to their homes, workplaces and communities.

PCR testing is indicated for all patients with symptoms of COVID-19, which may include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and, diarrhea. Testing symptomatic patients is indicated regardless of their age or underlying health status. Testing asymptomatic close contacts of confirmed cases is indicated for early detection of new
cases among close contacts.

Instruct patients who have COVID-19 symptoms to self-isolate, and for their close contacts to quarantine. Although testing is recommended for close contacts, a negative PCR test of a contact does not rule-out infection nor shorten the 14 day quarantine period.

Reinforce the importance to your patients and your staff:

  • To maintain physical distancing,
  • To wear cloth face covering when closer than 6 feet to others who are not in their household (primarily to prevent infecting others in case the wearer has asymptomatic or presymptomatic infection, although they may provide limited personal protection),
  • To wash their hands frequently to avoid passing virus from their hands to their eyes, nose, or mouth, and to stay home when ill.

Washington law requires healthcare providers to include the patient’s name, date of birth, address and phone number when ordering tests for COVID-19. This is critical for timely case investigation, contact tracing, and epidemiological analysis. Although laboratories are required to report test results to public health, healthcare providers should also report cases to WCHD to assure timely contact tracing. (Call 24-hour Communicable Disease Report Line 360-778-6150)

Patients should be provided with specific guidance from the linked DOH patient handouts if they are a confirmed case, have had recent exposure to a person with confirmed COVID-19, or are symptomatic and without contact to a known case.

In general, patients with COVID-19 should be separated from others during their infectious period and be in isolation (and excluded from work) for at least 3 days (72 hours) have passed since resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and, at least 10 days have passed since symptoms first appeared. Asymptomatic cases should be isolated for 10 days after their first positive PCR test and not have developed symptoms.

In general, close contacts of confirmed cases of COVID-19 should be quarantined during the incubation period and separated from others for 14 days after their last exposure. They should isolate themselves immediately if they develop symptoms and contact their provider for testing. If positive, they are treated as a case. If negative, they need to complete their quarantine period.

Please contact WCHD to discuss other isolation or quarantine instructions. Critical infrastructure workers might be able to return to work during quarantine if they always wear face coverings while at work for source control and their workplace has implemented other measures to prevent transmission of the virus to other staff or customers.

References:

For more information, contact:

Whatcom County Health Department Communicable Disease Program
1500 N State Street, Bellingham WA 98225
360-778-6100 Main | 360-778-6150 24-hour Communicable Disease Program Report Line | 360-778-6101 Fax