Alicia Hills has interviewed each of the 29 Baker County residents who have tested positive for COVID-19.
And Hills, the nursing supervisor for the Baker County Health Department, said she’s been gratified by residents’ willingness to try to curb the spread of the virus.
“Most people have been very agreeable,” Hills said on Friday morning.
“I’m very thankful that the people we’ve talked to, they want to reduce the risk of anyone else getting sick,” Hills said. “They don’t want to put any of their family members at risk, or anyone in the community.”
Hills said people who have tested positive have cooperated with the county’s contact tracers to compile a list of people whom they might have inadvertently infected.
And these patients have also complied with the county’s request that they self-isolate at home for 10 days after the onset of symptoms, and for 24 hours after symptoms dissipate, she said.
Hills said people who have been in close contact with a resident who tested positive have also cooperated, by self-quarantining for 14 days after having had close contact with an infected person. The county also asks those people to take their temperature twice per day and report the results, as well as any other possible COVID-19 symptoms, to the Health Department.
“From our interactions with people, I think that, yes, the majority of them are following our guidance,” Hills said.
Case investigation process
Hills said the rate of confirmed cases has been slow enough that she’s been able to conduct all the initial interviews with infected residents.
Baker County’s weekly peak has been nine cases from July 19-25, according to the Oregon Health Authority (OHA).
Of the 29 positive tests, 28 have been reported since June 30, including two new cases on Friday.
(The county’s first case was reported May 6.)
As of Friday, 922 county residents have tested negative for COVID-19, according to the OHA. That’s about 5.5% of the county’s estimated population of 16,800.
Hills said that when she receives confirmation about a positive test, either from a doctor or medical clinic, she telephones the patient.
In most cases the person has already been notified by a health care provider, she said, although in some cases she has told the person about the positive test.
Hills said the initial phone call generally lasts around 20 minutes. She asks the patients about symptoms and any underlying medical conditions they might have.
A crucial part of the interview, though, is compiling the list of the person’s close contacts. The Centers for Disease Control and Prevention define close contact as being within 6 feet of another person for 15 minutes or longer, Hills said.
Those criteria apply regardless of whether the encounter happened indoors or outdoors, and whether or not either of the people involved was wearing a face covering, she said.
Hills said she asks patients to list all potential close contacts from two days before symptoms began.
She said all the people who have tested positive had symptoms of varying degrees. Generally local residents who don’t have symptoms aren’t being tested because they don’t meet the CDC criteria for testing.
Because it can be challenging for people to remember who they might have had close contact with over a period of a week or longer, Hills said that after her initial phone interview she schedules a follow-up call to give people more time to consult a calendar, talk with relatives or otherwise refresh their memories.
“We try to help jog their memory,” she said.
Typically close contacts occur at social gatherings, appointments or similar events, Hills said.
A person who has shopped at a store, for instance, probably won’t have any encounter that qualifies as a close contact. However, Hills said she asks people to make sure they didn’t, say, stop to talk with a fellow shopper for longer than 15 minutes at the grocery store.
Hills said the number of people on the final list of close contacts has varied, in Baker County’s 29 cases, from as few as two people to around 10.
Once Hills has compiled the list of close contacts, she or another county employee starts the contact tracing process.
Thus far she and four other tracers have been able to handle the workload, although Hills said the county has additional people trained to do contact tracing if necessary.
Contact tracing is similar to the interview with the person who tested positive.
Hills said she phones the person and explains — if the person hasn’t already been notified by the resident who tested positive, as sometimes has happened — that he or she might have been in close contact with an infected person.
She inquires about possible symptoms, and then asks the person to self-quarantine for 14 days from the date of the close contact.
The county encourages people who have symptoms to visit a doctor and, ideally, be tested.
Self-quarantine means the person tries to avoid contact with others as much as possible, generally leaving home only for doctor’s appointments, or to take a walk or car ride if it’s possible to avoid contact with others.
People are also asked to try to minimize contact with others in their household, if they don’t live alone.
Hills said the self-quarantine period is important because a person can infect others up to two days before symptoms begin.
Hills said there have been situations in which a person who was listed as a close contact by an infected person subsequently had symptoms and also tested positive.
Some of these cases involved transmission by a resident to a family member in the same household, and others involved the infection of an acquaintance who isn’t a member of the household, Hills said.
Hills said the Baker County Health Department doesn’t follow up on cases for the purpose of determining whether the person has recovered.
The OHA does maintain some statistics about the recovery rate, but the data are not separated by county.
However, no one in Baker County has died as a result of COVID-19 infection.
Moreover, county officials have said no one is hospitalized for treatment.
Recommendations for residents
Hills said that in interviewing the residents who tested positive, it’s clear that in many cases symptoms of infections are “very mild.”
Some people have initially believed they were suffering from allergies, she said.
Hills urges residents to be especially vigilant in taking stock of their health, and to not ignore symptoms such as a sore throat, headache or muscle aches just because they don’t also have a cough or a fever.
Although the latter two symptoms are strongly associated with COVID-19, neither is definitive. People can be infected with the virus and not have a fever or a cough, she said.
Hills says people who feel sick should at a minimum stay home from work and try to minimize their contact with others.
And she urges people who have cold-like symptoms to visit a doctor and, potentially, be tested for COVID-19.
Hills said the county’s ultimate goals are to protect the community and to handle the pandemic to the extent possible to ensure businesses can remain open.