With the first COVID-19 cases related to community spread now out in the state, and numbers expected to rise, public health officials are trying to get the word out on the correct way to get yourself tested.
“We’re hearing from our clinical providers in the community that they are seeing increasing numbers of residents showing up asking for testing,” said Olmsted County Public Health Services Director Graham Briggs. “One thing we need to be working on is not putting a strain on those emergency departments.”
A March 9 news release from the Northfield Hospital and Clinics advised that patients may need to seek testing if they are exhibiting the primary COVID-19 symptoms — fever, cough and shortness of breath — in addition to meeting other potential risk factors such as recent travel or close contact with a confirmed COVID-19 patient.
The release also noted that fever and a rash, or fever and vomiting or diarrhea, would also be reasons to call in and see if testing is recommended.
Leslie Lovett, Minnesota Department of Health emerging infections unit supervisor, said individuals returning from China, Iran, Italy and South Korea — countries with a Level 3 Travel Advisory — should closely monitor their health and are asked to stay home for a two-week period upon re-entry based on guidelines from the Centers for Disease Control and Prevention.
“If they’re sick enough to normally seek out a health care provider, then they would be advised to notify their provider in advance that they had recent travel and work out appropriate care and testing,” added Lovett. “If they’re not sick enough to go seek out care, then we just recommend that people stay home when they’re sick.”
Public health officials and providers across southern Minnesota echoed Lovett’s advisory that anyone with a potential case of COVID-19 should call their clinic first, instead of going in person. This way, clients will be able to talk through their situation and make a plan for limiting exposure to others if they are ill.
“Don’t just go to the clinic,” reiterated Cindy Shaughnessy, Le Sueur County Public Health director. “Health care providers can make that assessment and use their judgment on whether or not they think one of their patients needs to be tested.”
According to the Northfield Hospital press release, “MDH helps providers make the decision whether to test a patient for COVID-19, based on specific criteria. MDH encourages providers to first test patients with symptoms for other respiratory illness like influenza.”
How COVID-19 spreads
According to the CDC, individuals with COVID-19 may begin displaying symptoms between two days and two weeks after exposure. Lovett said there’s not enough information at this time to determine whether a person is contagious even when they are not symptomatic, but she noted that with any respiratory illness the likelihood of transmission is highest when symptoms are present.
“That’s when they’re spreading the most viruses because that’s when they’re having the most sneezing, coughing and fluids,” she explained.
On its website, the CDC noted that there have been some reports of the new coronavirus spreading before people show symptoms, but that it’s not thought to be the primary means of transmission.
Currently, COVID-19 is thought to spread mainly from person to person, between those who are within about 6 feet of each other and when an infected person produces respiratory droplets by coughing or sneezing — these can then land in the mouths or noses of bystanders and be inhaled into the lungs.
The beginning of community spread means that more people will become infected with the virus in one area, without being able to easily identify how or where they might have been exposed to the disease.
As more testing is being done across the state, Le Sueur County’s Shaughnessy added that she’s been told to expect additional cases.
When to get tested
Andrea Ahneman, communications planner for the Minnesota Department of Health, said March 11 that over the prior week and a half, the number of cases being tested per day had increased as capacity ramps up and testing becomes more common. Lovett added that a number of commercial labs will also likely be coming online soon to test swabs for COVID-19, but that she’s unsure of the exact timeframe.
While the oral and nasal swabs necessary for the test are fairly common and easy for clinics to order through their regular supply chain, there has still been a limitation over the past few weeks to the number of tests that can be performed, according to Timothy Sielaff, Chief Medical Officer at Allina Health.
“There’s not a limitation to testing for those who meet the criteria,” he explained, “but if we started having people who were well coming in who were worried, that might overwhelm the system.”
He also noted that this limitation will likely go away in the near future, as the country adapts to dealing with the novel virus. While he noted that the situation is evolving every day, at this point, he said there would be no reason to try and schedule a test while not exhibiting COVID-19 symptoms.
“One of the public health benefits of that is then you’re saving the access for people who are ill and do need testing,” said Sielaff.
Briggs mentioned the same sentiment at a recent press conference, adding that emergency care providers are also continuing to process accidents and other sudden illnesses. According to Briggs, the infected individual in Olmsted County was sent home to self-isolate due to the mild nature of their symptoms and was told to notify providers if anything changes.Preventative measures
In order to avoid contracting the virus and necessitating testing, Lovett reiterated the importance of following basic hygiene practices. These include washing hands with soap and water for 20 seconds or more on a regular basis, using hand sanitizer that contains at least 60% alcohol if soap and water aren’t available, avoiding any face-touching, cleaning frequently-used surfaces daily, covering coughs and sneezes with an elbow or tissue, and more.
“If you’re sick, stay home,” reiterated Sielaff. “If you’re unwell, but not short of breath and not experiencing the more severe systems, self-isolation is a good option.”
According to Betsy Spethmann, Northfield Hospital and Clinics communications director, self-isolation should last 14 days to account for the maximum amount of time that it may potentially take COVID-19 symptoms to develop. She also noted that people living with someone in isolation should take added precautions, including using a separate bedroom and bathroom if available, making sure that shared spaces have air flow either by an air conditioner or open window and other steps recommended by the CDC.
The patient should wear a face mask around other people and refrain from handling any animals in the home. To date, the CDC notes that there have been no reports of companion animals contracting or spreading the disease, although it’s believed it initially emerged from an animal source in China earlier this winter.
For additional guidelines on prevention, symptoms and treatment, visit the CDC’s website at www.cdc.gov/coronavirus/2019-nCoV/. The MDH has also set up a COVID-19 hotline, which will be available at 651-201-3920 from 8 a.m. to 4:30 p.m. on weekdays.
If you believe you should be tested for COVID-19, call your health care provider to talk through your situation and make arrangements before going to a health care facility in person.
COVID-19 and its spread has caused fear and uncertainty across the globe. To ensure our community has the latest information on this public health threat, APG Media of Southern Minnesota is providing stories and information on this issue in front of its paywall.