A Local Spike

On Monday, we heard community reports of more than 30 positive antigen tests for COVID-19 in Manchester, Vermont, and its surrounding towns. On Tuesday, the Vermont Department of Health confirmed that information, but they did not update their data to reflect the increase in cases. This is certainly concerning and confusing. I would like to share some information that I hope will clear up some misunderstandings and give helpful directions to keep you safe.

How many cases are there?
It is difficult to know how many cases there are locally. There are three major types of tests, each of which has varying degrees of accuracy and usefulness. Complete information about testing can be found here. 

• PCR tests, like those we use at SVMC, rely on genetic material from the virus to produce a positive result. They are typically processed at the state lab and are a very accurate reflection of whether an infection is present. 
• Some clinics are using antigen testing, which are not as fully accurate for determining an active infection. The state does not record positive antigen tests as true positives but do DOES consider them to represent presumptive cases. Those who have had a positive antigen test are advised to get a PCR-based test.
• The biggest concern are those who receive a negative result from an antigen test. The rate of false negatives, depending on which antigen test, can be 15 – 20 %.
• The third type of test, an antibody test sometimes referred to as serology, looks for infection in the past. Current antibody tests don’t tell you whether you are immune to COVID and may not tell you if the virus you were exposed to is COVID-19 or another corona virus. This test needs a lot more research before it is useful to most people.

What should you do?
If you don’t think you’ve been exposed, continue to practice social distancing, masking when near others, and frequent handwashing. Limit your travel, and do not go to parties or other places where people gather. Stay up to date on current cases by monitoring the Vermont Department of Health Website. The site posts the COVID-19 activity in each town, including new confirmed cases. It is updated every day.

If you think you may have been exposed, you have been closer than 6 feet for 10 minutes or more, to someone who has tested positive, quarantining immediately is the best action. To quarantine means that you and your family members stay home and monitor yourselves for symptoms for 14 days.

Alternatively, those who have had a single exposure can quarantine for 7 days and get a test.  Waiting 7 days after a single exposure will increase the accuracy of the test by giving the virus the opportunity to build up a measurable response. If you have been exposed repeatedly over the last 7 days or more, you can get tested right away. Get additional details here.

If your exposure is confirmed before you are tested or after you test positive, you will hear from a contact tracer. The contact tracer will be interested in how you are doing and whether you are at risk of serious illness. The contact tracer will gather information to verify your identity and so that they can continue to monitor and support your family.

Note that contact tracing is free. If someone claims to need payment information, they are not a contact tracer.

The contact tracer will recommend testing and quarantine and provide information about each in addition to resources you may need to meet your needs during this time. More information about contact tracing can be found at here and here. Their aim is to help you get the help you need and to determine who else may be affected.

If you test positive for COVID-19, you will need to isolate yourself from the community and others in your household for at least 7 days, plus 72 hours after any fever has subsided without the use of fever-reducing medications. To isolate means that you should stay away from others in your household by staying in separate rooms most of the time. You should wear masks when in the same room or when passing in common areas. You should use a separate bathroom, if possible. You should not eat together. Continue frequent handwashing and sanitizing of surfaces.

When will this end?
As long as people are socializing in person, we should expect outbreaks. Instead of socializing in groups, I encourage everyone to stay physically distanced, wear masks, and wash their hands frequently. Remain socially connected by checking in by telephone or video chat. Please choose wisely regarding where to travel by abiding by the Governor’s travel guidelines. Avoid parties and gatherings of any size where social distancing is difficult or if you know people attending will not wear masks.

COVID-19 is deadly for some who get it and very disruptive to most of the others. The most important way to care for our communities right now is by behaving in ways that reduce the spread.