St. Charles County has reported a significant increase in COVID-19 cases in recent weeks, with more than 40 percent of the 20,000+ total confirmed cases occurring in the past month. This increased case level has resulted in delayed investigation or follow-up on more than 8,500 cases. To better respond to new COVID-19 cases — especially those individuals at a higher risk for adverse illness outcomes — the department is implementing changes to its investigation protocols, effective today.
Prioritizing Investigations and Contact Tracing
The Department of Public Health is prioritizing its contact tracing for probable and confirmed cases diagnosed in populations that are at higher risk for severe illness and where early investigation will yield the greatest mitigation impact. The department is focusing on case investigations using the following criteria:
- Cases diagnosed within the previous 6-day period.
- Cases involving vulnerable populations.
- Cases associated with congregate settings.
- Cases associated with outbreaks.
- Cases involving other high-risk groups, including those who may have been re-infected and those with underlying health conditions.
“With cases and exposures placing St. Charles County in Category 1 – Extreme Risk according to the Missouri Department of Health and Senior Services, the Department of Public Health requires cooperation from residents,” Department of Public Health Assistant Director Sara Evers says. “Along with this prioritization, the department continues to assist long-term care facilities, businesses and schools, which have shown to be places where outbreaks are most likely to occur.”
Elimination of Release Letters
In addition to addressing case investigations and contact tracing for priority populations, the Department of Public Health is amending its protocols for release from isolation and quarantine. Starting today, the department is no longer providing a release letter at the end of the 10-day isolation or 14-day quarantine period. On November 5, the department updated its Order of Quarantine to outline the criteria for self-release and will continue to provide those criteria with each quarantine notification order. The department no longer accepts requests for formal documentation of release from isolation or quarantine outside of an individual’s quarantine letter.
“With the guidance provided in our quarantine or isolation notice, along with the CDC guidelines on those policies, our community will receive information on quarantine procedures that will enable residents to return to work, school and other activities safely,” Evers says.
Procedures for Isolation and Quarantine
“Due to the high volume of positive cases, and the resulting increase in close contacts to those cases, the Department of Public Health has not been able to contact every affected individual as quickly as we desire,” Evers notes. “Even if they are not contacted by the department, individuals have been exposed to a highly contagious virus with very little treatment methods. COVID-19 spreads person-to-person, so eliminating contact with others is the most effective way to stop it.”
The St. Charles County Department of Public Health’s standard quarantine policy follows CDC guidance for isolation and quarantine procedures. To prevent further spread of illness, individuals should not wait until they receive notification from the Department of Public Health to begin their isolation or quarantine measures and should follow the appropriate procedures outlined below:
- Individuals who test positive for COVID-19 or who are symptomatic after exposure to a case should follow CDC guidance for isolation and immediately inform their close contacts. A person on isolation must separate themselves from others who are not infected and should use separate living facilities within their household.
- To discontinue isolation, the person must be fever free for at least 24 hours, have had a significant improvement in symptoms and have passed at least 10 days from the start of symptoms.
- For those with more severe illness, the isolation period may be extended by the department. Please consult a healthcare professional if you experience new or worsening symptoms past Day 10, especially difficulty breathing or shortness of breath.
- For individuals who have not experienced symptoms, isolation will be for 10 days from the date the test was collected. A negative test does not reduce the isolation period.
- Employers: A positive lab report supports the need to isolate. Others within the household are instructed to quarantine.
- Individuals who are notified that they are a close contact to someone who has tested positive for COVID-19 or someone who is symptomatic after an exposure to a close contact should immediately follow CDC guidance on quarantine. A person on quarantine should stay home, monitor their symptoms and avoid contact with others during the designated period. Quarantine should last 14 full days after the last date of exposure. If the individual does not become symptomatic, they can discontinue quarantine after the assigned period is completed.
- A typical quarantine period lasts 14 days, and the last day of exposure counts as Day Zero. (Example: if you were around a positive case on Monday, you would start your 14-day period on Tuesday.) A negative test does not remove an individual from quarantine.
- Living in a household with a positive case increases your likelihood of contracting COVID-19 and may require extended quarantine. Isolation and quarantining away from individuals within a household is extremely important. This means separate living quarters (bedrooms and bathrooms when possible), wearing masks when you must be in the same space (limiting this as much as possible), practicing good hygiene and disinfecting. If you are unable to isolate from the positive case in the household, your 14 days will begin on the case’s Day 11 (i.e.: Day 10 for the positive/symptomatic = your Day 0).
- Anyone on quarantine who becomes symptomatic is considered a positive case and should isolate for 10 days from symptom onset.
- Employers: Continue to monitor the health of staff especially upon return from quarantine.
Additional guidance on proper isolation and/or quarantine procedures is available on the St. Charles County Department of Public Health and CDC websites. This guidance is updated as new information is available; the department encourages residents and the business community to review these guidelines often.
Contact Tracing and Notification of Close Contacts
There are many positive cases that the Department of Public Health has not been able to interview, delaying the ability to identify close contacts, determine the method of transmission and enact mitigation efforts.
- To prevent further spread, the department requests that individuals who test positive or who develop symptoms after COVID-19 exposure reach out to everyone with whom they’ve had close contact beginning 48 hours prior to the positive test or symptom development.
- This notification should inform close contacts of the exposure and the date of exposure.
- These exposed individuals should immediately quarantine for 14 days from that exposure date.
- Quarantined individuals should monitor themselves for symptoms daily and seek testing if symptoms develop.
The Department of Public Health appreciates the cooperation from St. Charles County residents and businesses in efforts to reduce the spread of COVID-19. Following recommended precautions such as maintaining social distancing, washing hands and frequently touched surfaces regularly, covering your nose and mouth and limiting contact with people outside your household will reduce the risk for exposure to or spreading of this contagious illness. For additional information on St. Charles County’s efforts to reduce the spread of illness, visit sccmo.org/COVID. For questions about symptoms or testing, call the St. Charles County COVID-19 Information Hotline at 636-949-1899 or speak with a medical provider.