Carson City Health and Human Services address facts, myths surrounding COVID-19

As the country, and Carson City, continues the ongoing battle against COVID-19, there is a new enemy making its way onto the field: misinformation.

There are many conspiracy theories floating around the internet surrounding COVID-19, and sometimes, it’s difficult to be able to suss out what’s real.

That’s why we posed the questions people have been asking directly to Carson City Health and Human Services Director Nicki Aaker, to get to the bottom of the truths — and lies — surrounding COVID-19 and how our capital city community is affected.

Here's our list of questions and here are the responses.

1. If someone goes to get the COVID-19 test done, and they leave before it’s performed, how often are they “receiving a positive test in the mail” afterwards? 
* If an individual gets in line at a testing event to be tested for COVID-19 and they leave before having the test performed, they will not receive a result since the specimen was not collected. CCHHS does not notify people of their results through the mail. CCHHS notifies individuals by phone if they are positive or negative.

2. How many false positives have been detected by your department? 
* CCHHS to the best of our knowledge has not received any false positives. The test used is very reliable. If someone testing positive one day and then comes back the next day and tests negative would not mean a false positive. There are many different factors that contribute to the accuracy of a test, in particular the duration of the disease. The individual could have tested positive at the end of their disease period and when they test the next day and it comes back negative, it could be because their viral load is undetectable since it is the end of the period. Or someone tests negative one day then tests positive the next day could be because the individual was newly exposed and there was not enough of the virus in the nose to be detected. A good example of a false positive would be if we use an Abbot Rapid Test on someone and it comes back positive but the swab we sent into the state lab came back negative, the Abbot result would be classified as a false positive.

3. How many false negatives have been detected by your department? 
* The tests conducted by CCHHS determine if an individual has an active infection with the virus that causes COVID-19 at the time of specimen collection. An individual can test negative one day and then develop symptoms and test positive at a later time. The first test would not be considered a false negative. It just means that there was either no viral load at the time of collection or the viral load was low.

4. If someone dies in a motorcycle crash, and they postmortem test positive for COVID-19, is that considered a COVID-19 death? 
* This would not be considered a COVID-19 death since COVID-19 would not be the leading cause of death.

5. What are the parameters for marking something as a COVID-19 death? 
* When an individual with COVID-19 passes away, CCHHS receives a death certificate signed by a physician. In order to be considered a COVID-19 death, COVID-19 would need to be listed on the death certificate as a leading cause of death. The cause of death is determined by a physician.

6. Can wearing masks give people carbon dioxide poisoning? 
* Mask wearing does not pose any risk to healthy individuals. Wearing a mask does not cause carbon dioxide poisoning. The carbon dioxide molecules can freely diffuse through the mask and any carbon dioxide that a person might rebreathe can easily be eliminated by the body.

7. Why is it important for people to wear masks during this pandemic?
* Wearing a mask during this pandemic helps slow the spread of COVID-19. If an individual with COVID-19 is wearing a mask in public, the risk of transmission to a healthy individual is lower than if the person with COVID-19 was not wearing a mask. Wearing a mask does not protect you, it protects others.

Furthermore, the masks we talk about are the cloth face coverings. N95s should be reserved for medical use. A cloth/fabric mask helps prevent people who have or may have COVID-19 from spreading the virus to others. A person may not know that have COVID-19 and without a mask, they can spread it to their friends, family, coworkers, and other community members, including those who are most at risk. Wearing a cloth face covering protects those around you by keeping your germs to yourself. The best type of cloth/fabric face covering is made from material that is tightly woven and fits snug around the edges of the mask.

8. How long on average is it taking a test result to return to the tested person? What is the testing process consisting of, and are people out in public while they're waiting for their results, or are they being asked to quarantine? 
* On average, results are taking up to a week. The testing process depends on if the individual was tested onsite at CCHHS or at a drive-thru event. If a person calls the Quad-County COVID-19 Hotline for testing, they will be contacted by a scheduler who will arrange for them to be tested. The scheduler will take the individuals information and provide them with directions to our location and instructions for what to do when they arrive. When the person arrives for their appointment at CCHHS, they will be asked to remain in the vehicle. A nurse will come to their window and verify their information. Once information is verified, the nurse will swab the inside of each side of the individual’s nose. The nurse will then provide the individual with information on what to do since they have been tested and what their results mean. CCHHS will notify the individual of their results once they are received.
* If an individual comes to a drive-thru event to be tested, they will be given two forms to fill out; a consent form and a form that is sent to the lab. They will then move on to the screening station where a staff member verifies that both forms are filled out. The consent form is collected and the form that goes to the lab is placed on the windshield of the vehicle and they move on to the testing station. At the testing station, a provider will verify the person’s name and date of birth. They will then swab the inside of each side of the individual’s nose. The nurse will then provide the individual with information on what to do now that they have been tested and what their results mean. CCHHS will notify the individual of their results once they are received.

9. Are antibody tests being counted as new positive cases? 
* CCHHS does not count any antibody tests as new positive cases CCHHS does not conduct antibody tests at this time.

10. What is the difference between COVID-19 and previously documented coronavirus strains? 
* The coronavirus that causes COVID-19 is a new virus that has not previously been seen in humans. There are many different types of coronavirus that commonly circulate among humans and they cause mild illnesses such as the common cold. The virus that causes COVID-19 causes a more severe illness than other coronaviruses.

11. When a new case is listed as being "connected to a previous case," has that other person been tested?
* When we state that the case is connected to a previous case, it means that one of their contacts was already a case confirmed through testing.

12. If a person tests positive once, and is tested again and it comes up positive, is that counted as a separate positive case? In other words, when you say "case", is that connected to a person, or just a positive test result?
* An individual is only counted as a case once. The term “case” is connected to a person, not a positive test result.

13. How exactly does the contact tracing work? Are you seeing problems with people refusing to help in contact tracing?
* When someone tests positive for the virus that causes COVID-19, they will be contacted by a disease investigator who will ask where they have been and who they have been around starting 2 days before their symptoms appeared until they were isolated. If someone is considered a close contact of a positive case, meaning they have been within 6 feet of a person with COVID-19 for 15 minutes or more starting 2 days before they started feeling ill until the time they were isolated, they will be notified by a contact tracer. The contact tracer will have the contact self-quarantine and they will continue to monitor the contact for symptoms for 2 weeks after the last known exposure date. Contact tracing identifies those who could have been exposed to COVID-19 to quarantine them and prevent others from becoming exposed. One of the biggest challenges is that contact tracing relies heavily on memory and not everyone can remember who they have been in close contact with. There are some individuals who can not recall who they were in contact with or who do not want to give that information to investigators. Investigators discuss the importance of contact tracing with the case and explain that the information shared is confidential and their name will not be shared with the contacts. Also, some individuals are not answering their telephone when a contact tracer is calling.

14. What safeguards are in place to prevent people from making up cases/numbers?
* CCHHS keeps track of the case number assigned to everyone.CCHHS uses a variety of databases and spreadsheets to ensure our numbers are accurate. We also have multiple people verify the numbers each day. When a person tests positive and becomes a case, we create what is called a line listing. Essentially, it is a spreadsheet and each line is a case of ours. The line listing contains all of the information we need to identify the case. It goes in numerical order and we have the ability to search it if needed. When we receive a positive result, our investigators notify the case and conduct the investigation. Once complete, they input the information into the line listing and the case number is assigned. Having a single source for case numbers and having it in numerical order allows us to ensure case numbers aren’t repeated. For example, if I assigned someone case number 740 but case 740 had already been assigned to another person, I would catch that when I put the case in the spreadsheet since 740 would be on there twice. This is similar to how we track the number of people we test and the number of tests given. Each person tested is assigned a “patient under investigation” (PUI) number. This is a unique number that allows the individuals sample to linked to them. PUI numbers are used across the nation but are unique to each person tested. These numbers have been assigned to each county testing by the state. When we test an individual, we input their information into a testing spreadsheet which is similar to a line listing. We assign their PUI number to them and schedule their test. We do this for everyone tested by CCHHS, including those who attend a drive-thru event. This spreadsheet is one way we keep track of how many people we test. We also have a test inventory sheet. We track how many tests we have and how many samples we send to the lab each day. This acts as a second way to track how many people we test and the number of tests administered.

15. What are the biggest struggles you are seeing in your efforts on this issue?
* The biggest struggle we are seeing in regard to COVID-19 and our efforts is compliance fatigue. Our communities have been living in a COVID-19 world for months now and they are eager to have their lives return to normal. It is important for everyone to remember the importance of continuing to practice preventative habits such as wearing a face covering, keeping 6 feet of space between themselves and others, washing their hands often with soap and water for 20 seconds, covering their coughs and sneezes, staying home if they are sick, and not attending large gatherings.