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Q&A: If you have COVID-19 symptoms or have been exposed, Butte County Public Health says stay home

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Zoltan Balogh
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AP Photo
A medical student takes a nose swab sample for the novel coronavirus COVID-19 from a staff member.

COVID-19 cases continue to increase in California, and the North State isn’t immune.

NSPR’s Sarah Bohannon recently spoke with Lisa Almaguer, communications manager for the Butte County Public Health Department, who said there’s been a rapid increase in COVID-19 cases in the county, and the omicron variant is likely driving the surge. On Friday, Jan. 14., Almaguer said just over 20% of cases were the omicron variant, but a lag in state data means it’s likely many more.

The omicron variant was detected in Butte County on Dec. 27. Before that time, Almaguer said the highest number of cases the county recorded in a week was 927, now it’s more than 1,400. The county is also seeing an increase in people in isolation with the virus, children being infected and hospitalizations.

Editor's note: Data regarding COVID-19 is continuously changing. The latest data for Butte County can be found on the county’s COVID-19 dashboard

This interview has been edited for brevity and clarity.

On the number of hospitalizations and people in isolation with COVID-19 

Locally we are seeing an increase in hospitalizations, but keep in mind that more significant increases in hospitalizations typically occur several weeks after a surge in newly recorded cases, so we're likely to see these hospitalization numbers climb. We currently have 1,030 people in isolation, meaning they're actively infected with COVID, and there are 64 people in the hospital. This has been steadily increasing since around the 23rd of December. And we are at 342 deaths of people who have succumbed to this illness, tragically. And just to give some perspective, and I'm going to keep using that date of December 23rd because that's really where we started seeing everything increase. At that time, we had approximately 140 people in isolation, in contrast now 1,030. So seeing a lot of jumps. The first week of January we reported more cases than any other week in the pandemic. And of note, cases among children have dramatically increased since December 26th versus the first week of January, for example, ages between 13 and 17 almost more than tripled for this age group. So significant jumps, that information is available on our dashboard for anyone to see.

Editor's note: As of Jan. 20, the number of people in isolation in Butte County has further increased since the recording of this interview to 1,521. The number of deaths has increased to 344. 

On the shortage of at-home tests kits and limitations of rapid tests

Unfortunately there's a nationwide shortage of these over-the-counter rapid tests, including here in Butte County. It is very frustrating for residents. It's also frustrating for local health departments, we really are at the mercy of the state and the federal government for ensuring that there are enough tests. So it does make accessing these a challenge and the implications of this shortage is that many people either won't be able to purchase or find a test, or they will choose not to get tested. And if they don't know they're infected they likely won't isolate and will continue to spread, especially omicron to others. So rapid tests, you might be able to find some in local pharmacies. Likely a lot of pharmacies are sold out. They can be purchased online. We have received questions about people concerned that they're going to buy fake tests. And so we recommend purchasing from pharmacies that you know, or a trusted vendor that you know, avoiding third party sales, and looking for tests — either iHealth or BinaxNOW — we know that those are two of the better tests. And there are limitations with the rapid test. It's literally a snapshot in time. They are less sensitive than the PCR. And they may produce more false negatives in the beginning of an infection where not enough of the virus is showing. So in contrast, if you receive a positive result from a rapid test, it is typically very accurate. We do recommend that you get confirmatory PCR testing, but you should isolate if you receive a positive rapid test.

On the availability of PCR testing in the county and its accuracy 

Fortunately, we have PCR testing available in Butte County. On the flip side, obviously more people are seeking testing and so there are longer wait times and slightly longer turnaround time. So getting results on PCR used to take 24 to 48 hours. It's now somewhere between two and five days, just depending on how busy the labs are and perhaps the day of the week that you're getting tested. PCR tests are very accurate. So we still encourage everyone who thinks that they are exposed or possibly infected or symptomatic to get that PCR test. And recently, OptumServe, a state run testing site that we have here in Butte County, the location is at Whitney Hall on the Chico State campus, they recently expanded their capacity. They can now do 600 tests a day. They're open seven days a week, 12 hours a day. You can also get a PCR test at many local pharmacies, and many health care providers have them as well. So if you have someone who you see for your regular health needs, you can inquire with them to see. You do need for OptumServe to register as a patient. You just get a patient ID and book an appointment. At this time, it's unlikely that they'll take walk-ins, but if they have space they will. I think mornings are probably more successful in getting a walk-in appointment than the afternoon. So that's just a little bit of advice there. Yeah, so the bottom line is, if you can't get tested, or you choose not to get tested, and you know you've been exposed, or you have symptoms, stay home. Stay home until your fever is gone, you're not using any medications to reduce that fever, and other symptoms have resolved. And wear a well fitting mask indoors and around other people for at least 10 days.

On COVID-19 tests being able to differentiate between the virus and the flu 

Some types of PCR tests are only looking for COVID, others can test for both COVID and influenza. Many hospitals are now running tests that can detect both illnesses. So a person infected with influenza would not have a false positive test for COVID-19. This is because PCR tests detect the actual genetic material of the virus, and influenza virus is a very different virus than the virus that causes COVID-19.

“Having a large percentage of residents in Butte County that remain unvaccinated means that we will have more cases, and more cases will be hospitalized since unvaccinated people are four times more likely to be infected, and 10 times more likely to be hospitalized. Additionally, they're 17 times more likely to be admitted to the ICU, and 18 times more likely to die. This means that our hospitals will be heavily impacted. And that's very unfortunate, and I know it's very frustrating to the hundreds of health care workers in Butte County.”

On what to do if you’re waiting on test results and might have been exposed to the virus 

It really depends on whether or not you are fully vaccinated. California Department of Public Health recently released new isolation and quarantine guidance to be in line with what the CDC issued. And we have all that information on the Butte County Public Health website. If you're fully vaccinated, and you think you may have been exposed, you don't have to stay at home and quarantine, you should monitor for symptoms. You should get tested and you should wear a well-fitting mask.

And you know, we have requirements for masks for indoor public spaces anyhow, and for all health care facilities and public transportation and shelters. So there are places where it's required to do so and places where you really should just take that extra step.

On masking recommendations during the omicron surge 

What I like to say is any mask is better than no mask, right? And more layers are better than less layers. And then, to go a step further, yes, the N95 is a high efficiency mask. They're not always readily available, and they're not as comfortable to wear, and they certainly aren't appropriate for children. And so in certain situations, maybe if you're on a plane flight, I would recommend an N95. But a surgical mask also, which is more comfortable and more effective than a standard cloth mask. So really ensuring that that mask is well fitted. So if a mask has a bendable nose bridge, that is a good sign, and then you want to reduce the gaping on the sides where your cheeks are.

On people not masking in the community 

Those who are unmasked, especially those who are unvaccinated or those who are vaccinated and not boosted, they are at increased risk for catching omicron. Omicron is extremely highly transmissible. And so if you catch omicron, then you are then someone who is spreading it in the community. There's a variety of places where I see more masks and places where I see less masking. And I say to people who are concerned, ‘You know, you can choose where you spend your money and if you're not happy with people in a certain business not wearing a mask, you can choose to not go to that business.’ Also, if you're at higher risk, older with underlying health conditions, this might be a time to go back to having friends and family help you with your errands or your grocery shopping, so you can avoid additional exposure right now.

On 42% of Butte County residents remaining unvaccinated 

Having a large percentage of residents in Butte County that remain unvaccinated means that we will have more cases, and more cases will be hospitalized since unvaccinated people are four times more likely to be infected, and 10 times more likely to be hospitalized. Additionally, they're 17 times more likely to be admitted to the ICU, and 18 times more likely to die. This means that our hospitals will be heavily impacted. And that's very unfortunate, and I know it's very frustrating to the hundreds of health care workers in Butte County.

On antivirals the county has received and their effectiveness on omicron 

There are two oral antivirals for the treatment of COVID-19. And Paxlovid is a highly effective oral antiviral, it's currently in short supply. With everything in this pandemic, whenever there's something new, whether it's testing, or treatments, it's typically in short supply and it's typically reserved for those who need it the most. The second oral antiviral Molnupiravir, and it has a limited effectiveness against omicron, and so it'd be only used if other treatments were not available. So as far as Butte County receiving these, we have received a distribution of the Molnupiravir. And just to be clear, the county receives these, they don't come to public health, we allocate them to pharmacies and health care providers. So please don't call public health and ask for these because we don't have them to give directly to the public. The way in which you would receive an oral antiviral is by visiting a health care provider and receiving a prescription directly. So again, supplies are limited, prioritized for those at high risk for severe illness. And all antivirals including those monoclonal antibodies must be given as soon as possible after illness onset. So after experiencing symptoms. And there are no antivirals at this time for people under 12 years of age. here's another option, Remdesivir, which you've probably heard of. It's also effective, it can be used as an outpatient treatment, but again, must be give as soon as possible. And it's an intravenous administration daily for three days.

Our greatest action that we can take is to get vaccinated, get boosted, wear a mask when around others. And if you are sick, if you think you've been exposed, you have symptoms, please stay home. That's what we need to do right now.

On where we are in the pandemic and when COVID-19 will be considered an endemic disease 

For a while it appeared that we were headed in a really good direction. Yes, we're tired. I'm tired. Everyone that I work with is tired. We do have an excellent public health staff and excellent partnerships throughout the county. And we will continue working hard to do what we can to keep everyone informed and prevent the spread of illness. But this is a novel coronavirus. It's still new. Health scientists and public health experts are still learning and that's why guidance continues to change. And it gets confusing for folks. It gets confusing for me. I have to be very diligent about making sure that I'm constantly checking the state website and other agencies like the CDC. But we're at it, that’s a really tough question. And, you know, we had talked earlier about, will this be an endemic? I think the key word here is eventually. Whether or not COVID will be called an endemic is yet to be seen. But we hope to get to that point where we treat COVID as we do with other communicable diseases, such as influenza, and we respond with appropriate public health measures rather than constantly being in a state of emergency response.

On what Butte County residents should be doing during the surge 

Our greatest action that we can take is to get vaccinated, get boosted, wear a mask when around others. And if you are sick, if you think you've been exposed, you have symptoms, please stay home. That's what we need to do right now.

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