No easy answers to COVID-19 response

County health department helps determine next steps
By: 
Carol Ryczek
Editor-in-chief

If, then.

If someone tests positive for COVID-19, if an employer has an employee with symptoms, if a restaurant has a regular customer who has symptoms of COVID-19, what is the next course of action?

The answer is, it depends.

“There are a lot of variables,” said Vicki Dantoin, Shawano-Menominee counties health officer. “If this, then that. It’s not the same for every place.”

When the health department is notified of a positive COVID-19 case, the staff begins a process called “contact tracing,” which means asking the infected person where they work and who their close contacts have been. This information is not always something that people want to share, and the health department can’t compel them to do so.

They also don’t have to say where they work. If they do choose to share this, the health department must get permission to talk to the employer.

“We can’t call the employer and tell them, ‘We think you have a case,’” Dantoin said.

As a health care professional, Dantoin must abide by the patient privacy rules of the Health Insurance Portability and Accountability Act, better known as HIPAA.

Even in a time of communicable diseases, HIPAA goes one way, Dantoin said. As a public health official, she can receive the report but can’t share that information without permission.

She emphasized that a positive test for one employee does not automatically mean that a business needs to close. It depends on the type of business and what it needs to operate. She helps business owners make these decisions by asking questions.

“If everybody is in quarantine, what can you do?” Dantoin asked. “Can you close for a couple of days and deep clean? We like to offer options for going forward.”

Whether an employer wishes to disclose that an employee tested positive depends on the situation, she said. It may depend on how many employees were exposed and have to go into quarantine.

“We ask them, ‘If half the staff was in close contact, can you operate with half staff?’” she said.

Dantoin said she also discusses what precautions have been taken and what the business can do once they reopen. Is it possible to be physically distant in the current building? If it is a restaurant, are tables cleaned before the next person sits down? How many staff are needed to operate safely? What are the communication strategies, and how will they control rumors?

“For the most part, they are pretty cooperative,” she said. “There are some that are, ‘No, thank you. But have a nice day.’”

Many, she said, ask excellent questions and have already thought about, “What happens next?” They are concerned about the business, but ultimately, they are concerned abut the people, she said.

“The humanity factor brings it back,” she said. “The issue is how COVID-19 works. We really don’t know who it will affect, who it will affect severely. We don’t know who is an asymptomatic carrier.”

When it happens, she said, those who have been told have said they are prepared but also have a personal affirmation that “This is real.”

One of the responses Dantoin emphasizes is time off for the infected individual. At the beginning of the pandemic, many employers were working on getting policies in place for who should stay home. Some have sick leave or short term disability for employees.

That’s the important thing for public health, she said.

“If people who are sick are out and about, you can’t stop the spread of the virus,” she said.

However, she noted, it’s not that easy. For employees, it’s hard to go two weeks without a paycheck, she said. For employers, the question is, “How do I keep my business running?”

It depends on the resources and policies, she said, and it is an ongoing concern.

The issues are faced not just by businesses but other agencies that serve the public, such as schools.

“Schools keep asking, ‘How do we know when to close?’” she said.

Like everything else, the answer is, “It depends.”

If there is a cluster of cases, are they in one classroom? That would mean shutting down that classroom but not the whole school. If there are a number of cases throughout different classes, it means the spread is occurring throughout the building, and the recommendation may be to close.

“There is no good answer,” she said. “It’s like putting a puzzle together. You have to put all the pieces together to see the whole picture.”

RELATED: Businesses need a COVID plan

cryczek@newmedia-wi.com