COVID-19 Testing: It’s Still Essential

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We are now at slightly over 65% of all eligible residents in Skagit County having received at least one vaccine dose. It is exciting to think of how far we’ve come in our vaccination journey since December of 2020. Even still, we have a long way to go before COVID-19 is no longer of concern. With the rapid spread of the Delta variant throughout Washington State and rising case counts and hospitalization rates this past month, we know that we are not yet in the clear.

In the latter half of July, Skagit County Public Health was seeing daily new case counts repeatedly in the tens and twenties; a high not seen since our last wave in April of 2021.This increase is likely due to multiple factors, including increased spread of the more contagious Delta variant, increased social gatherings and summer-time travel, and businesses reopening—all happening with fewer people wearing masks.

Skagit County COVID-19 case trends from the WA DOH dashboard. https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard

While the conversation has been primarily focused on vaccination of late, it is important to remember that getting tested for COVID-19 is a tool that we can, and should, use if/when exposed to COVID-19 or when traveling. So, let’s revisit the matter of testing…

Testing is essential.

Anyone with signs or symptoms of COVID-19 should get tested as early as possible regardless of vaccination status. With allergy season waning and flu season ramping up, it is no doubt that you’ll feel a tickle or two, or develop a cough at some point this fall. When you know you’ve been exposed; when you feel a little under the weather: Take precaution. GET TESTED!

Not sure if your sniffles warrant a COVID test or not? Use the Coronavirus Self-Checker here.

If you have been exposed to COVID-19.

Whether you have been vaccinated or not, if you’ve been around someone who has a suspected or confirmed case of COVID-19, you should get tested 3-5 days after your exposure, even if you don’t have symptoms.

You should continue to monitor for symptoms for 14 days following an exposure, and if you develop symptoms, isolate immediately and consider re-testing. If your test is positive, you should isolate for 10 days.

For unvaccinated folks, it is important to note that quarantine guidelines have not changed. If you are unvaccinated and are exposed, along with getting tested, you will need to quarantine for 14 days—even if you do not have symptoms.

If you are experiencing any of the symptoms below, get tested for COVID-19 at a testing location. For a full list of locations, go to: https://www.doh.wa.gov/Emergencies/COVID19/TestingforCOVID19/TestingLocations.

Symptoms may include:

  • Fever or chills
  • Cough
  • Fatigue
  • Muscle or body aches
  • Headache
  • Shortness of breath or difficulty breathing
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea, vomiting, or diarrhea

Note: If you are in quarantine or isolation and you find yourself in need of assistance with getting supplies or food, call Skagit County Public Health at (360) 416-1500 between 8:30 a.m. and 4:30 p.m., Monday through Friday.

Testing and Travel

Some restrictions around travel have lifted recently, but it is important to remember that precautions must still be taken. After all, travel increases the chance of contracting and spreading COVID-19. The Center for Disease Control (CDC) continues to recommend that folks limit travel if unvaccinated, and that all people, regardless of vaccination status, use extra precaution if they do travel.

Here are some important things to keep in mind when making travel plans within the United States:

  • Refrain from travel if not fully vaccinated. The CDC recommends that those who are not fully vaccinated delay their travel. If you must travel, follow safer travel options including a viral test 1-3 days before your trip. If you are traveling with children who cannot get vaccinated at this time, follow recommendations for unvaccinated people and choose safer travel options. 
  • Testing before travel. People who are fully vaccinated with an FDA-authorized vaccine can travel safely within the United States. Unvaccinated individuals must plan to get tested with a viral test 1-3 days before their trip.
  • Check travel guidance before you go. While most states no longer require a test, travel restrictions vary by state based on vaccination status and are subject to change at any time. Check state and local guidance before you make concrete plans.
  • Wear a mask during travel. Masks are required indoors in travel hubs and on public transportation regardless of vaccination status. Follow all state and local recommendations and requirements for mask wearing and social distancing.
  • After-travel requirements for fully vaccinated. It is not required to get tested before or after you travel if you are fully vaccinated, but you should still follow all other travel recommendations, self-monitor for COVID-19 symptoms, and get tested if you develop symptoms. During travel, if you’ve been around someone who has COVID-19, you should get tested 3-5 days after your exposure, even if you don’t have symptoms, and wear a mask in indoor public settings until your test result is negative.
  • After-travel requirement for unvaccinated. Those who are unvaccinated must get a viral test 3-5 days after travel AND stay home and self-quarantine for a full 7 days after travel. They should also isolate and monitor for symptoms for a full 14 days and seek repeat testing if symptoms develop. See CDC guidance for unvaccinated travelers.

For international travel:

Those who are traveling internationally should check requirements of their destination country as they may require a test prior to arrival even for vaccinated people. See CDC guidance and testing requirements for international travel.

Where to get tested.

Many doctor’s offices are offering COVID-19 testing to their patients. Contact your healthcare provider first to see if they offer COVID-19 testing. If you are experiencing severe symptoms such as shortness of breath or chest tightness, consider going to an emergency department nearby.

For a list of testing locations in your area, go to: https://www.doh.wa.gov/Emergencies/COVID19/TestingforCOVID19/TestingLocations.  

At-home tests are also now available for purchase. Check out the following links for at-home testing options:

What to bring with you when getting tested.

  • A photo ID with your date of birth. Testing is available regardless of your citizenship/immigration status.
  • Your insurance card if you have insurance. If you have private insurance, Medicare, or Medicaid you must provide this information and the lab will bill them. You will not be charged for the test. You do not need to have insurance or a doctor’s note to schedule a test.
  • A well-fitted mask. As healthcare facilities, masks are required at all indoor and outdoor testing locations regardless of vaccination status.

How and when to get results.

  • Most results typically come by email, text, or through the provider’s chosen online portal. Check with your testing provider about how results will be sent.
  • Results are usually available within 48 hours, though it may take up to 72 hours.

If you test positive.

If you test positive, expect a call from Public Health. Our staff is still actively following up on all confirmed cases and will need to ask you some questions. If you receive the call, it is imperative that you pick up and help us with our contract tracing. Thank you!


Have You Heard About WA Notify?

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Information provided by WA DOH.

On Monday, Governor Inslee and the Washington State Department of Health (DOH) announced the launch of WA Notify, a simple, anonymous exposure notification tool to help stop the spread of COVID-19.

What is WA Notify?

Washington Exposure Notifications (also known as WA Notify) is a new tool that works through smartphones, without sharing any personal information, to alert users if they may have been exposed to COVID-19. It is completely private, and doesn’t know or track who you are or where you go.

How does it work?

When you enable WA Notify, your phone exchanges random, anonymous codes with the phones of people you are near who have also enabled WA Notify. The app uses Bluetooth Low Energy (BLE) technology to exchange these random codes without revealing any information about you. If another WA Notify user you’ve been near in the last two weeks later tests positive for COVID-19 and adds their verification code to the app, you’ll get an anonymous notification that you’ve had a possible exposure. This lets you get the care you need quickly and helps prevent you from spreading COVID-19 to the people around you.

How will it help?

Studies have found that the more people who use exposure notification, the greater the benefit. Models based on three counties in Washington state show that even a small number of people there using WA Notify would reduce infections and deaths. Just like wearing masks, physical distancing and keeping gatherings small, WA Notify is another tool to help prevent the spread of COVID-19.

How do I sign up for notifications?

WA Notify is free and can be enabled in iPhone settings or downloaded as an app from the Google Play Store for Android phones. Users can opt out at any time.

Is it safe to use?

WA Notify uses privacy-preserving technology jointly developed by Google and Apple and works without collecting or revealing any location or personal data. WA Notify is based on Google Apple Exposure Notification technology, which was designed to safeguard user privacy. The system never collects or shares any location data or personal information with Google, Apple, the Washington State Department of Health (DOH), or other users. Participation is entirely voluntary. Users can opt in or out at any time.

Once I am signed up, what do I do next?

Additional action is only needed if:
1. You test positive for COVID-19, or
2. You receive a notification that you may have been exposed.

If you test positive, and public health reaches out to you, they will ask if you are using WA Notify. If you are, they will generate a verification code and help you enter it into WA Notify. The code is not tied to your personal information. Public health has no way to know who will be notified by the app about exposure when you enter your code. The notification will not include any information about you. The more people who share their codes, the better we can prevent the spread of COVID-19.

If WA Notify detects you may have been exposed, a notification on your phone will direct you to a website with information about what you should do next. This includes how and where to get tested, information about keeping yourself and those close to you safe, and resources to answer your questions. It’s important to read and follow the directions on the website carefully. The notification will not include information about who may have exposed you or where. It’s completely anonymous.

Why did Washington choose this solution?

Washington formed a state oversight group, including security and civil liberties experts and members of several communities, to review the Apple/Google solution. The group recommended adoption based on the platform’s proven reliability, robust data protection and use by other states.

Visit WANotify.org to learn more.

View a video that describes how WA Notify works:


Case Investigation and Contact Tracing

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Reports from the front lines of Public Health

Over recent weeks, you have likely heard media reports that expanded COVID-19 testing, case investigation and contact tracing are the main tools in combating COVID-19. These efforts are also necessary to safely launch Governor’s Inslee’s phased Safe Start re-opening of Washington’s economy. You probably have an understanding of what is involved in testing, and may know that drive-thru testing has been launched in Skagit (click here for details). But you may wonder: What exactly is case investigation and contact tracing? I called Skagit County Public Health’s Community Health Worker Graciela Ibarra and Public Health Nurse Ian Capron to hear what it’s like to be on the front lines of these efforts.

What is case investigation?

Skagit County Public Health staff contact people who test positive for COVID-19 to provide important guidance and complete detailed interviews. Guidance includes how to safely isolate at home after testing positive or developing symptoms, as well as ways to access resources. Interviewing is a methodical process in which answers are pieced together to create a detailed history of where the interviewee has traveled, eaten, slept, and bathed. These questions focus on other people who may have had close contact with the person interviewed and who are at risk for COIVD-19 infection.

Asking personal questions, especially with someone you just met over the phone, can be a delicate process. Ian notes that people’s responses are “on a continuum.” Graciela adds that people “usually understand this is needed to keep them and others safe.” They may be hesitant to share the names of family members or coworkers. “We reassure them no one has done anything wrong. No one is in trouble or being punished.”

As you have likely concluded, case investigation requires a special skill set – a mixture of calm understanding and a steady focus on the goal of reaching all at-risk contacts. Investigators have to make certain that interviewees are heard and respected while ensuring that people who were possibly infected are identified.

What is contact tracing?

In contact tracing, the same investigation process is repeated in reaching out to those contacts who may have become infected as well. The number of contacts can add up fast and reside throughout the community. However, Ian notes, “Since Stay Home Stay Healthy began and people started physical distancing, the new cases and contacts tend to be in clusters within families or in the community at job sites of essential services.” One success of distancing is this narrowing of where exposures are occurring.

How do case investigation and contact tracing work?

Ian sums it up best: “Case investigation and contact tracing are our bread and butter. It’s the most proactive thing Public Health can do about COVID-19.”

One clarification before we go further: the difference between isolation and quarantine. Isolation refers to when a person separates themselves from others following a positive lab test or when they have symptoms consistent with COVID-19. Quarantine is for people who have no symptoms but have been exposed to the virus and could develop the illness in the 14 days after being exposed. Some people may quarantine and later become ill while others may not.

In short, case investigation and contact tracing:

  • Identify the spread of COVID-19 within the community.
  • Prevent further spread of COVID-19 within the community through reduced contact from people infected with the virus.
  • Provide people who are confirmed to have COVID-19 with guidance on how to successfully isolate so they can keep loved ones, neighbors and other community members safe.
  • Provide people who have been exposed to the virus with guidance on how to quarantine so they can help others stay safe.
  • Linkage to health care which can result in early diagnosis and care to those who need it.

High points and challenges in the day of case investigators and contact tracers

As you might imagine, the workdays of investigators and tracers might have several high points matched by ongoing challenges. The highpoints are obvious – at the end of each shift, public health staff know they have pushed backed against COVID-19 and prevented transmissions of the virus. They hear thanks from the public for the hard work and for keeping people safe.

The challenges tend to involve pre-existing issues affecting interviewees, such as lower income, a lack of resources and prior health conditions. These issues cause disproportionate hardship from COVID-19. Graciela describes a household in which ten family members live together but have only one bathroom, making risk of infection high and isolation all but impossible. Fortunately, Public Health is leasing a motel where people can isolate while other family members can safely quarantine, shortening the amount of time people are exposed to their sick family member. Ian points out that this temporary housing option enables “families to do the best they can” when facing COVID-19.  

Other difficult situations involve quarantine in which some household members work in critical infrastructure and can continue to go to work as long as they don’t have symptoms. Other people in the household have jobs that aren’t in these essential service industries. They cannot work during quarantine, even if they show no signs of illness. The difference in financial impact between those who are working and those who can’t seems unfair and can result in friction. This disproportionate impact is not unlike what is happening in our county and country overall, where the social distancing necessary to save lives results in harsh economic losses to some and little financial impact to others. Needless to say, working right in the middle of such a polarizing issue can be very difficult for investigators and tracers.

Skagit success

Early on, Skagit County Public Health realized case investigation and contact tracing was where it needed to invest its time and effort. The investigation/tracer team expanded quickly by cross training a large number of staff to do this critical work. Ian describes his co-workers’ efforts as “unbelievable,” as they set aside the work they were used to doing and took on a new job for the betterment of the community. This team enables Skagit to do a rare thing in Washington State – contact tracing not only with people diagnosed with COVID-19, but also with close contacts who have also developed symptoms (also referred to as probable cases). More contact tracing strengthens our outreach and ability to prevent spread. Skagit County Public Health also upped its outreach to businesses. Some larger statewide and regional employers have expressed great thanks, noting they had not experienced outreach from public health agencies elsewhere. Working directly with employers is key to promoting on-the-job safety for local workers.

A contact tracer’s advice

When I asked for what guidance they may have for the community, Ian pointed out that some people who later are diagnosed with COVID-19 “thought they just had allergies or a cold. Don’t ignore any symptoms, especially if they get worse,” adding, “but call your doctor first before you go in.” Graciela advises, “Listen to your body. See what it’s telling you. But if you are diagnosed with the virus, don’t let the disease take control of you. Look at media that is positive instead of all the negativity. Let yourself heal.”

More contact tracing info

Want more contact tracing info? Check at the Centers for Disease Control and Prevention webpage at: https://www.cdc.gov/coronavirus/2019-ncov/php/open-america/contact-tracing.html