Recovery

As of May 5, 2020, Macon County has no active positive cases of COVID-19.

COVID-19 is such a new virus, we are still learning about the recovery process. A person who tests positive is asked to self-isolate to help prevent transmitting the disease to others until being deemed “recovered”.

The CDC offers multiple guidance strategies for when isolation can end based on whether the person was symptomatic or asymptomatic.  In either case, public health works closely with the Department of Health and Senior Services throughout the entire disease process.

Symptomatic people that test positive for COVID-19 can fall under either of the following strategies to determine recovery:

• Symptom-based strategy
  • At least 72 hours have passed with no fever without the use of fever-reducing medications, and, improvement in respiratory symptoms such as cough or shortness of breath; and,
  • At least 10 days have passed since symptoms first appeared.

• Test-based strategy
  • 2 negative COVID-19 tests completed greater than 24 hours apart; and
  • Resolution of fever without the use of fever-reducing medications, and,
  • Improvement in respiratory symptoms.

Asymptomatic people that test positive for COVID-19 can fall under either of the following strategies to determine recovery:

• Time-based strategy
  • At least 10 days have passed since their first positive COVID-19 test, and,
  • No symptoms have developed.
• Test-based strategy
  • 2 negative COVID-19 tests completed greater than 24 hours apart.

These strategies may result in different timeframes for the discontinuation of isolation. The decision to discontinue isolation will be made by working closely with your local health department.

We are still learning about the COVID-19 disease process and how long a person is contagious. This is why there are multiple ways to determine when isolation should end. Symptoms cannot always be used to determine where the individual is in the course of their illness because each person can respond differently to the virus.  The time it takes a person to work through the disease process, from onset of the disease to shedding it, depends on a number of factors including a person’s general health.

Viral shedding is a process that occurs when the virus copies itself inside your body and is then released by your body into the environment. When viral shedding is occurring, the person is considered contagious. We are still learning about viral shedding of COVID-19. Research shows that viral shedding of COVID-19 could be happening before symptoms start and while the person is symptomatic. This is why it could possibly be longer or shorter than 10 days after the confirmation of the first positive test before they can discontinue isolation. We are still learning about the viral shredding process after the symptoms discontinue or for someone who has been asymptomatic.

With COVID-19 being a new virus, we will continue to learn about the disease process in the weeks and months to come.  What we do know is that until a vaccine is developed, following social distancing guidelines and continuing to protect our vulnerable family and friends is the best way to contain the spread of COVID-19 and keep our community healthy.

On April 30, 2020, Macon County Health Department staff and trustees, city government officials, mayors, county government officials, law enforcement agencies, prosecuting attorney, economic development and the chamber of commerce held a conference call to coordinate and discuss Macon County’s reopening starting on May 4, 2020.

The reason for the conference call was to discuss Governor Parson’s guidelines set forth in his “Show Me Strong Recovery Plan” and to decide how that would be presented in Macon County.  It was of general agreement among all present to follow the Governor’s guidelines for reopening.  The guidelines allow all businesses and places of worship to reopen, as long as they follow social distancing guidelines (6 feet from others). Businesses that cannot maintain social distance, like salons and spas, can open while putting in other safety practices to help both the employee and customer.

A strong focus is being placed on personal responsibility of individuals and businesses to practice and promote social distancing.  Social distancing will help prevent the spread of COVID-19 from person to person to help promote the health and safety of our community and businesses.

It was in agreement to put into place two stricter requirements in Macon County to help further protect the health of our community.  These requirements will be formalized by the County Commissioners to take effect through May 31, 2020 and then will reevaluate as phase 2 of reopening occurs.

First, there will be no unpackaged, self-service, ready to eat food options. This will include salad bars, buffets, food cases (for example, donuts and pizza), self-service food stations at events and other similar practices.  Being able to clean and disinfect these stations properly between each person could be difficult and could be hard to maintain.  Second, it was decided at mass gatherings and events, there will be a six-foot aisle between chairs and tables will be kept to a maximum of 10 people.  This requirement will still allow gatherings and events to take place, but will help everyone in attendance maintain social distancing and avoid overcrowding.

Places of Worship can reopen for in-person services beginning on May 10th.  They are to make sure there is a 6-foot distance between families sitting in services and it is recommended multiple services be held (if necessary, depending on size) to allow for proper distancing between families.  Practices that would normally encourage touching are strongly discouraged, like handshakes and hugs. Those that are feeling ill or vulnerable, should consider not attending an in-person service until they are feeling better to help protect themselves and others.

The Macon County Health Department has put together recommended guidance documents for businesses, places of worship and events, that can be used to help make decisions on procedures to put into place when reopening.  These guidance documents can be found on our website at www.maconmohealth.org.

All precautions and restrictions put into place during this reopening are to help protect the health of our community and its members.  COVID-19 has been affecting all age ranges, no one age group is untouchable or invincible.  We have seen in Missouri that the number of cases and deaths from COVID-19 have been highest in older populations, especially those 80 years and older.  There is no data from Missouri, but the CDC has also stated those who are immunocompromised with other health conditions are at larger risk for complications from COVID-19.  Social distancing will help the community protect these vulnerable populations by shielding them from coming into contact with the virus.  Anyone in these vulnerable populations should also consider taking this reopening slower, perhaps continuing to stay home and when going out for non-essential services, to take extra precautions to stay healthy.  Social distancing may not be 100% effective at preventing someone from becoming ill from COVID-19, so take caution when going out and who you surround yourself with.

As we reopen, we encourage you to visit these places responsibly, follow the distancing guidelines (6 feet from others) and other restrictions put in place to protect your health and the health of the businesses.

If you have any further questions or concerns regarding the reopening process, regulations for businesses or as a community member, please reach out to the Macon County Health Department at 660-395-4711.

Missouri’s Stay at Home order is set to expire on May 3, 2020, then Missouri will have to determine how to reopen.

Reopening the economy after the Stay at Home Order is a complicated procedure that has a lot of questions and uncertainty, but we do know however we reopen, we expect it will happen in phases.  Opening in phases means we will gradually reintroduce people back to each other and the community rather than all at once.  These phases are expected to be staged and to meet data standards in order to move to the next phase.  Research shows phases can help mitigate the chance of COVID-19 resurgence and protect our community, especially the most vulnerable to complications.

No matter how we reopen, the number of cases will increase.  As we reopen and start to come into contact with more people, our risk to be infected and ability to infect others will increase.  We just have to be cautious to not move through these phases too quickly and undo what was accomplished through the Stay at Home order.

Without the Stay at Home order, we do not know the strain COVID-19 would have put on our hospitals and healthcare systems.  The worst-case scenario would have been what we saw in other countries and states where hospitals were bombarded without enough supplies to provide the best care that everyone needed.  The Stay at Home order contained the spread of COVID-19 so healthcare systems and hospitals could prevent the instability, put policies in place and build a response.

Healthcare systems, hospitals and first responders are all short on personal protective equipment – meaning gloves, masks, gowns, everything they use to protect themselves from patients so they can provide care.  Without the correct personal protective equipment, medical providers and first responders are all at risk of getting ill and would then be unable to provide the necessary care. The Stay at Home order gave time to help systems, the state and federal government time to address the personal protective equipment shortage and come up with a solution.

The Stay at Home order also gave local health departments time to build the capacity to conduct contact investigations.  Each person who tests positive must have a contact investigation done per Missouri State statue.

A contact investigation is where every person who has had direct contact with a person positive with COVID-19, is contacted by the health department to let them know of the possibility they were infected.  It has been determined a person is contagious 48 hours before a person began to show symptoms of illness, so they have the potential to have been in contact with a large amount of people.  Each person who may have had close contact with a positive case of COVID-19 becomes a person under investigation (PUI) who is then placed under quarantine to watch for symptoms, which can take up to 14 days to begin to show.

Contact investigations can take a lot of time and man power, especially for smaller health departments, so having an overwhelming number of these without a plan and the time available could have caused an enormous strain on health departments.

Each PUI is placed under quarantine for 14 days to watch for symptoms and each positive person is placed under isolation until they meet the criteria to be recovered.  All are asked to self-isolate and quarantine, but sometimes it takes the health departments and even local law enforcement to enforce for the health and safety of an entire community.

Ultimately, the Stay at Home order and social distancing guidelines were put into place to help protect the residents of Missouri.  Not only did it allow health systems to prepare and plan for an unprecedented pandemic, it also helped slow the spread of COVID-19 by limiting person to person connections.

Now is the unprecedented step of reopening the State of Missouri from the Stay at Home order and determining what phases and how quickly these phases should be put into place in order to protect our healthcare systems, hospitals and residents of Missouri, while trying to get back to a way of life we are all used to.

Governor Parson is expected to release guidelines for counties to follow when opening up their economies.  Macon County leaders will use these guidelines in determining how best to open up business and commerce while maintaining the health of Macon County citizens.

 

On April 16, 2020, Governor Parson announced he would be extending the statewide Stay at Home order until May 3, 2020.

Dr Randall Williams, the Director of the Missouri Department of Health and Senior Services has issued a state wide Stay at Home order for the State of Missouri.  This order will go into effect on Monday April 6, 2020 at 12:00 am until Friday April 24, 2020 at 11:59 pm.

The order states –

1. Residents should not leave their home or place of residence except for essential functions like accessing food, gas, prescriptions, health care and other necessities.
2. If you should have to leave, you must practice social distancing, keeping at least 6 feet between yourself and others
3. Essential workers should continue to work but shall adhere to social distancing at their place of work
4. Retailers should limit the number allowed in their facility
5. Residents of Missouri should avoid social gatherings, planned or spontaneous, of 10 or more people
6. Schools shall close and remain closed
7. Residents should avoid eating at dine in residents, but drive thru and carry out are acceptable
8. People shall not visit nursing homes, long term care facilities, retirements home except to provide critical care
9. All state office buildings are closed to the public

The order allows residents of Missouri to carry out essential functions and receive essential services.

Read the full order – Stay at Home Missouri Order

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📱  Go to the Apple store and search “Apple COVID-19”

💻  If you do not have an apple device, but have internet access: https://www.apple.com/covid19/