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Health departments shift focus to high-risk COVID cases

With the state Department of Health discontinuing its COVID-19 contact tracing Virtual Call Center last week, local public health departments are now shifting their focus from calling those who may have been exposed to COVID-19 and recording every positive case to concentrating on vulnerable populations and promoting preventative measures.

Franklin County Public Health Program Coordinator Sarah Granquist said FCPH still plans to monitor all positive cases and to call everyone who tests positive, depending on the department’s case volume, but that the general public should not expect a follow-up phone call or text if they test positive.

She said department staff are especially looking to follow up with people at risk of serious illness who test positive and people in congregate care settings.

Granquist said FCPH will continue to work closely with local school districts.

Essex County Health Department Program Coordinator Andrea Whitmarsh said department staff did all of the county’s case investigation and contract tracing when the pandemic started, but she said they started to rely on assistance from the state VCC team to handle an overflow of cases during the winter of 2020 and 2021. Contact tracing ended a few months ago as cases started to wind down, Whitmarsh said, and now widespread case investigations in Essex County — or calling people to notify them of possible exposures and checking up on those who test positive — are coming to a close.

Whitmarsh said ECHD, like FCPH, wants to narrow the focus of its case investigations for groups at an increased risk of becoming severely ill with COVID-19. She said if there’s a cluster of cases in a nursing home, adult care facility or other developments with at-risk populations living there, ECHD plans to track and monitor those cases to limit spread and overall impact. People who take a lab test should still expect to receive their results from the healthcare provider that administered the test; ECHD was never responsible for communicating test results, Whitmarsh said.

Current statistics

In April, FCPH recorded 639 new cases of COVID-19. Franklin County has recorded 45 COVID-19-related deaths since the start of the pandemic. On Monday, FCPH reported 68 active cases.

Since the start of April, ECHD has recorded 754 new cases of COVID-19 and three new deaths. Essex County has recorded 65 COVID-19-related deaths since the start of the pandemic.

Adirondack Health has reported a consistent flow of patients who have tested positive for COVID-19 over the past month, but usually one or two and never more than five.

Reasons for change

The general decrease in local COVID-19 cases combined with the increase in popularity of at-home testing has decreased the effectiveness of ECHD’s case tracking efforts, according to Whitmarsh. Some people don’t report their results to the health department, she said, and some people might accidentally misreport their test results to the county.

“All of this work kind of loses its effectiveness when we have case numbers where they are, and when people are doing at-home testing and they’re not necessarily reporting the results to us,” she said.

Whitmarsh added that another reason ECHD is shifting its tracking tactics is because there are now more ways to prevent and treat COVID-19 than at the start of the pandemic. She said intervention from local health departments isn’t as effective now that people can get vaccinated or treated for COVID-19, and the health department is shifting focus to preventional methods.

“We’re looking to do that more than limit peoples’ personal freedoms,” she said.

Granquist said vaccination clinics are continuing in Malone on Mondays and Wednesdays from 10 a.m. to 2 p.m.and that people can call 518-481-1712 to make an appointment. Granquist also said some people are coming in for their first dose even now.

Whitmarsh said the U.S. Centers for Disease Control and Prevention considered Essex County as being at a “medium” level of COVID-19 transmission last week. ECHD reported 205 new cases county-wide on Monday, a rise from 180 new cases last week.

Whitmarsh said many counties in the rest of the state — including Franklin and Clinton counties — have a “high” level of transmission right now. She said that despite medium to high levels of transmission statewide, the severity of those cases aren’t comparable to earlier waves of the virus.

“A lot of these illnesses are not severe, and we’re not seeing this huge spike in hospitalizations and deaths — we just haven’t seen that,” she said. “So when we talk about risk, it’s hard to say. We’re certainly not where we were before with delta and the beginning of omicron, that’s for sure.”

People can still expect to see ECHD’s weekly report of new COVID-19 cases, Whitmarsh said. She added that the department plans to continue tracking and reporting the number of cases in the county as long as the state considers COVID-19 a reportable illness and the CommCare database, the system used by state health departments to track lab-confirmed and self-reported positive COVID-19 cases, is still active.

“I think it’s all going to depend on if we get to the point of deciding that this is going to be just like any other type of communicable disease that isn’t imminently impacting public health as a whole,” she said.

People who test positive for COVID-19 with an at-home test should still report their result through the ECHD website at https://www.co.essex.ny.us/Health/covid-19-testing. Positive lab test results will also be reported to ECHD by the lab that administered the test, Whitmarsh said.

People who test positive with an at-home test or a lab-administered test and need documentation of their isolation or quarantine for work can access those forms at www.co.essex.ny.us/Health/isolation-quarantine.

Now that ECHD staff is focusing less on COVID-19, Whitmarsh said the department is returning to some of the “pressing” health matters that were put on the backburner for two years. She said the department wants to refocus on maternal and child health care programming, lead poisoning prevention, chronic disease outreach and other programs the department has historically emphasized.

What to do if you test positive

FCPH says if someone tests positive they must isolate at home for five days after they start experiencing symptoms or after their test date if they do not have symptoms. After five days, if they have no symptoms they may end isolation, as long as they wear a mask around others for five more days.

If someone who is unvaccinated comes in contact with someone who tested positive, FCPH says they should quarantine at home for five days after their most recent contact and wear a mask for an additional five days after that. If they are up to date on their vaccinations they only need to wear a mask for 10 days without quarantining.

Anyone who already tested positive in the past 90 days is not considered a new case and is exempt from isolation and quarantine.

Forms to provide documentation of isolation or quarantine for Franklin County residents can be found at https://bit.ly/3s2b97p.

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