With confirmed positive cases of the 2019 novel coronavirus, or COVID-19, in the Kaiserslautern and Wiesbaden Military Communities, many concerned community members may be wondering whether or not they have been exposed to the virus if they had contact with infected patients or their families.
In order to dispel rumors and misinformation, Landstuhl Regional Medical Center public health officials want to share the process by which potentially impacted people are identified and notified.
According to U.S. Army Col. Rodney Coldren, chief of preventive medicine for Public Health Command Europe, the community is not at risk from someone who is a “close contact” of someone infected with COVID-19, as long as they are not displaying symptoms themselves.
“The people who came into contact with family members (of infected COVID-19 patients) are at absolutely no additional risk beyond that of being out in the general community,” said Coldren. “Close Contacts of infected COVID-19 patients are quarantined so we can observe them to make sure they do not develop the illness and to rapidly identify them if they do. But these Contacts would not have been infectious prior to being placed in voluntary quarantine.”
WHAT IS A “CLOSE CONTACT?”
When someone is confirmed as infected with COVID-19, U.S. Army Lt. Col. Laura Ricardo, chief of Preventive Medicine and the COVID-19 public health nurse lead at Landstuhl Regional Medical Center, and her team of public health nurses first instruct the patient on isolation requirements, whether in the home or at a healthcare facility. They then immediately begin a process called Contact Tracing, which is kicked off with a notification to the patient’s (or sponsor’s) unit commander, the garrison Public Health Emergency Officer (PHEO) and the host nation public health authorities.
Next, the public health nurses begin by asking the infected patient about his or her activities and the people around them since the onset of symptoms began. The purpose for this initial stage of questioning is to identify a “Close Contact.”
According to the Center for Disease Control and Prevention, close contact is defined as:
a) Being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case
— or —
b) having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on)
“Close Contacts can be family members, coworkers, friends and healthcare providers,” said Ricardo. “People truly need to understand the difference between being a contact, and coming into contact with the infected patient.”
In accordance with the CDC definition of close contact, Ricardo explains that being a Contact requires both time and distance.
“You may have passed by a person with COVID-19 in a hallway, in which case you did come into contact and meet the distance criteria,” she explained. “But if you truly just passed each other, and the infected patient did not cough, sneeze or wipe his or her hands on you, then you don’t meet the ‘prolonged time’ requirement and therefore are not at risk of COVID-19 exposure.”
Once a Contact has been identified, the Contact Tracing process continues with notification measures.
WHAT HAPPENS AFTER A “CLOSE CONTACT” HAS BEEN IDENTIFIED?
The COVID-19 Public Health team will call all of the Contacts to discuss symptoms and provide instructions on isolation or quarantine.
“When we ask you to isolate, we mean that you should have your own bedroom and bathroom, and if you live with someone else, that you not go to any other part of the quarters except those two rooms,” said Ricardo. “Quarantine, on the other hand, means that you simply restrict your movement and stay within your living quarters, except to those areas where you may have another family member in isolation.”
Ricardo noted that even in quarantine, household members should continue to practice safe social distancing, or keeping at least six feet of separation between each other. Family members who are in quarantine with someone who is isolating in another part of the living quarters are able to deliver food and other items to the infected patient, but must thoroughly disinfect any products that are exchanged (e.g., used dishes, soiled towels, and clothing), and follow up with proper handwashing.
During the isolation or quarantine period, the public health team will connect with the infected patient and Contacts for temperature and symptoms checks, and to discuss follow-on treatment options.
DIGNITY AND RESPECT
For Ricardo, the importance of remaining calm and treating each other with respect is paramount.
“COVID-19 has all but taken over every conversation and action happening in the military community right now,” she said. “However, it is critical that we remember that those who are infected with COVID-19, and the Contacts who have been asked to quarantine, are still people. We should be respectful toward one another, and treat them and each other with empathy and compassion. With how quickly the virus spreads, any one of us could be the next to contract COVID-19 so we need to remember to be decent human beings.”
Military community members living in Germany who are concerned about their exposure risk to COVID-19 should call the TRICARE Nurse Advice Line at 0800-071-3516 to discuss any symptoms and seek advice on further instructions for care. Or visit https://rhce.amedd.army.mil/Families/nurse_advice_line.html for more NAL contact information. As always, if your conditions are life-threatening, please call emergency services or visit the nearest emergency room.