When Portland resident Jessica Rogers Hall contracted COVID-19 for the third time last month, she followed the advice of the Oregon Health Authority.
When she felt really bad, she isolated herself. And a day later, when she started feeling better, she put on a mask and returned to her job as a life coach for people experiencing homelessness.
Her friends and colleagues, including a restaurant worker and an airline pilot, also tested positive around the same time. Oregon Recommendations: People with fever and other debilitating symptoms stayed home for several days, then returned to work.
Rogers-Hall believes Oregon is taking the right approach by telling people that life doesn’t have to stop if you get the virus. Specifically, as long as you have not had a fever for 24 hours and your symptoms have improved, it is safe to go out even if you are infected with the new coronavirus. Officials are simply asking those infected with the virus to avoid people with weakened immune systems and wear a mask for 10 days.
“COVID-19 is everywhere,” Rogers-Hall said. “Life goes on. It must go on.”
Four years after the first coronavirus cases reached Oregon and the rest of the country, public health officials are still figuring out how best to live with the virus. last mayOregon was the first state to deviate from that direction. Centers for Disease Control and Prevention recommendations Anyone who tests positive for coronavirus must stay home for at least five days and wear a mask for an additional five days.
But Oregon’s policy went unnoticed by many until last month. California has followed suit. and many more national public debate It exploded not only among epidemiologists but also among the general public alike. Many people are thinking about the following questions: Since the coronavirus is so mild for most people, is there no need for the public to stay home even though they may still be contagious? Additionally, should public health officials celebrate residents returning to daily activities such as work, school, public transportation, gyms, stores, and social gatherings?
this week, The Washington Post reported The CDC could follow the lead of Oregon and California in revising its guidelines in the coming months, possibly releasing its ideas for public feedback in April. The move would be seen as a more pragmatic approach to what people want at a time when the coronavirus no longer poses a serious threat to most people due to vaccinations or past infections. right.
Dr. Melissa Sutton, OHA’s medical director for respiratory pathogens, said the virus is so widespread that it became clear that so few people were actually testing for COVID-19 that Oregon He changed the guidelines months ago and said asking a small number of people to isolate “raises serious problems”. This places a burden on workers and school children. ”
Oregon is one of the slowest To recover from the learning loss caused by the pandemic.
“Isolation is a policy typically used when the public health goal is to contain infection,” Sutton said. “That’s not our goal.”
Sutton said today’s goal is to “help Oregonians make informed decisions to protect themselves from serious infectious diseases,” including those at high risk. This includes advising people to get tested if they have symptoms and to take antiviral medication if they test positive.
In January, an average of about 250 people were hospitalized each day in Oregon with the coronavirus, and more than 60 people died from the virus that month, a fraction of the number at the height of the pandemic. Ta. However, this remains a serious public health concern, especially for those at highest risk of complications.
Sutton said public health officials have not noticed any difference in Oregon’s hospitalizations and deaths compared to other states in the nine months since the state lifted its five-day quarantine guidelines. But Sutton said she doesn’t have data on whether the number of mild or moderate cases of the virus has increased compared to other states because states are no longer tracking that information.
Oregon’s position is news to many.
Many Oregon residents appear to be unaware of Oregon’s recommendations. The Oregonian/OregonLive asked 30 people they encountered on the streets of Portland and found that 4 out of 5 still believed anyone should quarantine if they tested positive, regardless of their symptoms.
People who told news outlets they knew about the state’s new stance were more likely to work in the health care field, get information from their child’s school, work in education, or read an OHA newsletter outlining the policy. He said he learned about it through a very special route. One person who works at a bakery said her employer told her of Oregon’s recommendations. The hope was that Oregon’s new policy would help ease labor shortages by encouraging staff not to take too many sick days.
Conversely, some of those interviewed said they had mixed feelings about going to work, especially in the restaurant industry, even though staying home would mean losing pay if they tested positive. told The Oregonian/OregonLive. However, a significant percentage also said they would not go out even though they knew they were infected with the new coronavirus.
Jen Grove Heuser said when she, her husband and their 10-year-old daughter contracted the coronavirus last fall, she quarantined her husband for two weeks. She said the situation would not have changed even if she had known that the Oregon Health Authority advised people not to do so.
Her daughter, who had the mildest symptoms of the three, only had symptoms for two days and was completely fine after that. But in an effort to break the chain of infection, Grove-Heuser sent her girl home from school for a week, then put her mask on and sent her back, she said.
Because otherwise, says Grove-Heuser, I think if we all do our bit to protect others, we can bring this problem under control. ”
But, he added, “I feel like other people don’t feel that way.”
Grove-Heuser’s neighbor, Patricia Riley, agreed to stay in the house. “It’s public health etiquette.”
Even life coach Rogers Hall, who tested positive for the virus last month, said he thinks it’s OK to go out with COVID-19 as long as people wear masks, but it’s a high risk. He said he is concerned about Oregonians. As soon as she found out she had the virus, she posted on social media telling people in her downtown Portland condo building and the building next door that she was in the elevator, I was alerted that I was in the laundromat and luggage storage room. The day before – so you may want to get tested if you develop symptoms.
“It was more of an act of kindness,” she said. “There are some elderly people living here.”
Myrna Gatlin lives a few miles away in the Bethany area of Washington County, but she is among those at high risk because she has a weakened immune system. Over the past few years, she has taken great care, including getting vaccinated, but she finally contracted the virus last month, she said, days after visiting an outpatient surgery center. There, she said, she felt uneasy about people coughing and sneezing without masks in the waiting room. .
“I’m very angry with Oregon,” said Gatlin, who was aware of Oregon’s latest advisory. “It could stall Oregon.” “You can walk around and be like Typhoid Mary, carrying the virus but showing no symptoms and spreading the virus around. It’s ‘Go to school, you’ll be fine.’ Go to work, it’s okay. ”
She said her medical condition made her ineligible to take the antiviral drug Paxlobid.
“I wish I was one of those people who felt this was like a mild cold. It felt like I had been hit by a bus,” she said. “I’ve never been sick like this before.”
Some medical experts say it’s unlikely she was contagious after all this time, but five weeks later she still tested positive, has congestion, coughs and is in isolation. she said. She said she is grateful that her employer, the city of Portland, allows her to work from home.
“I’m not going anywhere,” Gatlin said. “I don’t want to give it to anyone.”
Public health experts weigh in
The Oregonian/OregonLive asked three experts in Oregon, Washington and California what they thought. All have backgrounds in public health, epidemiology, and medicine. And all are from West Coast states that have been among the most coronavirus-wary in the nation during the pandemic.
Ali Mokdad, a professor and epidemiologist at the University of Washington, called it “courageous” that Oregon was the first state to end its coronavirus quarantine recommendation. He doesn’t think it’s a good idea to only ask people who have gone out of their way to get tested to confirm they have the virus to stay home, so similar measures are being implemented not only in Washington but across the country. He said he supports it. That’s a small number, he said.
“Twenty people in each office are infected with coronavirus, and they don’t know it,” Mokdad said. “Then why do we need to punish that man?”
Dr. Esther Chu, a professor of emergency medicine with a master’s degree in public health from Oregon Health and Science University, is not enthusiastic about Oregon’s latest recommendations. She understands that this may be a public health breach. People who do not have a fever may go out, but if they do, they must wear a mask.
A better approach, she says, is to decide whether it’s wise to get tested. If you are positive, please stay home.
But she understands that many people don’t want to pay for an at-home test or deal with the potential consequences.
“People don’t want to deal with the limitations that come with knowing a COVID-19 diagnosis,” Chu said. “Because I think there’s still, in some situations, a social expectation that people who have COVID-19 don’t come to parties. So it’s like, ‘Don’t ask, don’t tell.'”
Dr. Abrar Karan, an infectious disease expert at Stanford University, said he wants people to heed new guidelines to wear high-quality, well-fitting masks after testing positive. Even if he hasn’t had a fever for 24 hours, May still be shedding virus.
And Curran said, “Just because your symptoms are improving doesn’t mean you’re no longer contagious. That’s outrageous.”
If you are sick, best practices are to test, isolate, and wear a mask.But he said recommendations It is a waste If most people didn’t follow it. So the policies in Oregon and California may ultimately have the best outcome by encouraging people to wear masks at all times, at least if they develop coronavirus-like symptoms. He said that there is. Masks may also protect others from diseases such as RSV and influenza.
“I think the big takeaway is that even if you’re not in isolation, you can stop ongoing transmission,” Curran said.
— Amy Green; [email protected]; @o_aimee
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