21 October, 2020

Missoula City County Health Department COVID 19 Daily Briefing 04 13 20

Hi my name is Cindy Farr and I'm theincident commander for the Missoula City County Health Department's COVID 19response.

Today is Monday, April 13th and this is my daily briefing.

We've had a total of 32 cases to date in Missoula.

30 of those cases wereidentified by testing and 2 were what we call epi-linked.

We've had 24 cases thathave recovered and that leaves 8 active cases.

At this time, we'remonitoring 155 close contacts who are in quarantine and over 1270 tests have been performed in Missoula County.

The state has had total of 394 cases and there have been 7 deaths in the state with 1 inour County.

So I just mentioned that we have two cases that areepidemiologically linked or epi-linked and I just want to take a moment to explainwhat that means.

Up until this weekend, all of the casesin Missoula County were found through laboratory testing and as you've heardfrom me before when we find out that someone tests positive, our public healthnurses make sure that they isolate and then they start a case investigation.

They identify the person's close contacts and confidentially reach outto those people and ask them to quarantine.

Then the nurses followup with everyone twice a day until the 14-day incubation period has expired andif a close contact develops symptoms in the 14-day incubation period, we try toconnect them with a health care provider for confirmatory testing and.

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excuse me sorry I'm having a little bit of allergies today.

However, since sampling resources are tight, we can use a caseclassification that is well established in epidemiology to consider the person acase without actually testing them.

This practice is pretty regularly used inoutbreaks from everything from pertussis to E-coli so with COVID 19, we know thesymptoms, the onset and then it passes from person to person and being a closecontact to someone with a confirmed case of COVID 19 and then later developingsymptoms within that incubation period can be enough to consider them epilinked but unconfirmed case.

So for those of you who might be worried that thismight hinder our Public Health response or that it meansthere's less follow-through, don't worry, it doesn't.

The biggest hurdle isidentifying the cases so that we can have that person isolate.

That stillhappens with epi linked cases.

So as far as exposure or risk to the public topublic's health there isn't an increased risk.

What thisdoes change is how things are actually reported out to you.

So we want to betransparent and report all cases and not just the lab confirmed cases so whatyou'll notice now on our website is that there are going to be two categories ofcases: positive COVID 19, which are the number of people who are laboratorytested and then epi linked, which are the people with COVID 19 who are not labconfirmed.

If you just add those two numbers together then you're going toget the total number of cases from Missoula County.

But I do want to pointout that our our state health department website is only going to be listing thelab confirmed cases so our numbers are going to be just a little bit differentthan what you see on the DPHHS State Health Department website.

So on Friday, the staff working to enforce the Governor's directives closed fabricsfabric and hobby stores.

We know that there were a lot of people who are upsetabout this and they feel that this move didn't make sense in light of the CDC'srecommendations for cloth face coverings.

I just wanted to discuss how and whythis happened and again provide clarification on CDC's guidanceincluding some really important points that I think people might be missing.

Iwant to start off by saying that our department originally interpreted theGovernor's directives to include these businesses in the essential category.

Thehealth department staff worked with those stores to minimize the risk tocustomers and employees.

However, another Montana County asked thestate for a legal opinion on this and that legal opinion came down at the endof last week.

It stated that these businesses are not considered essentialit said and I quote: “The directive is to slow the spread of COVID 19 to thegreatest extent possible while ensuring that people self isolate in their placesof residence to the maximum extent feasible while enabling only essentialservices to continue.

Characterizing craft and hobby stores as essential businesses on the basis that a de minimis amount oftotal materials sold might be used by others to assemble masks would frustratethe purposes of the directive.

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” End quote.

Once we got this legal opinion, we had to change course and ask those stores to close.

I think that while thislegal opinion may frustrate people, it's really important to consider what it'ssaying.

The governor's stay at home directive that required non-essentialbusinesses to close had the objective of keeping people at home as much aspossible to avoid unnecessary congregation and to support socialdistancing.

Social distancing and staying at home are the best preventive toolsthat we have to slow the spread of COVID 19.

The CDC's face coveringrecommendation was never meant to be in place of social distancing and it's notdeemed to be effective on its own.

To dismiss social distancing to getsupplies to make face coverings goes against that objective.

As we'vediscussed before, cloth face coverings are not personal protective equipment orPPE for the person wearing the cloth face covering.

They're meant as anadditional as additional tools to prevent people who don't have symptomsfrom exposing others when social distancing is not possible.

So let's talkonce again about the face covering recommendations.

The recommendationwasn't that everybody needs to sew masks.

That was not not at all.

Therecommendation was that people should cover their mouth and nose with somesort of cloth.

The recommendation is to use a cloth face covering and it doesn'tneed to be sewn or made specifically for this purpose nor does it need to have acertain shape to be effective.

A bandana, a scarf, many of the other things thatyou might already have at home can definitely be used and you don't need togo to the fabric store, learn how to sew to make this happen, especially if socialdistancing goes out the window.

If you're passionate about doing this, you candefinitely still order supplies online while adhering to social distancing oruse curbside pickup at Walmart, a store that it's still opnewhich also has fabric.

So I just wanted to make sure that we are just reallyclear on that.

That you know we did have to change our recommendations for thosefabric stores based on the legal guidance that came down from theState Health Department but that does not necessarily mean that you can'tstill make masks if you get fabric from another another place.

But it is reallyimportant to just remember that it doesn't have to be a mask that you useto cover your face.

You can use anything that you happen to have on hand andavailable and that that is meant to protect other people from you in theinstance that you might have this disease and just not be having symptomsyet.

So that's all I have for my daily briefing.

I will talk to you all againtomorrow.

Thank you for everything that you are doing to keep our communitiessafe.

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