March 30, 2020

Multnomah County’s Communicable Disease Services program works to reduce the spread of disease by supporting individuals who have contracted or been exposed to certain reportable diseases. The introduction of COVID-19 has put a spotlight on a centuries old function of public health.

Communicable Disease Services works to reduce the spread of disease by supporting individuals who have contracted or been exposed to reportable diseases.

Our team of disease detectives is doing what it always does, and is scaling up quickly. Key goals of disease investigating are to understand the disease and its spread better, to identify contacts who may have been exposed, and to help contacts and cases access any needed prevention advice, testing, or treatment.

Role of local public health

Multnomah County Communicable Disease Services does prompt follow up with individuals who are confirmed to have COVID-19. As part of its investigation, a communicable disease nurse or epidemiology investigator will ask where that person has been and who they have been near.

Communicable Disease Services determines the risk of disease transmission for those contacts; public health considers someone at higher risk when someone has face-to-face contact for a  prolonged time. If an individual has high risk of exposure, is vulnerable to severe illness, or works in a setting that could expose others who are vulnerable (like health care), the Health Department will notify those people and educate them about possible symptoms.

With some exceptions, people who have been exposed but are without symptoms are not generally asked to stay home from work. 

The health department may reach out to employers for information or notification. For example, if public health learns that there is a significant risk of transmission to multiple people in a high risk setting, such as a long-term care facility, it would reach out to that facility. Employees may also choose to disclose their diagnosis to employers. 

On March 23 the Oregon Health Authority changed its investigative guidelines regarding COVID-19, to accommodate an increase in cases and prioritize those people at highest risk, including older adults living in a long-term care facility.

Multnomah County has transferred three disease investigators from other county programs and is adding more than a dozen public health graduate students and on-call nurses to the COVID-19 team to support the increased case investigations, allowing Communicable Disease Services to continue reaching out to every individual who tests positive for COVID-19 and follow up with close contacts.

Health guidance

Unless someone was in close proximity or has symptoms of respiratory illness, there is no recommendation that an individual who feels well isolate themselves. That said, the state is currently under a “Stay Home, Save Lives” executive order and people are advised to limit being outside their households unless otherwise necessary. 

Health officials know this virus is in the community, and that’s why they are asking everyone to follow standard tried-and-true health recommendations.

Know when to seek care

If you have no cough, fever, or other signs of illness you do not need to seek care or testing. But keep in mind that even if you are feeling well, physical distancing is absolutely necessary to slow the spread of COVID-19. Everyone needs to protect those most vulnerable to severe illness

Make sure to practice everyday prevention. That means staying home unless it’s absolutely necessary, washing your hands regularly, cleaning frequently touched surfaces and taking extra care if you are someone at risk of complications from this virus.

If you feel ill

If you start to feel sick — especially with a fever and cough — stay home and do the things you normally do to feel better: sleep, rest, drink plenty of fluids. 

If you need to seek care, call your doctor before going to the clinic. 

If you have COVID-19 or think you may be ill with the virus, do not take public transit. If you need urgent care, get a ride from someone in your household. If your symptoms are life-threatening call 9-1-1.

Take care at home

Most patients with COVID-19 can receive the care they need at home, as mild symptoms of COVID-19 may be similar to a cold or the flu: runny nose, cough, low-grade fever and aches.

When someone at home has confirmed or possible COVID-19, one person in the household should act as the main caregiver. That person should not be among those at higher risk for complications from this virus.

The risk of catching a virus from a sick person is highest for the direct caretaker, but everyone in the home should take precautions to limit risk and monitor health regularly to watch for development of similar symptoms.