A Friend Found Out This Morning That He Tested Positive For Covid-19......

[global1]

He called me to inform me of this and as I questioned him I learned the following.

One of his part-time employees died of Covid about 3 weeks ago. He said the last time he saw the guy was about 3 weeks before he passed. This employee was a 68 y/o Latino. Knowing this - my friend was experiencing a sniffling nose and because he was exposed to a person that died of Covid, he went for testing. This morning - 2 days after he was tested - he got the news that he tested positive. We are in Illinois.

Upon further questioning of him - I learned that he wasn't told to quarantine for 14 days nor was he asked whom he'd been in contact with in the recent weeks.

I'm surprised of that because I thought it was standard procedure to inform a positive test case to quarantine and for them to perform some 'contact tracing' at the same time. You know - ask him whom he's been in contact with recently so they could follow-up with his contacts.

So now I'm wondering - what is the standard procedure and the responsibility of those informing a person of a positive test result?

[albacore]

1. No nation-wide standard procedure.

No national plan. Period.

[sfstaxprep]

3. Yeah, You're Pretty Much On Your Own

That seems like a long incubation time. I bet the employee gave it to at least one other person, and then that person gave it to the friend. It seems like a good possibility he has other employees that are also currently infected.

[MH1]

10. Make America YOYO again

would have been a more accurate slogan for Trump in 2016.

[global1]

9. I Know There's No National Plan - But.....

isn't it just common sense for the health workers that did this testing and reporting of results to give this information to a person that tests positive?

I'm appalled by this lack of providing of such critical information.

We're never going to get out of this crisis - if this is how this is being handled.

[Rorey]

2. The standard procedure

Yeah, we don't have one.

My 17 year old grandson has been in the ICU at Children's Hospital in Denver for 8 days now. He has the symptoms of COVID-19, but has tested negative with the swab thing three times, and also negative with the antibody test. The nurses continue to say that it sure looks like he has it, but they're also confident in the testing at this point. I'm just not as confident.

When he was first in the ICU, they followed protocol for COVID-19. They had the negative pressure thing going in his room and wore PPE. Then they stopped the protocol. Then they restarted it. Then they stopped it again. It boggles the mind.

I just don't think anyone know what the hell to do anymore.

[BComplex]

6. I'm so sorry, Rorey. I know you must be terribly worried and upset.

I hope your grandson finally gets paired with a diagnostician that can figure out what is going on with him.

[Rorey]

8. He's finally doing better - fingers crossed

They're hoping to move him out of the ICU tomorrow. At this point, I'm just as worried about his dad, my son, who has been with him non-stop through this ordeal. He's super careful, but you never know. Waiting at home is his pregnant wife, who is due in early August, and his three year old son.

This morning I tried to convince my son to try to get testing for himself too. My daughter-in-law has been completely isolating with their three year old. It would be comforting to know that my son and grandson aren't going to be bringing the virus to them after this hospital ordeal.

But I'm not convinced that the testing is accurate anyway, so I'm just hoping for the best.

[BGBD]

16. I'm glad he is doing better.

I was thinking about him last night and actually tried to find any posts you had made to update on him since I hadn't seen any in a few days, but I couldn't find them just looking through the pages.

It must be very frustrating to see him that sick and with those symptoms and not be testing positive. It just leaves you in a place where you don't know what to do and the unknown is the worst thing.

I know you had mentioned that he had chest imaging that showed viral pneumonia. That should tell them a lot about the cause of the pneumonia. I have some research findings here that you could look through, but essentially if it were a COVID related pneumonia as opposed to other viral (influenza, adenovirus, etc) there should be some markers that would suggest that.

Results
For all chest CTs, three Chinese radiologists correctly differentiated COVID-19 from non-COVID-19 pneumonia 83% (350/424), 80% (338/424), and 60% (255/424) of the time, respectively. The seven radiologists had sensitivities of 80%, 67%, 97%, 93%, 83%, 73% and 70% and specificities of 100%, 93%, 7%, 100%, 93%, 93%, 100%. Compared to non-COVID-19 pneumonia, COVID-19 pneumonia was more likely to have a peripheral distribution (80% vs. 57%, p<0.001), ground-glass opacity (91% vs. 68%, p<0.001), fine reticular opacity (56% vs. 22%, p<0.001), and vascular thickening (59% vs. 22%, p<0.001), but less likely to have a central+peripheral distribution (14.% vs. 35%, p<0.001), pleural effusion (4.1 vs. 39%, p<0.001) and lymphadenopathy (2.7% vs. 10.2%, p<0.001).

https://pubs.rsna.org/doi/full/10.1148/radiol.2020200823

That doesn't guarantee anything, but if they just aren't sure based only of testing maybe those images should be referred to someone experienced with diagnosing COVID from chest images.

[Rorey]

17. Thank you so much

For the kind words, and for the information.

As long as everything keeps moving in a positive direction, I'll be relieved. But it would still be good to know for sure.

[Rorey]

22. Bronchanoscopy

The respiratory team wants to do more labs and may do a bronchanoscopy, but if they do that, it won't happen until tomorrow. He'll be in the ICU at least another night.

[Ms. Toad]

4. And that's why we're #1

in COVID 19 cases.

What a lack of responsiblity.

In Ohio the standard is 14 days or, if you develop symptoms, the longer of 48 hours from your last fever OR 7 days from the first day of the fever.

[Newest Reality]

5. Wow.

You wouldn't expect that, huh?

We are in a Trump-induced, GOP-backed free fall and I consider it to be intentional until something other then the behaviors and actions indicate otherwise.

[BittyJenkins]

7. I think it starts state to stats and

then it is county to county. Our county does tracing on everyone that is possitve but I am not sure every county does.

[localroger]

11. We are in a very dangerous moment

At this point we have stomped the dragon back with late but decisive measures in places like NYC and NOLA. But this whole reopen thing threatens to reopen Pandora's box on those more rural areas where hardly anybody has been infected yet -- and therefore most of the population remains vulnerable. I was talking to a coworker who lives in rural Mississippi last week who said it was 35 miles to the nearest hospital for him -- a rather small and not very impressive hospital, and while the population density is low there are still a LOT of people for whom that is the ONLY hospital. Some of the other countries that relaxed restrictions are already clamping them back because the infections started to spread again so rapidly. It is the very people who think they're immune because only those hippie libs in the big cities are at risk who are going to get struck next.

[colorado_ufo]

12. I was told to strictly quarantine until I got the results,

which were negative. However, I still "shelter in place" and only go out when I absolutely have to, and then I wear mask and disposable gloves and take hand sanitizer with me. When I get home, every grocery item is disinfected, as well as the car door handle and steering wheel, etc. and the keys. When we get the mail or a package, every piece is disinfected. That's for starters.

Yet, none of this is a guarantee of safety. We just do the best we can.

[BComplex]

19. That's the same ritual I go through every time I go out.

Mail, groceries, door handles, the bottom of my purse if I set it in the grocery basket. The grocery basket gets a sani-wipe, as well.

[hurple]

13. What part of Illinois?

I'm snack dab in the center of the state, and my county has only 3 reported cases while all those around us have many many more times that number.

I've been wondering if we are somehow just some anomalous bubble, or if this county isn't reporting (or isn't testing)

[appalachiablue]

14. AMAZON warehouse workers in NY

were protesting about 2 weeks ago because they weren't informed of a warehouse co-worker who had Covid. Employees from a few other businesses joined in the demonstration.

Workers also weren't receiving any supplies like hand sanitizer, gloves, masks and of course no health insurance from their employer.

[Warpy]

15. The official CDC contact quarantine was/is 14 days

and your friend was beyond that period, so it's likely he was exposed some other way. The average time between exposure and illness is 5.1 days. Outliers beyond 14 days are likely people with multiple exposures.

Since people who look perfectly healthy are transmitting this thing, contact tracing is probably not going to work, especially in the US, where it varies by state. Only large scale testing, antigen and antibody, will allow them to get any real data about this thing, and we know that's not going to happen.

Big baby in DC doesn't like bad numbers.

[clutterbox1830]

18. My friend's father-in-law tested positive and according to his doctor,

he said it was safe for him go back to work since he was asymptomatic. My friend's father-in-law live in NYC.
I ask my friend this can't be true and she swears by it. I told my friend that your FIL needs to get a new doctor immediately.

In short, there is no standard practice given out.

[helpisontheway]

20. My son was exposed to a co-worker that died minutes

after he was with him. He had to quarantine for 14 days.

[KY_EnviroGuy]

21. Global1, I reviewed the AMA's web site and the CDC's site....

regarding suggested doctor's advice for patients knowing they have had exposure and it's clear they should be advised to quarantine for 14 days.

1. From this AMA site: https://www.ama-assn.org/delivering-care/public-health/covid-19-frequently-asked-questions

(snips)

Ethical questions
How do physicians enforce quarantine while respecting patients’ autonomy?

A physician’s primary duty during a public health emergency like the COVID pandemic is to protect the health of the community.

In a quarantine situation, each individual physician’s role is to engender cooperation by communicating clearly and by acknowledging the natural fears and feelings of powerlessness that infectious disease outbreaks create. In some circumstances, however, when persuasion fails and a patient poses a risk to others but won't voluntarily adhere to isolation, physicians should support mandatory quarantine.

The AMA Code of Medical Ethics (E-8.4) states that during a public health crisis, it is a physician’s duty to:

* Educate patients and the public about the nature of the public health threat, potential harm to others, and benefits of quarantine and isolation.
* Encourage patients to adhere voluntarily to quarantine and isolation.
* Support mandatory quarantine and isolation when a patient fails to adhere voluntarily.
* Inform patients about and comply with mandatory public health reporting requirements.

Read more on quarantine from the AMA Journal of Ethics or read the Code guidelines.

The AMA generally defers to the CDC for guidelines.

2. CDC web page on the issue: https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html

See this section: Current guidance based on community exposure, for asymptomatic persons exposed to persons with known or suspected COVID-19 or possible COVID-19

(snip from that table)

Recommended Precautions for the Public

* Stay home until 14 days after last exposure and maintain social distance (at least 6 feet) from others at all times,
* Self-monitor for symptoms: Check temperature twice a day. Watch for fever*, cough, or shortness of breath,
* Avoid contact with people at higher risk for severe illness (unless they live in the same home and had same exposure),
* Follow CDC guidance if symptoms develop.

Therefore, where there are no laws that can be used to force people to quarantine, we have to rely on a doctor's dedication to following the AMA's ethics and "best practice" guidelines.

Sadly, the CDC appears to no longer suggest people attempt contact tracing, likely due to pressure from tRump's administration.

Hope this helps.

KY...............