COVID-19 update: “If everyone is wearing a mask, why are the numbers still high?”

By LeAnn R. Ralph

MENOMONIE  — If people are wearing masks to protect others from contracting COVID-19, then why are the transmission rates still high?

Not everyone is wearing a mask, said KT Gallagher, director of the Dunn County Health Department and the county’s health officer, during her weekly update via Facebook Live on December 4.

Wearing a mask reduces the amount of viral exposure and reduces the amount of virus coming from an infected person, she said.

According to various news sources, scientists believe the size of the SARS-CoV2 “dose” at the time of infection can affect how sick someone becomes with COVID-19.

In addition to not everyone is wearing a mask, not everyone is wearing a mask in the right way, Gallagher said, noting that some people wear a mask below their nose instead of covering their nose.

People also are engaging in “super-spreader” events where people come in contact with each other who are not wearing a mask, she said.

As of December 4, the Dunn County Health Department could document 25 people who had been exposed to SARS-CoV2 over Thanksgiving, Gallagher said, since people do not wear a mask while they are eating a meal.

If someone is at the table who is pre-symptomatic or asymptomatic, that person can share the germ and spread it very effectively, she said.

When people are at a tavern, they also are not wearing a mask, Gallagher said.

“We are seeing that high-risk social interactions are being very effective at sharing this germ,” she said.

“We see a ton of spread among family members. I don’t typically wear a mask in my house. My kids don’t either. That’s the kind of spread we are seeing,” Gallagher said.

“If everyone wore a mask when they are indoors, appropriately, covering both their nose and their mouth, tight fitting at the side — very important — not dirty, not wet, not gross — we would have a reduction in transmission,” she said.

“If people chose not to engage in high-risk social activities, like gatherings or going to the bar, we would have a reduction in transmission. I urge you to do those things, and I have for many months,” Gallagher said.

Primary transmission is through close contact with some who is actively sick or is pre-symptomatic. Transmission through touched surfaces, or someone who likes to give wet, sloppy kisses on the cheek, is not the primary method of transmission. The primary method of transmission is through respiratory droplets, she said.

Respiratory droplets are released when people talk, laugh, sing, cough and sneeze.

Close contacts

In response to a question, Gallagher reiterated the definition of close contact.

Close contact can be talking with someone, within six feet of you, for 15 minutes or more, she said.

The Centers for Disease Control and Prevention has updated the definition for close contact, although Wisconsin and Dunn County have been using the updated definition for a long time, Gallagher said.

The updated version of close contact is 15 minutes of cumulative exposure over a 24-hour period, she said.

The possible infective dose of the virus adds up over the day. If you stand by the water cooler talking to someone for five minutes, and then a while later, you spend five minutes talking over the shoulder of that person while you are working on a project, and then at the end of the day spend five minutes standing and visiting with that person — that’s a close contact, Gallagher said.

Quarantine

The CDC and the Wisconsin Department of Health Services have updated guidelines on quarantine for an “abbreviated quarantine.”

The science has not changed. The time between exposure and becoming actively sick is still two to 14 days, Gallagher said.

The CDC and DHS have determined the risk of a shorter quarantine than 14 days does not outweigh the problems of being able to go to work or to school, she said.

The most important part of a shorter quarantine is that people must still do all of the other measures — stay six feet away, wear a mask and engage in good hand hygiene of frequently washing your hands for 20 seconds with soap and water, Gallagher said.

If people have any symptoms, including feeling tired, headache, stuffy nose, coughing, they should stay home and then get tested, she said.

One in every 10 people get sick seven days after exposure, Gallagher noted.

People in Dunn County who had close household contact with people actively sick with COVID-19 have converted to positive upon testing after 12, 13 or 14 days, she said.

“It happens,” Gallagher said.

The new guidelines say you do not have to stay home for the full 14 days unless you cannot stay six feet away from other people or you cannot wear a mask or you cannot wash your hands, Gallagher said.

The risks for people who go back to work or school too soon is that one out of 10 of them will test positive after seven days. There is still a risk for people who have a negative test and go back too soon, she said.

Regarding the antigen tests (saliva) versus the PCR tests (nasal swab), the PCR is still the “gold standard” and gives no false positives and is less like likely to have a false negative, especially if you are tested on day six or later, Gallagher said.

The problem with antigen testing is it can give false negative or false positive results for people who are asymptomatic. The antigen tests are fast, and you can get results in about 20 minutes. But if the antigen test is positive, even though you do not have any symptoms, you should still get the PCR test, she said.

If you abbreviate quarantine from 14 days to 10 days, you still have to self-monitor and not have any symptoms if you go back to work or school, Gallagher said.

You must document that you are symptom-free with no cough, no loss of taste or smell, no shortness of breath and none of the other symptoms associated with COVID-19, she said.

“The gold standard is still 14 days. If you can stay home for 14 days — do that,” Gallagher said, noting that many people will need to have documentation before they can return to work or to school.