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How the Indiana Department of Health is monitoring people possibly exposed to coronavirus

Avon schools, health officials discuss COVID-19

AVON, Ind. (WISH) — With four confirmed cases of coronavirus in Indiana and reports of individuals and families quarantining themselves after possible exposure, Indiana State Health Commissioner Kris Box on Monday explained some of the processes in place for monitoring the virus in Indiana.

Box’s comments came at the end of a news conference where Avon Community School Corporation announced closure of its two schools for two weeks, ahead of its scheduled, two-week spring break. On Sunday night, an Avon elementary student tested positive for coronavirus, and a second student in the district began showing symptoms of the virus.

As Box urged families to treat the time the schools were closed as a period for “social distancing,” she discussed other people in self-quarantine around the state and ISDH’s efforts to keep them healthy and cared for while limiting their interaction with people not exposed to the virus.

Cases and testing in Indiana so far

The first case in Indiana, confirmed Friday, is a person in Marion County who had traveled to Boston in late February for a BioGen conference. The second case, confirmed Sunday, is a person in Hendricks County who was also tied to that conference. And late Sunday night, officials confirmed a student at an Avon elementary had tested positive. Those three people were self-isolating. A fourth case, announced Monday, is a person in Noble County who is hospitalized.

In total, the Indiana State Department of Health has tested 32 people, including three people whose tests were sent to the Centers for Disease Control and Prevention, the department said Monday afternoon.

Box said the state is following CDC guidelines and testing “individuals that are hospitalized with severe lower respiratory illness with no other indication of what’s causing that, individuals that are high-risk, especially individuals that are in a high-risk setting and may have been exposed to COVID-19 and then those individuals that we know were exposed to COVID-19 that we are on watch for, to make sure that if they develop signs and symptoms.”

Box also said the state is making sure that health care professionals who develop symptoms will be tested.

People possibly exposed

When asked about how the department was investigating and tracing the “web of individuals” who may be exposed, Box said:

“It starts with an individual maybe that flew back, say, from Boston and was exposed there. So what flight did they fly on? And we get that information to the CDC. Then the CDC gets information back to us about individuals that live in our communities, that sat within a certain radius of that individual who became ill. Those are people that we’re following up. If we have a particular case, we’re going, ‘Where were you, pretty much every minute of the day?’ … so that we can start to trace back close contacts of that individual. Again, this is usually spread with someone that you came into contact within 6 feet, not just for a brief period of time but a protracted period of time. And then we actually reach out to those individuals to make sure they know they may have been exposed and if those individuals potentially develop symptoms, how they can reach us to facilitate medical care.”

People are returning to Indiana from countries and states with confirmed cases and are being told by the Centers for Disease Control and Prevention to self-quarantine. ISDH does not get names and numbers for all of those people “because those numbers are actually overwhelming with so many countries involved in this now,” Box said.

Confirmed cases

The state instead follows “individuals that are isolated, meaning that they have tested positive for COVID-19 and we know that they are stuck in their home. They may need resources from a medical perspective. They may need someone to deliver medicine or food to them and they may be separated from the rest of their family because they’re isolating from their family also,” Box said.

“We actually make sure that they have things like Tylenol and Motrin and a thermometer and a sheet to actually record this and then we usually virtually touch base with them so a lot of times that’s over a cellphone where we can look at them and ask, you know, ‘Have you developed shortness of breath? Has your cough gotten worse? What has your temperature done in the last 12 hours?” Box said. The department usually checks in with those individuals twice a day, she said.

Minimizing exposure

Box encouraged anyone who is ill to practice social distance, especially those who are at higher risk, including elderly individuals. She also suggested that you consider helping people in your community who need supplies from stores or doctors but may be staying at home to avoid possible exposure because they are at high risk.

Box discouraged people who are sick from visiting any kind of long-term care facilities, calling them “a collection of our highest-risk population, under one roof.”

Box said eventually “we’ll all get to the point where we just kind of live with COVID-19 as a part of the infections that we get during this flu season time probably.”

“What we see with global disease right now across the entire world is that children that get COVID-19 do very well with it — but they are great spreaders, that’s the problem — their mortality rate with that is below influenza. So that should be reassuring I hope to families out there.”

Resources for people with possible symptoms

Box recommended people who think they have developed symptoms reach out to their own primary care physicians as a starting point and reiterated that people should not go to emergency rooms but instead reach out by phone about symptoms.

If you’re a concerned citizen but are not exhibiting symptoms, you’re encouraged to first visit the ISDH and the CDC websites to get initial questions answered and allow people with possible symptoms to use the state hotline.

The state hotline is being staffed by 10 people from 8 a.m to 8 p.m. and then staffed by another group from 8 p.m. to 8 a.m., Box said. The Poison Control group and the state Epidemiology team is working to field those calls, as well as to contact health care providers.

The state will also use IU Health’s telehealth services as needed to answer questions and determine whether someone has symptoms that mean they should be tested.

Anyone who experiences symptoms such as fever, cough, shortness of breath, have a recent history of travel to China or have had contact with someone suspected of having coronavirus is asked to call the ISDH Epidemiology Resource Center at 317-233-7125, or call 317-233-1325 after hours. You can also email epiresource@isdh.in.gov.