The Oklahoma State Department of Health on Thursday announced a public health advisory to speed up COVID-19 test turnaround times and formally recommend face coverings be used in counties with moderate levels of virus spread.
The state’s seven-day rolling average of new COVID-19 cases has dropped 39% since Aug. 1, and hospitalizations have bounced between about 500 and 650 for about four weeks. Oklahoma’s interim Health Commissioner Lance Frye said the data are encouraging but that now isn’t the time to ease up.
About a dozen cities in Oklahoma implemented mask mandates at different points in July, with cases rising statewide since June.
Does Gov. Kevin Stitt — who hasn’t implemented a statewide mask mandate and often doesn’t wear one himself — credit the downward trend in cases to those face covering orders?
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“I would have to dig into the data, but absolutely. All of that stuff goes into the reason that we’re seeing a drop across the state,” Stitt responded. “The social distancing, the working from home — just Oklahomans being cautious with how we’re fist bumping and staying socially distanced.”
The “Safer in Oklahoma” public health advisory recommends:
• Public and private entities should increase capacity to do more tests and have all test results turned around within 48 hours or less.
• Individuals ages 11 and older in a county in the orange (moderate risk) or red (high risk) of the state’s COVID-19 alert system should wear a face covering over their nose and mouth when social distancing can’t be achieved between or among people not in the same household.
• The State Health Department continue to develop its data collection system to deliver advanced analytics to strengthen the management of COVID-19.
In mid-July, OSDH acknowledged fax machines and manual data entry create challenges that lead to inconsistencies in the movement of test data among health departments, clinics and laboratories.
Dr. Dale Bratzler, chief quality officer at OU Medicine, at the end of July said there had been a “fairly drastic increase” in tests during the prior several weeks, leading to test result delays of seven to 10 days.
Public health officials pointed to shortages in reagents to perform the tests and lack of personnel to carry out the testing process.
Frye clarified Thursday that the public health advisory isn’t a mandate nor does it contain new recommendations. It simply offers the guidance in a more formal manner.
“The good news is the power to slow the virus is within our control,” Frye said. “If we use common sense and simple actions, such as wearing faces masks, social distancing and frequent hand washing, we can decrease viral spread and keep our schools and economy open and keep Oklahomans safe and healthy.”
COVID-19 basics everyone needs to know as the pandemic continues
COVID-19 basics everyone needs to know as the pandemic continues
How it spreads, who's at risk
Studies have shown many infected people show no symptoms or have symptoms so mild they may go undetected; those people can still transmit COVID-19 to About 20% of patients diagnosed with COVID-19 require hospitalization.
The disease can be fatal, especially for vulnerable populations: those older than 65, living in a nursing home or long-term care facility, and anyone with underlying health conditions such as diabetes, heart disease, lung disease or obesity.
Science of virus spread
COVID-19 is spread mainly from person to person via respiratory droplets produced by an infected person. Spread is most likely when people are in close contact, within about 6 feet. A person might also be infected with COVID-19 after touching a surface or object that has the virus on it and then touching their face. According to the CDC, evidence suggests the novel coronavirus may remain viable for hours to days on surfaces, though that form of transmission is said to be minor.
Transmission between people more than 6 feet from one another may occur in poorly ventilated and enclosed spaces, the CDC says, especially where activities cause heavier breathing, such as singing or exercising.
The infectious period for patients can begin up to 48 hours before symptom onset.
List of symptoms
The CDC recently expanded its list of possible symptoms of COVID-19. The symptoms can appear from two days to two weeks after exposure.
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
This list does not include all possible symptoms and will continue to be updated by the CDC. One symptom not included is "purple toes," which someone may experience with no other symptoms, sometimes several weeks after the acute phase of an infection is over. The coloration and pain is caused by a lack of blood flow to the toes caused by excessive blood clotting, a late-stage concern with COVID-19 infections.
Kinds of testing
Those getting tested may experience different kinds of swabs. The viral test, known as PCR, involves a deep nasal swab that can be painful.
Other tests that require less-invasive swabs may produce results faster, but with less accuracy. These should not be used diagnostically.
It is not yet known whether COVID-19 antibodies can protect someone being infected again or how long protection might last.
The 'serious seven'
The "serious seven" refer to close contact environments where residents should take extra precautions if they choose to attend. The seven are gyms, weddings, house gatherings, bars, funerals, faith-based activities and other small events, according to Tulsa Health Department Director Bruce Dart.
Treatments being investigated
The FDA has allowed for antiviral drug remdesivir, previously tested on humans with Ebola, to treat more severe cases of COVID-19 in adults and children. Safety and effectiveness aside, preliminary studies have shown it can shorten recovery time for some patients.
After previously approving an emergency use authorization, the FDA as of July 1 cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial. A review of safety issues includes reports of serious heart rhythm problems and other safety issues, including blood and lymph system disorders, kidney injuries, and liver problems and failure.
Convalescent serum therapy
Some patients are receiving convalescent serum, meaning the antibodies made by people who have recovered after a COVID-19 infection. Antibody-rich blood plasma is being given to severely or critically ill COVID-19 patients, including Ascension St. John, Saint Francis Health System, OSU Center for Health Sciences and Hillcrest HealthCare System in Tulsa.
From June to July, requests for convalescent plasma from the Oklahoma Blood Institute multiplied seven-fold.
Recovery, as defined by CDC
To be considered recovered (without a test), these three things must happen, the CDC advises:
- No fever for at least 72 hours (three full days of normal temperature without the use of medicine)
- Other symptoms improved (no more cough, etc.)
- At least 10 days since symptoms first appeared
