First case confirmed in Clinton

Health and local officials confirmed last Friday during a press conference that the COVID-19 pandemic had, in fact, reached into the boundaries of Clinton County.

Lake Cumberland District Health Department Director Shawn Crabtree, speaking to a small gathering Friday afternoon in the Clinton County Courthouse upstairs courtroom, announced that the first patient to test positive for the virus who lived in Clinton County had been confirmed.

“We do have a case in Clinton County,” Crabtree announced early in Friday’s 30 minute gathering.

Although further pinpoint details were not given as to the demographics of the new patient, he did indicate that the case involved a resident who likely lived near the Clinton County – Wayne County boundary.

“We thought last night that this was going to be a Wayne County case, but when we used GPS, it actually was a Clinton County resident,” Crabtree said. “So we are announcing it as a Clinton County case, although this person probably spends most of their time up in Wayne County.”

From there, Crabtree explained that the investigation into the patient and habits had immediately moved forward.

“We have reached out to Clinton County today, we have begun our case investigation, we have identified the close contacts with the patient.”

Crabtree went on to explain that the patient had been isolated and the people who had been in close contact with the patient had, in fact, been quarantined. Those quarantine orders would remain in effect for at least 14 days, he noted.

The LCDHD Director at first said that the time difference between the patient getting tested and receiving word of the positive results had been about three weeks.

However, he later recanted that assessment through an email that was forwarded to the Clinton County News, in which he explained that he had made the error by looking at the wrong line on the case report.

“The lab results were actually reported within four days of the specimen being collected,” Crabtree said. “I apologize for this error.”

He added that at the time of Friday’s press conference, the patient’s symptoms were not severe enough to require hospitalization, but instead the patient had been isolated at their home.

During Friday’s press conference Crabtree further explained the notion of flattening the curve by saying that officials were expecting more cases to surface in all of the 10 counties in the Lake Cumberland Health Department district, but the goal was to prevent a multitude of people from becoming infected at one time.

“When we talk about flattening the curve, we are trying to prevent too many people from needing to be in the hospital at once,” Crabtree said. “There is no cure for this and we expect it is going to run its course through this community, but we don’t want it to run its course so quickly that too many people get sick at once and can’t get into the hospital.”

He reminded the public to continue to practice social distancing practices when out in the public, but he also urged that people should not leave their homes and go out into the public unless it is absolutely necessary to seek essential items or health care attention.

Lucas Abner, Director of Clinton County Emergency Medical Services, also spoke briefly during Friday’s conference, also urging the public to continue to practice social distancing.

In addition, Abner explained again that if someone did call 911 requesting an ambulance, be aware that dispatchers would be asking questions about the patient’s condition, and to not be alarmed when the ambulance crew showed up in personal protective equipment (PPE), noting the extra precautions were being taken in order to protect the patients as much as it was being done to protect the ambulance crews themselves, as well as the general public.

He explained that in consideration of this highly contagious virus, he had to consider that an ambulance run with a possible infected patient, could be followed next by a run by that same ambulance and crew to the local nursing home.

“We’re taking added precautions, we’re wearing personal protective equipment, we’re disinfecting our trucks between runs, as we always do, but we’re going a little more in depth now with some extra bleach and disinfectants.”

He added that crews are given health screenings when they arrive for the beginning of each shift,and those screenings are repeated before the employees leave at the end of each shift.

“We’re there to help you and if you feel you need 911, that’s what we’re there for,” Abner said.

He also noted that daily updates would be given to the public via the Clinton County Emergency Management Services Facebook page as new information becomes available.

Abner also asked the public to also please understand that neither he nor his staff would be able to answer the many questions that the public is asking through the Facebook page, noting that there were simply too many questions and too little time to respond.

COVID-19 Question and answer meeting with

LCDHD officials

A media Zoom meeting was held on April 1, 2020 for media partners and community of the Lake Cumberland District Health Department

A list of questions was presented to the LCDHD staff by the media. Those questions, and the answers given are provided in the following article for the readers of the Clinton County News.

The media updates are presented weekly and the Clinton County News will continue to participate in those briefings so we can better keep our readers invovled.

The LCDHD panel consisted of:

Stuart Spillman, Environmental Health Director

Amy Tomlinson, Public Health Preparedness Manager

Laura Woodrum, Director of Nursing

Tracy Aaron, Health Education Director – moderator

There have been reports this past weekend of home improvement stores being overrun and some churches still holding public gatherings.

? What level of compliance have you seen across the district in adhering to social distancing and closures?

Stuart: That is correct, however, since the Governor personally contacted the home improvement store corporate offices they have taken extra steps to ensure their employee and customer safety and to improve social distancing in the store. As far as churches, we are hearing of some in-person services.

We are imploring churches not to do this. We have a case in Pulaski County where people attended church and now 11 of their members are sick with COVID. If you go to church, contract the disease, and then go to the store you are putting others at risk. We are begging the religious community to find other ways to conduct worship rather than in-house, in-person services.

? Are there specific types of businesses or gatherings that are of specific concern? How is the health district responding to violations and do you have any specific details: cease orders in each county, etc?

Stuart: We are getting great compliance overall. The vast majority of people are following the guidelines set forth. We are making visits to anywhere we get a complaint on to ensure the guidelines are being met. We have had to issue very few cease orders and most places seem to want to follow the guidelines to protect themselves, their employees and their customers.

We’ve made a lot of the first Pulaski County case attending church the Sunday before becoming ill and how several new cases were identified from there.

? Has the department determined how she may have contracted the virus? Had she traveled recently?

Amy: We now have 11 cases that were due to contact at a church. Because this was the first “reported” case, does not necessarily mean it was the first case. Our investigations are still ongoing and we’re working to determine as much about these exposures as we can.

? Throughout the district, how many patients have been hospitalized?

What are their statuses now?

Amy: Right now, we are aware of seven cases that are hospitalized. Two are in critical condition and one is listed as stable condition. Three cases are still being investigated and their conditions are unknown.

? Has there been any additional word on when mass testing will begin in this area? How many kits do we have as opposed to how many are needed?

Amy: Any estimation would only be a guess at this point. Resources are being rerouted and made available to support testing as widely and broadly as possible. Even when drive through testing does become available, I anticipate there will still be a screening process and testing will be prioritized for those at highest risk.

? How is the PPE situation for hospitals and other providers in the district?

Amy: There are still shortages for many local providers. Hospitals and EMS agencies, for the most part, have been prioritized and have enough PPE to make do for the time being. PPE levels are being constantly monitored. Burn rates are being calculated, but are dependent on the numbers of cases we are seeing.

? How many ventilators are estimated to be available here?

Amy: There are between 50-75 ventilators within the region. These can be requested from facilities and redirected to areas of need.

? Do you have enough data yet to determine if Kentucky’s efforts to flatten the curve have been successful?

Amy: Kentucky is certainly appearing to do better than neighboring states. I do believe this is due to the aggressive actions the state and local governments have taken.

? Has the department gotten any reports of local prescribers stockpiling pharmaceuticals rumored to treat COVID-19?

Amy: We have not received reports of pharmaceutical stockpiles being created.

? What does it means when a patient is released from quarantine?’

Dr Weyman/Laura

LCDHD is following guidelines from the CDC & Kentucky Department of

Public Health. When a positive COVID19 case is identified they are placed under isolation.

Isolation-separates sick people with a contagious disease from people who are not sick. Stay home and keep their distance from other household members

When a person is identified a contact of a positive COVID19 case they are placed on quarantine.

Quarantine-separates and restricts the movement of people who were exposed to a positive case to determine if they will become sick. The incubation period can last 14 days (average people develop symptoms around day 5-6) after exposure.

Quarantined individuals will self monitor for symptoms while separated from others. If the quarantined individual develops symptoms they will then be placed in isolation and seek additional guidance from their healthcare provider.

When a positive case is released from isolation they have been-

At least three days (72 hours) have passed since recovery defined as resolution of fever without the use of fever reducing medication and improvement in respiratory symptoms and at least seven days have passed since symptoms first appeared.

? What does this mean for the status on the other resident(s) in the household?

The household contacts still have to quarantine 14 days from the last date the positive case was symptomatic.

COVID – 19 Information from Lake Cumberland District Health

Department

The virus is thought to spread mainly from person-to-person:

• between people who are in close contact with one another (within about 6sixfeet).

• via respiratory droplets produced when an infected person coughs or sneezes.

• droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Personal Prevention Measures:

• Wash your hands often with soap and water. If soap and water aren’t readily available, use an alcohol-based hand sanitizer.

• Avoid close contact with people who are sick with a fever, coughing, sneezing, and having difficulty breathing.

• Avoid touching your eyes, nose, and mouth.

• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

• If you are over 60 or have underlying medical conditions that may make catching the disease more dangerous, please stay home as much as possible at this time.

• Purchase several weeks worth of medications and supplies in case you need to stay home for prolonged periods of time and to decrease the number of trips to purchase supplies.

Community Prevention Measures:

• Practice social distancing of at least six feet from others in public.

• Implement environmental surface cleaning measures in homes, businesses, and other locations.

Wipe down frequently touched surfaces and objects. Use regular household cleaning spray or wipes as recommended by the CDC.

• In following with Governor Andy Beshear’s order, no social gatherings such as church services, funerals, weddings, etc. will be permitted.

• Retail businesses are closed except for those exempted by the Governor’s order. Those that remain open must observe social distancing for staff and customers. Restaurants are closed except for drive-through and delivery. No dining room service is allowed.

What to do if you feel ill:

• If you have developed a fever or respiratory symptoms and believe you have had exposure to a known case or traveled to an area with community spread, isolate yourself from others in your home and call your healthcare provider or local health department to describe your symptoms and any recent travel before you go to the healthcare facility.

• If you feel ill enough to need a doctor’s care, please call your healthcare provider prior to showing up at their office. If you want to be tested for COVID-19, call the provider to see if they are offering testing prior to going to their office. All providers will screen you for symptoms prior to deciding to do further testing. Many providers will require a flu and/or strep test prior to testing for COVID-19. No testing is being done on non-symptomatic patients. If you feel you need emergency treatment, please call the hospital prior to arrival to alert them to your symptoms.

• Stay home when you are sick. Do not leave home until you have been fever-free for at least 72 hours without any fever-reducing medication, your other symptoms have improved, and at least seven days have passed since your symptoms first appeared.

LCDHD Response:

What we have done:

• Implemented our Department Operations Center and are at a level 1 (full activation)

• Provided frequent updates to our Board of Directors, local community partners, media, and the public.

• Received two distributions from the Strategic National Stockpile (SNS) and delivered Personal Protective Equipment (PPE) to Emergency Operation Centers

• Reduced our health department clinics to essential services only.

• Provided information packets to all primary care physicians in our region with information on COVID-19.

• Provided information packets to most/all local businesses.

• Helped to monitor PPE inventory at local hospitals.

• Analyzed outbreak models to assess projected community health care needs and local health department capacity.

• Residential mailing sent out giving information on COVID-19.

• Provided local businesses in our district with packets containing information on COVID-19.

• Met digitally with local nursing homes to provide guidance and recommendations for active cases.

• Met with personal care homes and jails to provide prevention plans, guidance, and recommendations on a future first case.

What we are doing:

• Performing case and close contact investigations and issuing isolation and quarantine orders for positive COVID-19 cases and high-risk close contacts of confirmed COVID-19 cases.

• Responding to issues of non-compliance with the Governor’s order to close down businesses specifically told to shut down for a period of time and also operating businesses not complying with precautionary measures.

• Providing weekly meetings to update the media and public on COVID-19 in our region.

• Evaluating local hospital ventilator and isolation room capacity.

• Planning for mobile testing centers once test kits are available in our area.

• Planning for mass immunization clinics once a vaccine is available in our area.

• Plan to reach out to theAmish community to share COVID-19 guidance.

To help answer questions, the Kentucky Department of Public Health has created a hotline to answer questions at 1-800-722-5725. Additional information can also be obtained by going to their COVID-19 website at https://chfs.ky.gov/agencies/dph/pages/covid19.aspx

The CDC also has a COVID-19 website that can be reached here:

https://www.cdc.gov/coronavirus/2019-nCoV/index.html

Lake Cumberland District Health Department’s website can be reached here:

https://www.lcdhd.org

The Kentucky Department of Public Health hotline can be reached at 1-800-722-5725.