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 informed

A media Zoom meeting was held August 12th, 2020 for our media partners and community. A list of questions was presented to our staff by the media.

Q1 -Can the health department address how the positive cases are added to a county’s list?

There is much misinformation about this on social media. We add a positive case to our list when we get a lab confirmation. Lab confirmed cases represent over 96% of our cases.

In rare instances, a case can be added as an “Epi Link”. This is when someone is symptomatic, has been a close contact with a case, and hasn’t been tested. This represented most of our final 4%. There is an extremely rare instance (less than 1% of our cases), where a case can be added as an Epi Link case even if they have tested negative. Sometimes tests give false negatives, and sometimes people may have tested before their viral load was sufficient for the test to detect the virus. Again, you would have to be symptomatic and a close contact to a case.

Q2 -If a person tests positive, is their entire household listed as positive in the county’s case count?

No. We only add positive cases to our list as detailed above. Most household members would be considered a “close-contact”, but not a case.

Q3 -Can you define the positivity rate?

The positivity rate is the number of positive tests divided by the number of total tests. We can not determine a local positivity rate because we have no way of knowing how many tests have been administered. Doctors’ offices and/or labs are only required to report positive lab results, not total tests given.

The state estimates a 5.87% positivity rate.

Q4 -If a state has 20% positivity rate would that mean in approximately 5-7 weeks most people in that state would have had the virus and their numbers would start to decrease significantly?

I think this question is confusing positivity rate with growth rate. The growth rate is how long it takes the total (not active) cases to double. This is calculated by dividing the number of new cases for a day by the cumulative total cases from the previous day. We don’t keep a daily growth rate, but use a seven-day average growth rate. This “levels” the data. Our growth, as of yesterday, was 1.0296. This means our total case count is projected to double approximately every 33.91 days.

Q5 -Can you define the infection rate? How does the infection rate differ from the positivity rate? I saw the news report that UK tested 1600 students and 12 were positive with a positivity rate of .75%. Does that mean in a random pool of people our infection rate is .75%. I understand if staff were included in this sampling it would have approximated our general population.”

An infection rate (or incident rate) is the probability or risk of an infection in a population. It is used to measure the frequency of occurrence of new instances of infection within a population during a specific time period. The number of infections equals the cases identified in the study or observed.”Hence it is the number of cases divided by the population-We have approximately 5 million reported cases in the US and a population of approximately 350 million -hence the infection rate is 1.4% in the US.

For Kentucky that would be approximately 36,000 cases divided by the population of approximately 4 million =0.9%

We use positive rate for tests ie number of positive tests divided by number of tests done-we know the approximate number for Kentucky but not for any individual counties as the number of tests performed is not reported to us, only positive results. For Kentucky it is approximately 6%.

Q6 -How is the growth rate calculated, and how does it compare to positivity rate?

The “case growth rate” is the rate at which the number of individuals in a population who have the disease increases in a given time period, expressed as a fraction of the initial number, often expressed as a percentage of the number of individuals with the disease.

Q7 -Since we have had a surge of cases in the immediate Lake Cumberland area, (Wayne, Pulaski, Clinton, Russell) in your follow up, what are the main causes of the higher numbers the last couple of weeks?

We are seeing most cases tied to family transmission, then recreation, then businesses, then at medical facilities. Travel related transmission has slowed with the end of vacation season. LTC facility spread, thankfully, has slowed, too.

Q8 -I have a question for this week’s meeting regarding the reason you are protecting others when you wear a mask more than yourself. I think there is still some lack of education and communication regarding the risk of contracting the virus through the eyes which arfe unprotected for most people. I think that is the primary reason it is important for all to wear masks preventing respiratory droplets, etc. from entering the eyes.

Since the primary method of transmission is via respiratory droplets which are wet and heavy and can be expelled several feet from a person into the environment, the mask prevents this from occurring, hence protecting the other person. They also protect the person who is wearing the mask to some extent. We know this is not 100% effective as outbreaks have occurred in places where people wore masks. So yes masks decrease the transmission significantly but are not 100% effective.

Q9 -A story was on the news the other day of a man that was positive for COVID-19 and his case was release when he had a negative test after his recovery. Why was he reported as a death that had complications from COVIC?

Public health focuses on the prevention of the spread of a disease through a population. A person can be released from public health monitoring when they are considered virus-free. That doesn’t mean they are released from “primary care”. They can still have lingering health consequences from their illness, and may even still pass away from those lingering issues.

Q10 -Have you see the church COVID related cases slow down or are they continuing to be a concern?

As of yesterday, we have clusters (more than one case) tied to two area churches. We have had clusters at 11 churches over the last several weeks. Statewide, there are 30 known church clusters at present.

Generally speaking, the churches following the guidance have fared much better than those that were not.

Q11 -It seems there is so much misinformation in the media concerning COVID-19. Who do we listen to and who should we not?

Don’t listen to national news, or social media. National news has turned this into politics. Social media is rampant with people who share their uneducated opinions. Listen to public health. This is our area of expertise. Those with extreme conservative leanings tend to look at the immediate (0.6% of the population have been impacted) and be dismissive. Extreme liberals tend to look at the projections and be alarmists. Public health looks at the percent of mortality (3.3% of known cases) and hospitalization rate (9.6% of known cases) and the growth rate (doubling every 33.91days).

So, if the growth rate holds, and the death and mortality rates hold, where will we be in a month or two? We can see places where hospitals have become overwhelmed. We want to avoid that. We neither want to be dismissive nor alarmists, we want to be cautious and use good sense (wear a mask, social distance, avoid crowds, wash your hands)

Q12 -Have you seen more people in the Lake Cumberland communities following recommendations of the governor and health department now than when this virus started? If so, in what areas?

On any given day it is “hit and miss” how many people are compliant. It does seem we are getting fewer business-related complaints.

Q13 -I am still seeing several businesses in McCreary County not enforcing the mask mandate. Is the health department getting many complaints about these and how is the process going to follow up on those?

While it seems our overall complaints are going down, there is still plenty of non-compliance.