Widespread testing for COVID-19 is a strategy that works in the first phase of a pandemic – containment. But that’s not where North Carolina health officials are now. WHQR speaks with New Hanover Regional Medical Center Epidemiologist Dr. Paul Kamitsuka about what this mitigation phase means.
RLH: Can you explain how the process is supposed to work? If we hear, for instance, about a family member or perhaps an entire family in a household testing positive, but they didn't get their positive results, of course, until after schools had closed, they'd come in contact with a bunch of people, maybe at school and other places. How would officials trace their contacts? And how does the quarantine process work?
Dr. Paul Kamitsuka: That's a good question. And again, everything has sort of changed since we have community spread here in North Carolina. Health departments are being instructed not to do that kind of contact tracing just because it's already widespread. So what I had mentioned earlier that anybody who becomes sick should self-isolate would apply in that situation. And everybody who's not sick yet should be sort of, but who is the contact should be taking their temperature twice daily, paying attention to whether they're having symptoms, a fever, and then develop respiratory symptoms. And then if so, then they would also self isolate. And if they are ill enough, then they would be calling their provider for advice.
RLH: I still get confused about this because I do understand we're in the mitigation phase, but if there are people walking around who are carrying the virus but are asymptomatic, but because they're asymptomatic and don't know they have the virus, isn't that just helping it spread faster and instead of flattening the curve, doing the opposite?
PK: Well, what you'd have to do to really use that strategy to try to prevent cases would be to test basically everybody and on a regular basis. And then put the patients on quarantine. We just don't have the resources to do that. In this community, for example, we don't even have a rapid test yet. Now we're waiting for a rapid onsite test.
And as of just three days ago, the quickest we were getting test results of was five or six days. Uh, now we're down to one day. It would be sort of a logistical nightmare at this phase of things too, to be testing everybody. It would be far better if we all assume that we might have it, and pay close attention to whether we're developing any symptoms, and if we develop symptoms, we automatically self isolate. That's the most effective way in the mitigation phase of epidemics that's been shown to be helpful.
RLH: Is there anything else, Dr. Kamitsuka that we haven't talked about that you think we should?
PK: Well, I think it's hard to get this message out in terms of not panicking. I think that if we understand what we're supposed to do and we adhere to it, we will get the best results. And that means adhering to the social distancing part of things. Also, if we are sick with a fever and lower respiratory symptoms, contacting our provider for advice, and that advice may be, put on a mask and come on over to the hospital, if the patient is sick enough to merit that. But if we all do all those things, then I think that the number of people who would be severely affected by this from a health standpoint of view really can be mitigated.
RLH: Dr. Paul Kamitsuka, thanks so much for joining us today.
PK: Sure, my pleasure.
You can catch a much more in-depth conversation with him on the next CoastLine -- Wednesday, March 25th at noon. You can also email your own questions about – and experiences with -- the coronavirus. Send them to coastline@whqr.org – to be answered by New Hanover County’s Director of Emergency Management.
