Novel Coronavirus COVID-19 Frequently Asked Questions

What are the symptoms of COVID-19?
Current symptoms according to the CDC.

Can COVID-19 be treated or cured?
Currently there is no specific treatment for COVID-19, so treatment of the patient’s symptoms is the same regardless of a positive or negative COVID-19 test result.   There is some medications now being used for hospitalized patients as treatment options. 

I tested positive for the COVID-19 virus, when can I go back to being around others?
Symptomatic persons (those with symptoms) can discontinue isolation when at least 10 days have passed since symptoms first appeared, AND after 24 hours have passed since the resolution of fever without the use of fever-reducing medications and improvement of symptoms which may exceed the 10 days since symptoms first appeared.

Asymptomatic persons (those with no symptoms) can discontinue isolation when at least 10 days have passed since the positive laboratory test AND the person remains symptomatic.  Asymptomatic persons who test positive and later develop symptoms should follow the guidance for persons with symptoms.

if I wear a cloth face covering does that mean I don't have to maintain 6 feet of social distance from others?
No, that is not correct. Wearing a cloth face covering is NOT a substitute for social distancing. However, wearing a cloth face covering can greatly reduce your risk of getting COVID-19.

Case and Contact Investigation - Frequently Asked Questions 

How are positive test results from the community reported to the Health Department, do I need to call the Health Dept. or will my healthcare provider do it?
As directed in WAC 246-101, all healthcare providers and laboratories must report certain diseases or conditions to the Health Dept. This is done through a 24/7 secure fax line and “on-call-duty-officers” using a 24/7 answering service.  COVID-19 is one of these reportable diseases.

What is a "close contact"?

A "close contact" is someone who was within 6 feet of an infected person for at least 15 minutes starting from 2 days before illness onset until the time the patient is isolated. If the infected person does not have symptoms, then the time frame starts 2 days prior to the person being tested.

Who reaches out to exposed individuals, CCCHS or the person with COVID-19?
It depends.  During times of high community transmission, CCHHS asks people with COVID-19 to reach out to their "close contacts" and notify them they may been exposed.   Close contacts are asked to follow the instructions in the CCHHS Close Contacts toolkit.   In certain high risk settings, like care facilities, correctional facilities, or inpatient treatment center, CCHHS "contact tracers" will reach out to exposed individuals (close contacts).  

I was contacted by someone from Health & Human Services (Public Health) about an exposure to COVID-19, what should I do?
Please return the call from Public Health by calling 360.414.5599 and choose option 2 in the menu.  This will connect you with a member of our Communicable Disease Team.  They can help you understand what type of exposure you may have had and help you understand what you should do.   They will talk to you about symptoms, testing, and what other steps to take.  After you speak with them on the phone, they will mail and/or email hard copies of COVID-19 guidance to you in case you forgot what was talked about over the phone.  They will talk to you about self-quarantine, and make sure you have what you need to stay home safely.

 If I am contacted by a contact tracer, is it mandatory for me to quarantine for 14 days?
If you are determined to be a close contact of a known case of COVID-19 and are contacted by a contact tracer, you will be strongly encouraged to self-quarantine at home for 14 days in an effort to keep yourself and others safe. This is to monitor for symptoms during the known period that people develop symptoms after exposure to COVID-19, and to prevent new cases from spreading the disease prior them displaying symptoms (persons can spread COVID-19 up to two days before displaying symptoms).  More information including a helpful video are available on our "What to Expect If You have been Exposed to COVID-19" page. 

What is the typical timeframe for CCCHS to begin contact tracing? Who reaches out to individuals exposed to by each case?
Contact tracing begins as soon as a person has been identified as having been in close contact (within 6 feet for more than 15 minutes) with someone who has been diagnosed as positive for COVID-19.  Public Health's aims to contact positive cases within 24 hours of receiving a positive lab result.  During periods of higher community transmission this time may be longer, and there is a possibility that cases won't be contacts.  If you test positive your healthcare provider should give you instructions on how to safely isolate away from other.  CCHHS has also created a toolkit for COVID-19 cases

What happens to my personal information that is given to the Health Department and their contact tracers?
CCHHS must abide by the same patient privacy laws that healthcare providers must follow.  Any information received for contact tracing is considered to be protected health information (PHI) and is treated with the utmost confidentiality like any other medical information. PHI is held in a secure location and only accessible by public health staff that need the information to contact or follow up with someone in relation to COVID-19. 

Why is there a 14-day quarantine when symptoms may last longer?
Most estimates of the incubation period for COVID-19 range from 2-14 days, with an average of around five days. The quarantine period starts from the last known exposure. If you do develop COVID-19 symptoms, quarantine recommendations will change.   

If I am contacted by a contact tracer, is it mandatory that I get tested?
If you are determined to be at risk, or have symptoms, you will be strongly encouraged to contact your healthcare provider for care. If you develop symptoms we would recommend testing, but not require it.  Options for testing are available on the Washington State Department of Health’s webpage for COVID-19 Testing Locations lists testing information by region across the state.

Will everyone in my household, including children be required to to be tested?
If a member of your household is determined to be at risk, or have symptoms, they will be strongly encouraged to contact their healthcare provider for care. Again, we would recommend, but not require testing for close contacts of a known COVID-19 case that develop symptoms.

If my children test positive, do they get to stay in my care?
Yes, anyone, including children will be asked to “self-isolate” at home. Your children will remain with you and in your care.

Do I have a choice to refuse and if I do, will I be fined or subject to jail time? What are my rights during this time?
When someone is a close contact, they are strongly encouraged to self-quarantine. When someone has symptoms of COVID-19, they are strongly encouraged to contact their healthcare provider for testing, and if they test positive to self-isolate at home. There are no fines or jail time associated with any of these activities. If we have evidence that someone is engaging in activities that puts the public at risk (for example, working at a nursing home while contagious with COVID-19, attending large events that put others at risk, or actively trying to spread the disease), the Health Officer reserves the right to order more strict enforcement of isolation. This is the case for any infectious disease including tuberculosis and HIV.

More information can be found on WA Department of Health’s Case Investigations and Contact Tracing webpage  as well as their Medium post Trusted tools in preventing disease.

What is the difference between "isolation" and "quarantine"?
Isolation can and usual IS done at home. Isolation is used to separate persons who have a communicable disease from those who are healthy. Individuals with symptoms who are lab-confirmed cases of COVID-19 and are not sick enough to be hospitalized are directed to care for themselves and isolate at home. If someone is not able to go home to self-isolate (they live with very vulnerable persons, they are homeless, etc.), then there could be a need to find a temporary location for shelter during recovery. 

Quarantine is usually done at home and voluntary. This is for a person that has been in close contact with someone with a lab-confirmed case of COVID-19 while the lab-confirmed case was ill.

If a close contact tests negative, are they able to resume normal activities or must they still wait for 14 days from contact with the Covid19 positive individual?
Even if a close contact tests negative they should still stay out of public places, home from work, etc., for 14 days after exposure. Symptoms can develop anywhere from 2 - 14 days after exposure. Getting tested will only show a "snapshot" what is happening at that moment in time and could change over the 14 day quarantine period.

Are employers required to pay their employees during the time they must be off work to isolate?
Employers are not required to pay their employees during the time they must be off work to isolate, however, some employers are able to do this. There are also other options available such as Washington Paid Family and Medical Leave.   The WA State Employment Security Department has created a useful chart showing the various options. 

Where can I get tested for COVID-19 in Cowlitz County?
COVID-19 testing is ordered at the discretion of local health care providers. Public Health does not provide COVID-19 testing and does not need to approve testing for COVID-19. Positive test results are immediately notifiable to Cowlitz County Health and Human Services.  If someone needs COVID-19 testing, they should contact their healthcare provider.   

In Cowlitz County, people who are uninsured or do not have a health care provider, can contact the Family Health Center to request testing.  Testing should come at no cost to the patient, whether they have insurance or not.

The  Washington State Dept. of Health has a list of testing locations in all counties on their webpage

Current guidance provided by Washington State Department of Health to healthcare providers on the WA DOH provider webpage

When is a person considered "recovered" from COVID-19?
An individual diagnosed with COVID-19 is counted as 'recovered' if, 28 days after symptoms began or a specimen was collected, they are alive and not hospitalized.

Are we testing enough people in Cowlitz County?
As of 10/21/2020, Healthcare providers in Cowlitz County were currently performing just over half of the number of tests per capita as the state average. Because levels of COVID-19 transmission vary between different parts of the state, there isn’t a goal for overall testing in the population. Instead, our testing goal is tied to the ratio between how many tests we are doing compared to the number of cases we identify. The State Dept. of Health goal for this is 50 tests for every one case we identify, which corresponds to a 2% positivity rate. If we are at or below this goal, then we are doing enough testing to identify enough cases to manage the spread of COVID-19 in our community. If we exceed this goal, cases are going undetected and we are less able to control the spread of disease. Based on our 10/21 report, we’ve been statistically at or below the state’s percent positivity level since mid-July, other than our bump the third week of September.

We look at multiple indicators to determine disease activity in the community. For example, if testing decreases and percent positivity increases, we might wonder if testing declines are due to limited supply. On the other hand, if testing rates decrease while percent positivity remains stable or decreases, the decline in testing may reflect decreased demand because there is less COVID-19 spreading in the community. This helps us understand if additional testing is needed.

Our epidemiologist explained this in-depth at the 10/27/2020 meeting of the Board of Health. You may be interested in viewing that video, open the link, click on "10-27-2020 Public Meeting and BOH Zoom”).

Should I get tested for COVID-19 again?
If you test positive for COVID-19, you do not need to get tested again for at least 3 months. People who recover from COVID-19 can continue to test positive for up to 3 months even though they are no longer infectious. Read more from the CDC.

I tested positive for COVID-19, isolated and recovered. Do I need to test negative to return to work or school?
You do not need to provide a negative COVID-19 test to return to work or school IF you did not require hospitalization and at least 10 days have passed since the start of your symptoms, resolution of your fever (for at least 24 hours without the use of fever-reducing medications) and with improvement of other symptoms.

COVID-19 Data - Frequently Asked Questions

How many Cowlitz County residents have been tested for COVID-19?
Cowlitz County does not receive information about all tests performed in the county, however the Washington State Department of Health does receive that information. That information is available on a Cowlitz County specific dashboard located on the Cowlitz County Health & Human Services data reports page.  

Where can I find the most recent case counts?
Cowlitz County Health and Human Services Daily Data Summary page
Washington State Department of Health dashboard
Centers for Disease Control and Prevention website

How are cases of COVID-19 counted in Cowlitz County?
All cases of communicable diseases, including COVID-19, are counted based on where the patient lives. Often times patients seek medical care outside of their county of residence, sometimes even out of state, but ultimately the positive result will be counted to their county/state of residence, even if that’s not where they received testing.

COVID-19 cases are currently identified using a specimen obtained using a nasopharyngeal or nasal swab, and analyzed using a PCR or Point of Care test. These methods look for the presence of actual virus in the nasal/nasopharyngeal cavity, not the presence of antibodies in the blood. Cowlitz County HHS does not receive results from antibody tests for Cowlitz residents.

Cowlitz County COVID-19 case counts only include cases confirmed through laboratory testing, they do not include any individuals that have not had a positive test results. Many people assume that the counts of people identified through contact tracing are included in that count, this is incorrect. Unless they have a lab confirmed positive test result from one of the above methods of testing they are not counted in those numbers.

How are COVID-19 deaths counted? How do we know that someone didn't die of something else?
Each time there is a death reported to Health & Human Services that lists COVID-19 as the cause of death, one of the Cowlitz County Health Officers (physicians) perform a thorough review of the patients medical records. Once that review is complete, if the Health Officer agrees then the death will be counted as a death related to COVID-19. If the Health Officer does not agree that the death is related to COVID-19, then the death will not be counted as a COVID-19 death. This review can take several days, so deaths may not be reported until several days after the death occurs at the end of it.

What are the “Total non-COVID-19 related Deaths” listed on the daily data summary page?
In Cowlitz County, when someone with active COVID-19 passes away, a County Health Officer (a physician) performs a thorough review of the patients medical records from the hospital, other healthcare provider, or the coroner, as well as the death certificate. A death will not be listed as being caused by COVID-19, unless it is clear that was the cause. This review can take several days or even up to a week or more. Once that review is complete, if the Health Officer agrees then the death will be counted as a death related to COVID-19. If the Health Officer does not agree that the death is related to COVID-19, then the death will not be counted as a COVID-19 death.

Deaths reported as “Non-COVID-19 Death” are related to individuals that died of a condition unrelated to COVID-19. While we aren’t able to release the details since it is protected health information, an example of this could be a car accident, a drug overdose, gunshot wound, cancer, etc.

What is a COVID-19 Hospitalization?
State metrics look at two different hospitalization rates to determine capacity and ability to respond to a surge of COVID-19 cases:
   1) Licensed beds occupied by all patients
   2) Licensed beds occupied by suspected and confirmed COVID-19 cases

A person who is hospitalized and tests positive for COVID-19 will require the same precautions and same use of PPE, regardless of the reason for the hospital admission.

Majority of people who are COVID-19 positive and admitted to the hospital are hospitalized due to COVID-19.

Hospitals are testing patients before procedures. If the person tests positive before a non-urgent procedure, the procedure is rescheduled and the patient is never admitted (or counted in the hospitalization number).

Is it true that once a person tests positive, they are tested a second time in a week, and both times they are tested counts as an additional positive case?
No, this is false information. Positive cases counts are unduplicated counts of the number of individual people with lab-confirmed active disease, not the number of positive test results. If a person tests positive more than once, they are only counted once as a positive case, regardless of how many times they are tested.

How many cases are false positives?
The false positive rate of a test is based on three figures: the sensitivity (how well the test correctly identifies people who are actually positive), the specificity (how well the test correctly identifies people who are actually negative), and the prevalence of the disease in the population. Health & Human Services does not currently have these figures.

Misc. - Frequently Asked Questions

How can I volunteer to help?
Cowlitz County Health and Human Services partners with Region IV Public Health Emergency Preparedness and Response for volunteers during public health emergencies. Information on how to volunteer for the Regional Medical Reserve Corps (MRC) can be found on this Clark County Public Health webpageInformation on how to volunteer through the Washington State Emergency Registry of Volunteers (WAserv)
Are there any restrictions for travelers entering Cowlitz County?
Governor Jay Inslee issued a recommendation on Nov. 13 that advises people who are entering Washington from other states (including Washington residents) to self-quarantine for 14 days after arrival. The recommendation does not apply to essential travel between state and country borders. Non-essential travelers are asked to limit their interactions to their immediate household.

On Dec. 21, Inslee followed the travel advisory with a requirement for people who travel to Washington state from the United Kingdom or South Africa to quarantine for 14 days after arriving due to a new variant of COVID-19 that is circulating. People who enter Washington from the United Kingdom or South Africa should get tested if they develop symptoms. If no symptoms develop, they should get tested five to seven days after leaving the United Kingdom or South Africa.

To read the full Nov. 13 advisory, click here. To read the full Dec. 21 proclamation, click here. For the latest travel guidance, click here.

I received the COVID-19 vaccine. Do I still need to wear a mask and avoid close contact with others?
The Centers for Disease Control and Prevention (CDC) currently recommends that everyone continue to wear a face mask, regularly wash their hands and remain physically distant -- even if they have received both doses of the COVID-19 vaccine. Before the CDC decides to change its existing recommendations, vaccine experts need to better understand the protection COVID-19 vaccines provide.
To learn how to protect yourself and others from COVID-19, click here.
What should I know about new COVID-19 variants?
Through mutation, viruses change constantly. New variants of a virus are expected to occur over time. Multiple COVID-19 variants are circulating across the globe. In the fall, new SARS-CoV-2 variants emerged in the United Kingdom and South Africa that appear to spread more easily and quickly than other variants. There is no evidence that these variants cause more severe illness or increased risk of death. Scientists are currently working to learn more. Read more from the CDC here.

Healthcare Providers - Frequently Asked Questions

I am a healthcare provider, where can I find current COVID-19 testing guidance?
Current testing guidance can be found in Washington State Department of Health’s document "COVID-19 Testing Information for Healthcare Providers"

Employers - Frequently Asked Questions

Employers - Frequently Asked Questions
I have an employee who was exposed to COVID-19, what do I do?
If your employee thinks they have been exposed to someone with laboratory-confirmed COIVD-19, they should follow the steps outlined in "What to do if you were potentially exposed to someone with confirmed coronavirus disease (COVID-19)".  Close contacts are asked to follow the instructions in the CCHHS Close Contacts toolkit

Will my business be notified if one of their employees tests positive for COVID-19? If so, how?
If an employee tests positive, once that person has been interviewed and confirmed as a case, if it is determined that there could be close contacts at work, the Health Department Communicable Disease staff may reach out to the employer to determine if there are additional contacts.  

Who is responsible for contact tracing if there is a positive case in an employee at a business?
More information can be found in the Cowlitz County Employer Toolkit - Contact Tracing & Return to Work

Does the employer have a role to play in contact tracing?
If an employee is determined to be a positive case, that person will be interviewed by a public health nurse. If the Health Department determines there are close contacts in the workplace, then the Health Department will work in partnership with the employer to ensure those close contacts are identified and contacted. (Close contacts are defined as anyone who has been within 6 feet of a case for 15 minutes or more while they were infectious)

How can an employer prepare to support contact tracing?
Close contacts are asked to follow the instructions in the CCHHS Close Contacts toolkit.   It could be helpful for employers to be prepared with floor plans or maps of facilities to be able to locate areas where employees may work together or congregate. Depending on the number of possible contacts, lists of people working in different locations onsite as well as those working on corresponding shifts could also be useful. If outside contractors are exposed, lists of those people or entities would also be useful.

If CCHHS determines my employees should be tested for COVID-19, who would perform those tests? Will the Incident Command Team and the Health Department perform onsite testing if there is an outbreak at our facility?
In earlier COVID-19 outbreaks, the IMT and health department performed onsite testing at a local food processing plant. At the time of that outbreak, testing supplies were limited and testing was not widely available. Most health care facilities now offer COVID-19 testing. People who are unable to access testing through their regular health care provider, those who do not have a health care provider, or those who are uninsured can contact the Family Health Center to request testing.  The Washington State Dept. of Health has a list of testing locations in all counties on their webpage

Will the Health Department or some other agency inspect my facility if we have an outbreak?
In earlier COVID-19 outbreaks, the IMT and health department did visit facilities to observe worksites and provide recommendations for worker safety. Now that many businesses are reopening the WA State Department of Labor & Industries (L&I) is involved in worker safety and may contact employers during outbreaks. Information for requesting a voluntary consultation from L&I is available on their website