COVID-19 “close contacts”: remaining aware during breaks

COVID-19

Steph Walters, MD, MPH & Paul Overvoorde, PhD; Infectious Disease Task Force Co-Chairs

We, along with the rest of the world, are surrounded by a rising third-wave of the coronavirus pandemic. In Minnesota, the number of daily reported cases have reached record highs and some colleges or universities have seen case counts shift from a handful to multiple dozens within a week. 

Closer to home, the number of coronavirus cases in the local Macalester community remains in the single digits. We recognize and applaud the way that members of our community have taken seriously the practices of maintaining 6-feet physical separation, wearing masks and using good hand hygiene. We encourage the continuation of such efforts. 

Given the unpredictable nature of the coronavirus, the coming weeks and scheduled breaks call for an awareness and vigilance about what constitutes a “close contact.” At the community level, minimizing the number of those we consider to be close contacts — whether friends, family, or strangers — will help mitigate viral spread. 

This week, the Centers for Disease Control and Prevention (CDC) updated the definition of a close contact to be “someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.” Viral spread can happen in this period before someone feels ill. Although it might appear arbitrary, the time and distance used to define a close contact reflects the on-going collection and analysis of scientific data.

Knowledge of what constitutes a close contact aids in understanding the contact tracing process, which helps minimize viral spread. In the event that you were to test positive for COVID-19, each of your close contacts (as defined above) would be required to quarantine for 14 days. Likewise, if one of your close contacts were to test positive, you would quarantine for 14 days. There is no testing out of quarantine. A negative test is reassuring, but it remains a snapshot in time and unfortunately doesn’t shorten the time of quarantine. This two-week time period accounts for the fact that the rate of viral replication or the development of symptoms varies from one person to another. We also know that recent estimates from the CDC indicate that up to 70% of individuals do not develop symptoms.

From a public health perspective, minimizing the number of close contacts increases the likelihood that those who might have been exposed can be identified and quarantined, thereby containing viral spread. In addition, a small number of close contacts means that those impacted (e.g. missed class, inability to work, etc.) by a positive case is reduced. 

Both college communications and media sources have variously referred to the formation of “pods.” Creating a pod should involve a conscious choice and open conversations with others about behaviors, level of risk and open communication. This truly is an example of practicing everyday consent. In some instances, college communities like Macalester have worked to establish “bubbles,” a sort of assembly of pods based on some common definitions and practices. Our Mac Stays Safer Community Commitment is an example of such an agreement. Because the coronavirus continues to circulate, however, a range of traditional everyday activities (e.g. shopping in-person, manicures, hair appointments, use of public transport, dining out, etc.) present potential breaches to both a pod and a bubble.

As circumstances and individual behaviors change, the likelihood of pods or bubbles being broken increases. The approach of the module break, the understandable desire to physically connect with family or friends and the upcoming holidays create particular concerns for our community. In addition to the rising number of cases, the recent shift in weather will have us spending more time indoors and perhaps physically closer to one another. 

As we move into the coming weeks, let us not forget the “why” behind our investment of mental, social, and emotional energy. These efforts protect the most vulnerable (e.g. differently abled, elderly, folks with historically marginalized identities, etc.), prevent the healthcare system from becoming overwhelmed, honor the role of essential workers, and recognize the differential impact of the pandemic on those with fewer resources. Some of us fall within the category of “most vulnerable” to the virus, and nearly all of us have a loved one who does. Each time we limit the number of close contacts, or alter an event to meet physical distancing recommendations, we contribute not only to protecting those we hold dear but also to the greater good.  

Finally, remember, there are truly so many things we still can do that are safer. Reread the definition of close contact, re-imagine what breaks from school, hosting visitors or visiting others might look like. Outdoor adventures, air-hugs, warm conversation, eye contact, empathy, smiles — these are all still possible. Please don’t lose sight of that, even as we make adjustments and sacrifices to slow the spread of the coronavirus. The Macalester community may look and feel different right now, but our commitment to one another has never been more important.

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