MONROE — Wisconsin and Green County aren’t following new controversial federal guidance on COVID-19 testing.
The Centers for Disease Control and Prevention (CDC) previously advised anyone with known or suspected coronavirus exposure to get tested. On Aug. 24, the agency quietly revised its COVID-19 guidelines.
The CDC now advises that people who have been in close contact with an infected person for at least 15 minutes “do not necessarily need a test unless you are a vulnerable individual or your health care provider or state or local public health officials recommend you take one.”
The change drew criticism from doctors and epidemiologists, who have long recommended widespread testing, including of those without symptoms, to slow the spread of the pandemic.
The directive to change the guidance came from the White House coronavirus task force, but member Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN he was “not part of any discussion or deliberation regarding the new testing recommendations.”
In June, President Donald Trump wrote on Twitter that increased testing is a “double edged sword — makes us look bad, but good to have!!!” He later called for testing to slow down.
Regarding the new CDC guidance, Green County Public Health Director RoAnn Warden said the Wisconsin Department of Health Services “is not going along with that for right now” and “doesn’t feel that we’re in a situation where we have to limit testing.”
People who’ve potentially been exposed to someone with COVID-19 but may not have symptoms “still should get a test,” Warden said. The goal is to identify and isolate positive cases “as quickly as possible.”
After a surge in late July and early August, Green County still has a high activity level of COVID-19 but growth rate in new cases is “static” and not trending upward or downward, said Warden.
As of Aug. 27, Green County reported 28 active cases, with two hospitalized, 232 recovered cases and one COVID-19 death. Community spread is down, and the majority of current active cases are from spread within a household or from gatherings, Warden said.
The county has had nine outbreaks, as counted by the state, but Warden said none have current active cases.
Four of the nine outbreaks, referred to as facility-wide investigations, are closed. Any workplace or other setting with two or more cases is considered an outbreak. For nursing homes, the threshold for a facility-wide investigation is just one positive case.
Three of the outbreaks were at private food industry businesses. Two were at bars — one in northeast Green County and the other in the Monroe area. Another was at S&B Tubing in Albany.
A birthday party was the source for another outbreak, Warden said.
Finally, both New Glarus Home and Pleasant View Nursing Home have had one employee at each facility test positive, which counts as an outbreak. In both cases, the employee was asymptomatic and returned to work after a period of isolation. Coworkers with exposure to the employees were also isolated as a precaution and have returned to work.
Testing shortages, surges challenge nursing homes
Erin Francois, director of New Glarus Home, said residents and employees at the nursing home are getting tested “as routinely as we can get tests from Exact Sciences.”
The challenge has been getting tests for this kind of proactive testing, as opposed to the reactive testing that occurs when an outbreak or symptoms are already present.
“We are having quite a hard time getting our hands on tests. Whenever we put an order in, we are told if we don’t have any concerns for an active investigation, they’ll put us at the end of the list,” Francois said. “That’s basically been our biggest hurdle, having access to testing.”
Nursing homes are under a federal directive to do proactive testing on a schedule.
“That has been pulled back upon because of the issue with testing supplies,” she said. So far, Francois said, New Glarus Home has had the cost of tests covered by the state.
Francois is a regional director for the senior advocacy organization LeadingAge Wisconsin and said she’s heard that nursing homes in other counties, including Dane and Iowa, are also having trouble getting tests for proactive testing.
That’s a problem because “the only way to really minimize the risk in a proactive way is to regularly test,” she said. “As a provider you want to ensure it doesn’t come into your building.”
Francois said she’s been paying close attention to COVID-19 caseload in Green County as a way to decide when to loosen restrictions for nursing home residents. Residents were allowed outdoor visits earlier in the summer, but then that had to be pulled back when cases started surging earlier in August.
“Isolation is a big issue ... Isolation isn’t good for anyone,” she said.
The facility is tentatively allowing outdoor visits starting the week of Aug. 31. In the meantime, Francois said, New Glarus Home staff are taking residents on outdoor walks and are “just doing the best we can every day for the people that we care for.”
“I think the biggest frustration that we have is we just want everyone to be safe and get this over with so we can resume family visits and business as usual. But it’s difficult when people aren’t wearing masks in public... It’s difficult because you feel like all of these forces are working against you.
“You want your residents to be able to see their families, to be able to hug their loved ones, to be able to see their great-grandchildren. ... You want to give those residents the quality of life that you would want for yourself.”