It could take 4-8 weeks to see benefit of ‘Safer at Home,’ Haushalter says

Testing totals will continue to be choppy, health department leader says

By , Daily Memphian Updated: March 25, 2020 6:29 AM CT | Published: March 24, 2020 9:42 PM CT

Editor’s note: Due to the serious public health implications associated with COVID-19, The Daily Memphian is making our coronavirus coverage accessible to all readers — no subscription needed.

The quiet that descends on the city now as nonessential businesses are closed is imperative for the fight in what is still an early epidemic here, according to the head of the health department.

“The community-based orders to stay at home are going to have significant impact. And what people do in the workplace is also going to have significant impact,” said Alisa Haushalter.

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For days, stories of people going to work sick have been rampant. The onus needs to be on the employer, she said, to end this means of transmission.

<strong>Alisa Haushalter</strong>

Alisa Haushalter

“If someone comes to work, and they’re ill with fever or cough, they should be sent home and not be allowed to be in the workplace,” she said Tuesday afternoon.

The test of will ramps up Wednesday when only the essential will report for work. It could be two months before the stay-at-home effort is visible in limiting the spread.

Under the infection model experts are using for coronavirus, the number of cases is expected to double every five to seven days.

The disease is progressing at that rate in Shelby County, making it necessary for the county and municipal mayors to issue their own safer-at-home edicts.

Shelby County had 135 cases as of Tuesday afternoon.

Masks are now recommended for people with chronic illness and “maybe even seniors,” Haushalter said.

While President Donald Trump said Monday he will reassess the need to keep the economy on lockdown next Monday, when the initial 15-day period ends, Haushalter and other medical experts here say it will take longer for the infection to work itself out.

“We would anticipate that you have to go through anywhere from two to four incubation cycles to see significant impact,” she said. “You are talking at least four to eight weeks before we begin to see these particular efforts around safer at home having impact. My personal opinion is that it would be difficult to return to normal within two weeks.”

Dr. Martin Croce, chief medical officer at Regional One Health, worries that people will get impatient with the process “and look upon it as punitive, when in fact, it will be lifesaving.”

“It will be a temporary nuisance in order to save more lives,” Croce said.

A new CBS poll out Tuesday found that a large majority — 72% — of Americans think it will take months or longer for the virus to be contained. Only one-fourth think containment will come in the next few weeks.

The University of Tennessee Health Science Center’s work to build a fast-turnaround testing station continues at Tiger Lane, where about 190 people have been tested since it opened Saturday.

The university wants to be able to read the results in its labs, cutting down what is now a several-day wait for results that people must spend in self-isolation. For now, it using commercial labs.

In early health department calculations here, positives were running about 3% of those tested. 

“That means a significant number of people had to remain at home for three to five days for the results to come back. With the rapid test, you will know immediately in your provider’s office, and you can take appropriate steps,” Haushalter said.

There continue to be inconsistencies between what is reported here and what the state reports for the county. She blames it on hiccups with private labs not reporting results here within the state-mandated 24 hours.

And locally, the health department has not reported the total number of tests given in Shelby County.

The state health department, for the first time Tuesday, included the data in its report. Of the 11,144 tests administered, 667 were positive, a rate of 6%.

To complicate matters, reporting is expected to get more difficult because tests expected to be available nationally in a week will allow people to test at home and take the samples to a lab.

“I think it’s fair to say that we’re going to continue to have some ups and downs on reporting what tests were done, or the number of tests and the number that were positive,” Haushalter said.

Cases here can still be traced to travel, both in and outside the region.

“Then, once they came home, they got sick around Day 5, which is the peak period,” she said. “And then from there, they spread it to their family members and close friends. And then to the workplace.

“We’re not seeing as much broad community transmission where we don’t see linkages to other people,” she said. “There have been one or two, which is a very small number.”

Experts are divided on whether surviving coronavirus will produce immunity.

Dr. Jon McCullers, infectious disease expert at UTHSC, expects people who survive the infection will be protected from future waves.

Croce says there’s a good chance there will some immunity, but cautions that viruses are “pretty smart.”

“They can change.”

Haushalter agrees, comparing the novel coronavirus to viruses that cause colds.

“And you know with colds, you get them again. So, there’s a belief that there is some immunity for a short duration, but because this is a novel virus, we really have to study it over a year or more to see what the likelihood of recurrence is, particularly in the future year,” she said.

With St. Jude Children’s Research Hospital reporting Monday a second staffer who has had contact with patients is on the confirmed list, fear is ramping up that that medical staff, already dealing with equipment shortages, are vulnerable.

“I would just say more broadly, we should be very concerned when front-line, essential workers test positive,” Haushalter said, naming health care workers, jailers and sheriff’s and police department staff.

(Monday, a worker in the county jail was on the confirmed list. Last week, a Memphis police officer was confirmed.)

“They’re going to have contact with vulnerable populations, but they’re also the people we need to have at work,” she said.

Infection spreading in those settings will affect patients and “people incarcerated in any of our facilities,” she said.

“So, yes, I have concerns.”

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Alisa Haushalter Shelby County Health Department
Jane Roberts

Jane Roberts

Longtime journalist Jane Roberts is a Minnesotan by birth and a Memphian by choice. She's lived and reported in the city more than two decades. She covers healthcare and higher education for The Daily Memphian.

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