Positive retests in KY counties raise questions about when patients are over COVID-19
After some recovered COVID-19 patients retested positive, a health department serving three Central Kentucky counties has revised its definition of when patients are considered coronavirus-free.
Forty-one patients, thought to be recovered under previous guidelines, were retested for the virus and 11 of those cases retested positive, according to data posted online by the WEDCO Health Department which serves Harrison, Nicholas and Scott counties.
In light of those patients re-testing positive, Dr. Crystal Miller, director of WEDCO, announced in a video posted online last week that the department was changing its definition of recovered patients. The decision is crucial to determining who no longer quarantines to prevent spreading the virus. There is no indication other counties are following WEDCO’s lead.
When the first patient in the WEDCO district tested positive in early March — which was also the first case in the state — Miller said the CDC specified that a patient could be released from quarantine after testing negative for the virus twice.
Due to a national testing shortage limiting the numbers tested, the CDC guidance changed and the department was allowed to declare patients—who had already tested positive once — recovered after 14 days without symptoms, Miller told WKYT.
The new coronavirus has been perplexing. Health officials are still not 100 percent sure if and how long someone is contagious if they do or don’t have symptoms after a period of time. Symptoms also can vary. Studies continue.
The WEDCO department decided to investigate one individual who had previously tested positive for the virus and “had been very sick” but was never hospitalized, Miller told the station, which is the Herald-Leader’s news partner.
“They were retested,” Miller said. “They retested positive.”
After that first positive retest, the department began to retest every patient in the WEDCO district who was previously declared recovered, Miller told the Herald-Leader.
Miller said the department will now consider patients to be recovered and able to stop quarantine only after they’ve tested negative for the virus and have had the disease for at least 14 days. Seven of those days will have to be symptom-free, including at least three days without fever.
According to data posted on social media by WEDCO on Wednesday, the district has had at least 46 confirmed cases of COVID-19 — 41 have been tested twice and 30 of those individuals are now declared recovered under the district’s new guidelines.
“When you see that people have recovered, you can find comfort in that we have implemented a testing procedure and we have received a negative test before they have been released from our care,” Miller said.
Despite the WEDCO results, Fayette County allows for patients to be considered recovered — and free of the need to quarantine — without retesting, an official said.
“The majority of Lexington’s reported COVID-19 cases have been released using clinical criteria, rather than using testing criteria,” said Dr. Kraig Humbaugh, the Fayette commissioner of health. “In general, we have not recommended that cases released under the clinical criteria be retested.”
In Lexington, an individual can be cleared for release from isolation either after testing negative twice in a 24-hour period or they can be released 10 days after symptoms began, so long as their respiratory symptoms have improved and they haven’t had a fever for 72 hours — without using any fever-reducing medication, Humbaugh said.
Most of Lexington’s cases have been released without being retested and were released after their symptoms subsided, Humbaugh said.
Lexington’s standards are similar to a CDC recommendation from early April which stated that an individual who had symptoms can be released from home isolation after a 7-day period with at least 72 fever-free hours.
However, that recommendation came with a footnote warning that the strategy would “prevent most but cannot prevent all instances of secondary spread.” The footnote stressed that the secondary spread from a recovered person was still unlikely as the affected individual would not be “shedding large amounts of virus.”
This story was originally published April 24, 2020 at 12:00 PM.