ST. GEORGE — If there’s something that the local medical community may be thankful for this year, it’s that local levels of respiratory diseases like COVID-19 and influenza are at their lowest for the Thanksgiving holiday since before the pandemic.  

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The latest data released late Wednesday by the Utah Department of Health and Human Services indicates that in the prior seven days, there had been an average of six emergency room visits per day among Southern Utah residents for COVID-19, 2.86 visits for influenza and 0.29 visits for RSV, or respiratory syncytial virus, a common cause of mile cold-like symptoms. 

That compares to 10.86 per day for COVID, 7.57 for the flu and 3.57 for RSV at this time a year ago, when local health officials were much more pessimistic about the holiday.

Nevertheless, even with the good pathogen cheer, local doctors and medical officials say people should still be germ-aware when gathering for the holidays. And especially for older family members and friends who are more susceptible to hospitalization and death from respiratory diseases, it’s best to stay away from the big gathering if you feel sick. 

“As we approach the holidays, we encourage you to take precautions if you are feeling ill while strengthening or rekindling family relationships,” Dr. Patrick Carroll, the medical director of St. George Regional Hospital, told St. George News. “Remember good hand hygiene, covering your mouth and nose with the inside of your elbow when coughing or sneezing, masks or staying home altogether if you have vulnerable family members.”

While the fourth Thursday of November is considered the unofficial start of the Christmas holiday season, it has also been considered as the unofficial start of what used to be the flu season. Medical experts and most doctors have now done away with the flu season label and look to the October-May period as the respiratory season with COVID-19 and RSV, now also peeking during that time. 

Graph using data from the Utah Department of Health and Human Services shows the seven-day average per day of emergency room visits for certain respiratory diseases in Southern Utah as of Nov. 15 for each of four years | Graphic by Chris Reed, St. George News | Click to enlarge

While COVID is no longer a pandemic, it still more than doubles influenza as the king of hospitalizations and deaths at this time of the year, according to the American Medical Association.

That’s especially true in the older population. All six people who died with COVID-19 in Southern Utah since June were age 65 or older, according to the Utah health department.   

David Heaton, spokesperson for the Southwest Utah Public Health Department, said if someone is feeling ill, it’s best to stay away from grandma’s house. 

“Although people love to get together for Thanksgiving and other holidays, it’s best to stay home if you have active symptoms of respiratory or gastrointestinal illness – especially fever, coughing/sneezing and diarrhea and vomiting,” Heaton said. 

But there are other health risks outside of COVID-19 or RSV that come with holidays, such as consuming undercooked turkey or not washing hands after touching raw meat or contaminated surfaces.

“There are also gastrointestinal illnesses causing nausea, cramping, vomiting and diarrhea, which can spread from infected people at gatherings or from contaminated food,” Heaton said. “Norovirus is the most common, sometimes called the cruise ship virus. There’s also other bacterial and food poisoning sources.”

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That poorly prepared food can also give false symptoms of a worse influenza.

“The stomach flu is usually not influenza, but probably norovirus or other gastrointestinal pathogens,” Heaton said. 

And don’t blame the turkey for that feeling of wanting to collapse in bed after Thanksgiving dinner, as studies have concluded it’s just eating too much that gives that high amount of tryptophan, not solely the turkey.

The latest statistics

Last week, the Utah Department of Health and Human Services began to provide new, more precise weekly data on the three main respiratory diseases: COVID, influenza and RSV. According to the latest data, incidences of COVID-19 in the five counties of Southern Utah have held around the same level after going up a bit in September. Incidences of influenza are on the rise, doubling in the last week, while RSV remains at near-zero levels. 

The state health department said that COVID-19 and flu activity are “increasing in Utah. As the winter months advance, we expect COVID-19 and flu infections and hospitalizations to continue to increase. The best time to get an updated COVID-19 and flu vaccine is now to be better protected throughout the winter months.”

The Utah Department of Environmental Quality collaborates with the state health department and provides local sewer readings of the virus that causes COVID-19. Numbers have been leveling off locally since September.

The one blip came in the first week of the month when readings in Hurricane reached their highest level since February 2022.  

A set of positive home COVID-19 tests, St. George, Utah, June 22, 2022 | Photo by Chris Reed, St. George News

According to Utah health department data, Hurricane has had the largest rate per capita of those infected by COVID-19 in Washington County and also currently has the lowest COVID-19 vaccination rate (8.02% up to date on vaccinations compared to 10% to 16% in other Southern Utah regions.)

As has been the case since COVID-19 was first discovered in late 2019, the virus that causes it continues to mutate into new strains that become increasingly more infectious but also less harmful in its effects. The latest strain, known as HV.1, became the dominant strain in the U.S. over a week ago. Multiple recent studies and the CDC indicate that the most recent COVID-19 vaccines and boosters are just as effective at preventing hospitalization and death.

COVID questions answered

What if I’ve been exposed to someone with COVID? My coworker said they tested positive

With more herd immunity, it is no longer the days where just being someone with COVID-19 means it’s time to stay home. 

“Unless you’ve been isolating, you probably have been exposed to COVID to the point where your immune system has developed some sort of protection for you,” said Dr. Benjamin Brooks, a molecular and cellular biologist and the clerkship director at Rocky Vista University in Ivins.

Health experts say exposure is more likely if someone has been in close quarters for more than 15 minutes with someone who tests positive and less time if they were exhibiting symptoms. 

The Utah Department of Health and Human Services says a person who thinks they have had substantial exposure shouldn’t get tested for at least five days, as it might take time for the virus to become detectable unless they exhibit symptoms. And they should take the test even if they feel fine. 

The Centers for Disease Control and Prevention also recommends wearing a mask to avoid possibly spreading the virus for 10 days, especially around friends or loved ones who are at high risk. 

And in any case, they should heed any sign from their body for the next 10 days if they feel like they might be ill. 

Are there still places that offer free COVID tests

The federal government is once again providing free COVID-19 home test kits through the mail by going to this link, though it’s advisable to request them before being sick as it can take at least a week before they arrive. All Southern Utah Walgreens locations offer free COVID-19 PCR lab tests through the federal Increasing Community Access to Testing program.

Otherwise, there might be a charge for either a PCR lab test or the purchase of an “at-home” rapid test depending on one’s health insurance. 

Undated, colorized scanning electron micrograph of an apoptotic cell (green) heavily infected with SARS-COV-2 COVID virus particles (yellow) | Photo courtesy of National Institutes of Health, St. George News

There is also still a difference in accuracy between the two types of tests according to the CDC. However, the CDC said last week that improvements in the home test have pushed their accuracy up to 88%.  The CDC adds that while the home tests can provide a false negative, they will not provide a false positive. If that line appears saying COVID-19 is present, you have COVID. 

The PCR test is 95% accurate, though it can take longer to receive a result since it usually has to be taken to an off-site lab. 

What are those main symptoms?

According to the CDC, the main symptoms to watch for are fever or chills, dry cough, shortness of breath or difficulty breathing, fatigue and muscle aches. While those can also be symptoms of influenza, one of these other symptoms in combination may give a clue that it’s COVID-19.

Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
Conjunctivitis, also known as “pink eye.”

I’ve tested positive. I have COVID. What do I do?

Will Christiansen, medical director of Family Healthcare, said the first thing someone should do is determine if they are at risk for severe complications from COVID-19. That includes being unvaccinated, over 65, immunocompromised or having other lung, heart or blood sugar conditions. 

“That’s a discussion we have to have with our patients,” Christiansen said. “What’s your risk factors? Are you already several days in and already getting better? Do you have someone at home you’re worried about exposure or where you work?”

If someone is at high risk or just experiencing more than mild symptoms, a doctor or pharmacist may prescribe Paxlovid, which the National Institute of Health says reduces the chance of COVID-19 worsening by 89%.

Paxlovid must be taken within five days of the appearance of the first symptoms and, for now, the cost of the drug is being covered by the federal government. While a doctor’s prescription is needed, a pharmacy can also proscribe it on its own for an additional fee. 

Whether Paxlovid is necessary, Christiansen said the rule of thumb with COVID-19 is to listen to one’s body and take it easy with a lot of rest. 

“Hydrate well and rest and, and watch for warning signs and let us know if they start getting shorter breath or start throwing up or getting really weak,” Christiansen said. “Ibuprofen is recommended for pain relief.

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According to a week-old study, there’s now another home remedy that can treat COVID-19 at home. In findings from an American College of Allergy, Asthma and Immunology study announced  Nov. 9 the old-fashioned neti pot could play a role in getting better while having COVID-19.  

People with COVID-19 in the study who gargled and nasal rinsed with 2-6 grams of salt dissolved in 8 ounces of sterile warm water cut their chances of complications and hospitalization in half. Doctors caution that people should use distilled or sterile water, rather than tap water to prevent the rare chance of amoeba infection.   

The Utah Department of Health and Human Services says there’s no reason to go to the emergency room unless there’s chest pain that doesn’t go away, inability to wake up easily, if one’s face or lips look bluish or there’s difficulty breathing. 

It’s also recommended to stay in a separate room from others in a household and wear a mask around them to avoid spreading the disease to others. 

There’s also another reason to take it easy. Experts have said long COVID conditions – where people experience fatigue, shortness of breath, brain fog and trouble sleeping – are more likely to happen and last longer if someone exerts themself too much while having COVID-19 or in the two weeks after symptoms disappear. 

According to the National Institutes of Health, long COVID has been shown not to last more than two or three months unless someone returns to strenuous activity within those first two weeks. Getting back to that job could mean a year or more with long COVID. 

How long do I stay at home?

Health officials say it’s all about five days.

“We’re encouraging people who, when you’re sick, don’t go to school, don’t go to work, don’t be around other individuals for at least five days,” said Dr. Tamara Sheffield, who heads community health and prevention for Intermountain Health.

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If there is a positive test, but no apparent symptoms, people should stay home for five days from the date of the positive test, according to information posted by the state health department.

Otherwise, a person should stay home at least five days after the onset of symptoms and not return to work, school or the public until they have been fever-free for 24 hours without medication and their other symptoms have improved over 24 hours. 

After that, Sheffield said the “kind” thing to do is to wear a mask for the next 10 days as there still is a potential to spread the virus to others. 

“If you’ve been ill, be kind and mask up for a while so you’re not spreading the virus,” Sheffield said, adding that people shouldn’t be judgmental if they see someone wearing a mask in public. “When I see a person with a mask, I think one of two things. I either think they are at risk themselves and need to protect themselves or they’re an individual who is caring about others, and they are concerned about possibly infecting someone else.”

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