ST. GEORGE — The respiratory illness season is easing back in Southern Utah as the continuing evolution of the virus that causes COVID-19 has prompted new guidelines from health officials.

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Last Friday, the Centers for Disease Control and Prevention simplified its guidance as to what to do if someone has COVID, which means people can go back to work and school sooner than before.

The CDS recommends that rather than staying home after testing positive or experiencing symptoms, people can go back to work or school if they have gone 24 hours without a fever and not used a fever-reducing medication.

The updated guidance also reflects what the CDC says is a more unified approach to all respiratory diseases including influenza and respiratory syncytial virus, better known as RSV. 

One medical professional says that four years after it was first discovered, COVID finally really is like the flu. But Dr. Benjamin Brooks, a molecular and cellular biologist and the clerkship director at Rocky Vista University in Ivins, said it is an affront to both history and the more than 500 people in Southern Utah who died when COVID was a more virulent disease to say COVID has always been like the flu.

“I think it is where we are in the history of the disease. It baffles me when people say it proves past (Federal Drug Administration) guidance was wrong, and this proves it. The politicization of the disease is dangerous going forward,” Brooks said. “In earlier strains, we had much higher amount rates of mortality and serious morbidity. It is important to remember that COVID-19 killed over 1.1 million people. For this current strain, the disease burden is similar to annual influenza.”

As far as being exposed to COVID, the guidance is now the same as the flu and RSV: Reduce prolonged exposure, increase hand-washing and other hygiene measures and monitor your own health if symptoms like fever develop. If there has to be prolonged exposure to someone with a respiratory disease, wearing a medical-grade mask is recommended.

The whole idea is like other respiratory viruses, a combination of vaccinations and repeated exposure has made humans more hardy against the COVID virus. The best way to avoid germs is to wash your hands and stay away from those droplets that are coming out of sick people’s noses and mouths, according to the CDC.  

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

As for getting tested to see if someone has COVID, there are only a few days left if someone wants to receive free at-home COVID tests in the mail. If someone has not received four free COVID home tests in the mail since October, people have until Friday to have them sent through a federal program by going to this link.

A full listing and guidance of how to deal with exposure and infection of COVID and other respiratory diseases is at the end of the article. 

David Heaton, spokesperson for the Southwest Utah Public Health Department, said the changing guidance reflects how common COVID-19 has become as part of the cold and flu landscape.

“It’s more widespread and less dangerous,” Heaton said. “Although, like the flu, it still poses a higher risk to older adults and the chronically ill.”

According to the Utah Department of Health and Human Services, 61 people in Southern Utah have been hospitalized with COVID since the start of the year. Five people needed intensive care and four patients died. There was a peak in hospitalizations on Valentine’s Day week, and all four deaths involved people ages 65-84 and all were in January. 

Among emergency room respiratory diseases this winter, there was a higher rate of daily visits for influenza in December and January, according to the state health department. But the rates for COVID and flu were about equal in February.

Wastewater detections by the state health department in local wells of COVID-19 are down 67.2% since Feb. 15 and are at their lowest levels since last September.

In a statement, CDC Director Dr. Mandy Cohen said last Friday that COVID is now “far less likely” to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.  

“Importantly, states and countries that have already adjusted recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19,” Cohen said. 

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 March 5, 2024 as of the last day of each of the last four months | Graphic by Chris Reed, St. George News | Click to enlarge

The CDC notes there are still some who have to take extra caution. Four specific populations need to be especially cautious around those who are ill and may experience symptoms like fever longer and are more likely to be hospitalized.

“This is far from over for some of us, but we do have to balance multiple factors,” Brooks said.

One group is those who are not up to date with the latest COVID vaccine. The CDC estimates that 95% of those who have been hospitalized for COVID nationwide since October 2023 have either not had the latest COVID vaccine that became available last fall or haven’t been vaccinated at all. 

Another is those ages 65 and older. COVID is far from the killer it once was – four people have died of COVID in Southern Utah thus far in 2024, according to the Utah Department of Health and Human Services. However, the CDC says people over age 75 are nine times more likely to die from COVID-19 than the rest of the population. 

The CDC also says that infants ages 6 months or younger are just as vulnerable to hospitalization as those 65 and older. 

The other two vulnerable populations are those with weakened immune systems and pregnant women. Pregnant and recently pregnant women are twice as likely to be infected with COVID as other women, the CDC says. But health officials say vaccinations for COVID and the flu have had an added benefit for pregnant women as 75% of infants who have been hospitalized for COVID were born to unvaccinated mothers and mothers vaccinated for the flu and RSV during pregnancy have reduced their children’s chance of being hospitalized for those two diseases in half. 

There is one more concern that remains: long COVID.

According to the state health department, about one of every 10 Utahns who have had COVID have had the long COVID condition where symptoms like fatigue, shortness of breath, “brain fog” and trouble sleeping have lasted for weeks or even up to a year or longer.

Stock photo | Photo by Djordje Krstic/iStock/Getty Images Plus, St. George News

I am increasingly concerned about long COVID,” Brooks said. “We still have mortality associated with some high-risk populations.”

And while the CDC has eased its guidance on getting back to normal activity after COVID infection, health experts say it’s still important to ease slowly back into general exercise and physical activity for about a week or two after COVID infection. While studies are still ongoing, evidence is that doing strenuous activity too soon after having COVID can lead to long COVID.

The CDC also says long COVID is happening more often in people who have not had any vaccinations for COVID, and each time a person is infected or reinfected with SARS-CoV-2, they have an increased risk of developing Long COVID, giving more reason to avoid it entirely.

COVID questions answered

Following is information for those who need to know what to do if they contract COVID and what to do if they have been exposed or are seeking testing. This information reflects the new guidance released by the CDC on Friday and also reflects actions for other respiratory diseases like influenza and RSV.

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

According to the CDC, it comes down to increasing distance from the exposed person as well as increasing hand hygiene and considering masking with an N94 or better mask as further protection if exposure will be on a continuous basis. 

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The CDC says infectious droplets and particles build up closer to the person who is releasing them. The closer one is to someone who has a respiratory virus, the more likely they are to catch it.

People should avoid being near someone who has respiratory virus symptoms. Also, if around regular exposure to respiratory virus, it is recommended to increase hand washing.

Those in vulnerable populations should take extra care to avoid further exposure and to increase hand-washing and masking measures. Those populations include those not up to date in vaccinations, those either 75 and older or 6 months and younger, those who are pregnant or those with weakened immune systems.  

If fever develops after exposure, it is recommended to stay at home and/or in isolation until 24 hours have passed without a fever and without using a fever-reducing medication.

People should also take an at-home test or a test at their doctor for COVID and/or flu, as there are several treatments now available to lessen the potential for severe effects – especially for those in more vulnerable populations.   

Are there still places that offer free COVID tests?

Until Friday, the federal government is providing free COVID-19 home test kits through the mail by going to this link.

All Southern Utah Walgreens locations offer free COVID-19 PCR lab tests through the federal Increasing Community Access to Testing program.

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tatyana_tomsickova/iStock/Getty Images Plus, St. George News

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. 

There is also still a difference in accuracy between the two types of tests, according to the CDC. However, the CDC says 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.

New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
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?”

Undated photo showx a box containing Paxlovid, a treatment for COVID-19 | Photo courtesy of Pfizer, St. George News

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.

For COVID, influenza or RSV, it’s 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. 

How long do I stay at home?

Health officials now say it’s all about the fever. 

According to guidelines released Friday, the CDC said a person who tests positive for COVID or has respiratory virus symptoms like fever, chills, fatigue, cough, runny nose and/or headache should stay at home and away from others. 

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The CDC recommends that people resume normal activities, including work and school if they have gone 24 hours without a fever and haven’t taken a fever-reducing medicine in that time.

After that time, if a fever returns, people should wait to return to normal activities until 24 hours have passed from the end of that fever.

Dr. Tamara Sheffield, who heads community health and prevention for Intermountain Health, said the “kind” thing to do is to wear a mask for the duration of symptoms and for a few days after 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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