The Kansas Department of Health and Environment on Sept. 8 began releasing locations of outbreaks in Kansas, connected to five or more confirmed cases of COVID-19 or private business locations with more than 20 confirmed cases.
Lawrence-Douglas County Public Health does not publicly identify sites of outbreaks unless we believe disease investigators are not able to identify all potential close contacts who were at risk for exposure. Our disease investigators answered questions about how we define outbreaks, especially in recent days with the University of Kansas conducting entry testing of all students, faculty and staff.
How do LDCPH disease investigators define outbreaks are in the county and report them to KDHE?
Jeni McDonald, LDCPH Epidemiology Supervisor:
We are defining an outbreak as two or more cases associated with the same person or location —also known as the same identified source of exposure — as long as they are not a familial unit. With the definition of the same source of exposure, this will mean we have to be careful and certain that this is not unrelated cases that are moving in together and that they are truly sharing exposure within the group of people living together.
If they are a household with two or more positives and are unrelated, we are then reporting that as an outbreak per KDHE instruction. This associates all sorts of congregate living situations such as long-term care, rental houses, halfway homes and other situations in which many unrelated people live in the same home.
Essentially the definition is the same, the only exclusion is that we do not report a familial unit as the source of an outbreak.
How does the KU entry testing factor in to determining outbreak sites in Douglas County?
From Sonia Jordan, Director of Informatics, LDCPH:
With KU doing the mass surveillance testing upon students’ return to campus from other parts of the state and country, it is highly likely you are going to find cases that seem like they might have same source of exposure, because living in same dorm or Greek house, for example.
However, they very likely have different sources of transmission. Upon those positive lab results, KU has acted quickly and efficiently along with LDCPH to put those students and their contacts into the required isolation or quarantine to prevent outbreaks. KU did a fantastic job, and I want to give kudos to Dr. Pavika Saripalli and her team at Watkins Health Services for their work.
So, what we have had to do from a public health perspective is wait for a transmission to occur, proper incubation time of up to 14 days and then a re-test of at least two positive case who likely received it from Student A returning to their dorm or housing arrangement. From there we are able to track transmission sufficiently to label it as an outbreak. However, this takes time, which is why KDHE likely doesn’t have any in this iteration.
It is likely that going forward we will see outbreaks tied to these environments, but we are waiting on that incubation period so we can determine the source of the exposure was the same to meet that definition of an outbreak.
For anyone in our community right now, we stress the importance of smart and safe habits, including wearing a mask, practicing social distancing, washing your hands and staying home if you do feel sick and contacting your healthcare provider.