Last Updated: 5:03 p.m.
The Department of Health told the Flagler County school district that one of its 1,700 employees has tested positive for Covid-19 as the coronavirus continues to propagate in the community.
“The Department of Health has completed its investigation of this case with the individual,” Superintendent Jim Tager told school employees this afternoon. “Anyone who was at risk from close contact with this individual would have been contacted by the epidemiology nurses from the Department of Health. They have informed us there is no risk due to close contact at the worksite.” The superintendent’s message does not indicate when the individual was confirmed as having Covid-19 or over what span of time the health department’s investigation took place. But in an interview this afternoon he said the district was informed this morning, by which time the department of health had already interviewed the person.
On Tuesday, a 48-year-old woman who had been treated for Covid-19 at AdventHealth Palm Coast revealed on WNZF that her son, a student at Flagler Palm Coast High School, has tested positive. Both those cases are considered Volusia County cases, however, because the family lives in Volusia. The student’s case is of course not the case Tager was referring to. This morning the health department announced Flagler’s cases were up to five. It’s still not clear whether that number includes the case Tager is referring to, as there’s been lags between the time a case is confirmed in the community and the time it appears on the department’s dashboard, while the department itself is still not revealing anything beyond the person’s age, sex, county location, and whether the infection is believed to have been contracted from travel or by community transmission. None of those details are known about the case of the school employee.
“We know concerns increase as news of the number of cases identified is shared. We will continue to be transparent and provide frequent updates,” he said. “Please know that due to health privacy laws, we are unable to comment on a specific individual’s health status, even if that person self-identifies.”
Nevertheless, Tager did not identify the site where the employee works, or say whether the employee is a member of any school’s faculty, an administrator, a service employee or a central office employee. FlaglerLive has since learned the employee is a custodian.
Tager also revealed the case in a public update, as part of a message today about food and computer device distributions that have been taking place this week.
In the interview this afternoon, Tager said he was bound by legal counsel to reveal no more than he had in his messages, allowing only that the employee’s spouse has also been advised to self-isolate for 14 days. But he said the employee was not involved in the daily food distributions at any of the four school sites this week, nor in the distribution of 200 laptops to students on Tuesday. The district distributed meals to 620 students on Monday, and has been closer to 1,000 on Tuesday and Wednesday, with numbers increasing.
“We know we’re going to have more of these,” district spokesman Jason Wheeler said.
He explained in his message the department of health’s investigative approach once an individual tests positive–the “contact tracing” and mapping that take place so that epidemiologists can trace back as many of the individual’s recent person-to-person contacts as possible, as well as the person’s locations. Individuals with whom the infected person has had what’s considered “close contact” only are then contacted by health department personnel and, depending on findings, told either to self-quarantine and monitor their symptoms or, in cases with pronounced symptoms that meet testing criteria, are themselves tested.
Close contact, Tager said in his message, “is defined as being within 6 feet of that person for a prolonged period of time. ‘Close contact’ normally occurs while caring for, living with, visiting or sharing space with a COVID-19 case. Simply walking past someone, or even being in the same room as the person does not count as ‘close contact.’ The public health nurses conducting the investigation will provide guidance to close contacts about self-monitoring and home isolation.”
The superintendent’s message does not indicate whether any employees are in self-quarantine, or if any area or work site is also quarantined. (The Hammock Beach Resort this week announced to its membership that one of its members tested positive. The club subsequently closed off access to golf courses and related sites.)
Tager and Wheeler said that among the year-round employees who have been reporting to work through the spring break period, there’s been no indication of any spike in absenteeism or illnesses, and other than employees who went on cruises during spring break, no self-quarantining, at least none beyond the recommendation from local governments and the department of health that people remain in their homes to the extent possible.
Today’s earlier updates are below.
Flagler Cases Up to 5, All Over 65 Told to Stay Home 14 Days; Testing Not Necessary for Most, Local Health Dept. Says
Flagler County Covid-19 cases are up to five, according to the Department of Health’s latest tally, and up to 1,682 in the state, including 26 in St. Johns and 20 in Volusia. Twenty-two Floridians have died of causes attributed to the coronavirus.
The average age of those infected in Flagler is 53, involving three men and two women. Local health officials continue to stress that testing for Covid-19 is not necessary for most, even those showing flu-like symptoms that don’t involve respiratory difficulties, but staying in place is necessary. (Jump to the detailed discussion on testing.)
The fifth Flagler case affects a 63-year-old man, according to health department data.
Following an advisory by the state surgeon general and an executive order by Gov. Ron DeSantis, Flagler County Emergency Management is asking residents over 65 years old, and anyone with pre-existing health conditions, to self-isolate at home for the next two weeks.
According to the Census Bureau’s latest figures, 31 percent of the population in Flagler-Palm Coast is 65 and older.
The governor’s executive order specifies serious underlying medical conditions that places people at a high risk of severe illness from Covid-19 as including chronic lung disease or moderate to severe asthma; serious heart conditions; immunocompromised status, including those in cancer treatment; and severe obesity.
The surgeon general’s recommendation is advisory only, and does not carry penalties for violators. Similarly, the surgeon general has issued an advisory “against all social or recreational gatherings of 10 or more people,” and in favor of working remote for all those who can.
How all these advisories are to take shape locally is still a work in progress. “The Department of Health is working with its partner agencies at the state emergency operations center to implement the requirements of both executive orders,” Bob Snyder, who heads the local health department, said this morning. “Each county health department will receive further guidance later today. They are right now putting together an implementation strategy as we speak, in Tallahassee, at the state EOC to provide guidance as to how this is going to be implemented.”
“Ideally, we’d like everyone to follow this slogan: ‘stay home, stay alive,’” County Administrator Jerry Cameron was quoted as saying in a release issued at midday. “The fewer people who are about over the next 14 days, the better off we will all be. Do it for yourself. Do it for your neighbors. Do it for the community.”
“You can still go out for essentials, like groceries, but don’t go anywhere if you don’t need to,” Flagler Emergency Management Chief Jonathan Lord said. “Remember that most grocery stores and big box stores have pick-up and delivery.”
But no one is considering penalties along the lines of those in France, for example, where some 100,000 citations have been issued to people violating a stay-in-place order, which has the force of law. Palm Coast government issued a stay-in-place recommendation on Monday, Other local governments have since followed. The governor’s stay-in-place recommendations for older people is so far the most far-reaching of his executive order.
Another far-reaching order affects all those who have traveled from so-called “hot spots,” such as the New York tri-state area, or those who have all persons who enter the State of Florida from an area with substantial community spread. An earlier executive order had directed all air travelers from the hot spots to self-quarantine, at their own expense, for 14 days. The order issued Tuesday evening extends that directive to “all persons who enter the State of Florida from an area with substantial community spread,” and it applies it retroactively, which means that if anyone locally has been in the New York region in the past 14 days is required to self-quarantine for the next 14.
The New York governor indicated today the first signs that hospitalizations in the New York regions were slowing, suggesting that stay-in-place orders were working. Cases in New York exceed 30,000. On Sunday, hospitals were expecting the number of needed hospitalizations to double every two days. People are still getting hospitalized in crushing numbers, but the rate is now expected to double every 4.7 days.
AdventHealth Palm Coast Chief Operating Officer Wally De Aquino said on WNZF’s daily town hall on the virus Tuesday that “just like everybody else in the nation, we are being very cautious, because we are all short” on certain supplies. “When we say we’re short, we need to be careful how we’re using it in making sure we’re being prudent. We’re working with our vendors and with our internal teams from our headquarters that are working out there, and making sure the channel of supply is still coming and then is distributed through our corporate office. The beauty of this system is that by being part of a national health system, we’re able to receive some of these resources from a corporate level, and then distribute it where there’s an immediate need right away. For example, just a few days ago one of our hospitals needed some help with one of the supplies, so they were able to channel more supplies for that hospital versus other hospitals that had a little bit more.”
De Aquino said the hospital was also getting a lot of donations, which go to the infection prevention department before being set aside to benefit from “when the time comes.” He was thankful for the community’s support.
The hospital has a “command center” that meets weekly at some levels, and daily at other levels to allow hospital staff to rapidly issue any policy and procedural changes, identify gaps, learn from other campuses and put in place whatever works best. As of Monday the hospital is not accepting visitors except in the most restrictive circumstances, such as end-of-life situations, case involving children, and patients going through surgery. But any sick or feverish visitors are not allowed in, and there are no elective procedures for now (that was ordered by the state).
As far as testing for the coronavirus, that’s limited at AdventHealth: “We have to send it to other labs that we have in our division, and obviously, we are prioretizing with the in-patients that we have,” de Aquino said. “We’re not doing it open to the public yet because of resources. We just don’t have enough resources to be performing the test for everybody.”
But local health department officials are saying the public’s insistence on widespread testing is misguided at the moment. “The principle people should keep in mind is that testing is useful when it leads to some action that makes a difference,” Dr. Stephen Bickel, the medical director at the Flagler and Volusia health departments, said on the same program. “So testing to just find out something in medicine is thought to be kind of a waste of money if there’s no real outcome difference that you’re going to gain from that. Why would you test people? Well, ideally you might want to test people to know how much of this is in the community, to get an idea of the prevalence, to know how you’re doing with your containment efforts, things like that, and we’ll get to that point as soon as there are enough tests available.”
“The second reason is, if you had an effective treatment that you could use right away to prevent the illness or to cut it short, decrease serous complications, then you’d want to test everybody and say OK, this person has it, we’re going to treat him right away and get right on top of it. The third reason is to test somebody so you know if you need to quarantine them. But the way we’re approaching this now is: everybody should be self-quarantining.”
Bickel continued: “Anybody with upper respiratory symptoms these days should be quarantining themselves for a week no matter what, whether they’re Covid-positive or not. If they’re negative, then they should be just doing it like people do to not spread colds like when they go back to work. But if they’re untested and could have Covid, they should be isolating anyway for a week. But the idea that you need to be tested to make sure you don’t have Covid or not, most people with this, especially younger and middle aged people, will have mild illnesses for which there’s no treatment. So they’re not really foregoing anything by not getting tested. They should just be isolating themselves anyway, partly to protect themselves from getting it,” while taking measures to get better and ride it out. “If in the next month or two some evidence emerges that some of these treatments that are being tested turn out to be useful, even moderately useful, we might start treating everybody who’s got it. In that case the whole game would change and we’d say come on in for testing as soon as possible.”
If an individual starts getting shortness of breath, a hallmark of Covid-19, that’s when the individual should seek attention. “But if it’s just kind of the run-of-the-mill thing, some cough and feeling crummy, that kind of stuff, like typical upper respiratory infection kind of symptoms, just wait it out.”
Gretchen Smith, the spokesperson for the local health department, said the department “has been getting a little bit of push-back on social media, and we’ve been hearing from a lot of people, kind of complaining about the fact that we’re not testing enough people. I want to basically underscore what Dr. Bickel just said, because you’re still going to have to self-isolate, regardless of whether you’re positive or not, and let’s face it, there’s other things that are going around in this community–severe upper respiratory infections, etc., that could be similar to these cases, and you need to stay home. So it really doesn’t make that huge of a difference. If you call the health department, if you’re screened for a test and if you don’t meet the criteria that’s put out by the CDC,” the Centers for Disease Control, “realize it’s not going to change your circumstance anyway. You should be home, you should be treating your symptoms as if you have the flu and self-isolate, get better, and then move on.”
Bickel said the testing strategy right now makes “total sense for the limited circumstances,” noting that three of 53 tests conducted locally have been positive. “And these are with somewhat selected patients. So the emphasis now is on identifying high-risk patients and also patients who are much more likely to have it.”
By today, the latest data indicated 69 local tests for Covid-19, five of them positive. The state had tested 17,058 people, with 1,682 positive, for a rate of 10 percent. AdventHealth Palm Coast had conducted six tests, with one positive.
See previous updates:
- Concerns About Hammock Beach Resort’s Activity as Governor Orders Air Travelers From ‘Hot Spot’ Quarantined
- Flagler Cases Up to 4; Woman Treated for Covid-19 at Advent Is Released, But Her Son, an FPC Student, Tests Positive
- Flagler Beach Police Officer Tests Positive for Covid-19, City Manager Larry Newsom in ‘Self-Isolation’
- Flagler Covid-19 Cases Up to 3 as Health Department Kicks In ‘Contact Tracing’ and Palm Coast Hunkers Down
The 24-hour Health Department hotline is is 866-779-6121.
The 24-hour AdventHealth Coronavirus Information Line is 877-VIRUSHQ, (or 877-847-8747).