The 14-day quarantines recommended by Barton County Health Department Director Karen Winkelman create problems for employers and their employees, County Commissioner Kirby Krier said Monday. Winkelman said she doesn’t recommend a shorter period because she’s following the best practices recommended at this time by the Kansas Department of Health and Environment (KDHE).

The Barton County Health Department (BCHD) continues to identify close contacts of individuals of each positive case. Close contact is defined as being within 6 feet for 10 minutes or longer or having direct contact with infectious secretions. The BCHD actively monitors the close contacts for 10 days for symptoms. Winkelman told the commissioners Monday that BCHD continues to recommend the close contacts quarantine for 14 days because that is the incubation period for COVID-19. However, it no longer issues orders to stay at home and BCHD will work with employers to explore safe ways for employees to continue working.

Nonetheless, Krier asked for a shorter quarantine recommendation, citing economic concerns.

“I’d like to see that reduced,” he said. “Every man, child and woman that works is an essential worker.”

If someone has COVID-19, that person should be in quarantine, Krier said. But when someone with symptoms tests positive, he or she has probably had multiple close contacts -- who may or may not get COVID-19. 

Close contacts can avoid the quarantine if they are fully vaccinated against COVID-19, which is an incentive for getting vaccinated, he noted.

Winkelman clarified that KDHE doesn’t use the “essential worker” designation much since the statewide shutdown ended last year. And quarantine orders have become quarantine recommendations. And when quarantine is recommended, “employers with a plan can talk to me.” The plan might involve having the close contact wear a mask at work.

That’s what employers want the county to recommend, Krier said.

“They want seven to 10 days where (the exposed employees) wear a mask and continue to work,” he said. Employers have “the most control” over their employees, above what the President or KDHE or the Centers for Disease Control or the County Health Director may say, he added. However, he said employers feel pressured to follow recommendations from the Barton County Board of Health because of liability concerns. The commissioners serve as the Board of Health with input from Winkelman. “We should take a vote,” he said.

Winkelman said an epidemiologist, whose job is to collect and analyze data to investigate health issues, spoke to the Board of Health previously. They were told that after exposure to a positive case, 80% of the people who will get COVID-19 will show symptoms by Day 10. The other 20% will have symptom onset at Days 11-14. The Delta variant of the virus appears to be more infectious than the original virus, she added.

“We’re trying to keep the public healthy. We need to follow the best practices,” she said. “Fourteen days seems to be what we need to follow because we have the Delta variant.”

She noted that KDHE now has county rankings to help county commissioners and local leaders stop the spread of COVID-19 in their communities. The rankings are a figurative way of “taking a picture of our county,” Winkelman said.

When the rankings were first created a few weeks ago, Barton County ranked 77th out of 105 counties. On Monday, the county’s ranking had slipped to 101st, based on the low percentage of vaccinated people, the high number of cases per 100,000 people and the low number of COVID-19 tests per 100,000 people. (See related story in today’s Great Bend Tribune.) Based on that information, she said, “This isn’t a good time to pull back.”

Keeping people on the job

“We cannot continue 14 days where people stay at home from work,” Krier said. He said people who get COVID-19 would be more honest when reporting close contacts if they knew their reports wouldn’t send others home for 14 days.

Commissioner Jim Daily asked Winkelman if the recommended quarantine could be shortened if exposed employees wear masks and receive daily testing.

“It would be possible,” she said. The problem is the time, cost and manpower that would require.

Daily asked if BCHD needs more nurses. Winkelman said they have a new nurse coming on board “possibly next week.” Also, a social worker is joining the staff and that will relieve nurses who have been filling in to do the social worker's duties. With the addition of a part-time dietician, “we’ll be fully staffed,” she said. The county has also used some contract nursing staff during the pandemic.

Third vaccination doses

Asked if BCHD is recommending booster vaccinations for COVID-19, Winkelman said they are not. It is more accurate to call them “third shots” (since those fully vaccinated with the Pfizer or Moderna vaccines have had two shots) rather than booster shots. In any case, they are only offering them for people who are immunocompromised at this time.

A local cluster

Even the best practices are no guarantee against COVID-19, Winkelman agreed. BCHD did on-site prevention at the Dominican Sisters of Peace convent in Great Bend and vaccines were administered, but the convent still became a cluster location two weeks ago. Every Wednesday, KDHE named the locations that have had five or more positive cases with symptom onset in the past 14 days. Last Wednesday’s list showed nine cases at the convent in the previous 14 days, with the last onset date being Sept. 12.

With people getting vaccinated there have been “lighter cases” at the convent but there was also one death, Winkelman said.

“They’ve missed some events in that facility that are very important to them,” she added.

Support for Winkelman

Commissioner Jennifer Schartz told Winkelman, “You have my total support. You’re working in the trenches.”

The discussion with Winkelman was done during the time set aside for meeting with department heads and was not part of the commission’s business agenda.