CDC Broadens Definition of 'Close Contact' in Tracing COVID Infections

THURSDAY, Oct. 22, 2020 (HealthDay News) -- In a move that widens the pool of people considered at risk for coronavirus infection, U.S. health officials released new guidance on Wednesday that redefines who's considered a "close contact" of an infected individual.

The change, issued by the U.S. Centers of Disease Control and Prevention, will likely have the biggest impact in group settings where people are in repeated contact with others for brief periods over the course of a day, such as schools and workplaces, the Washington Post reported.

The CDC had previously defined a "close contact" as someone who spent at least 15 consecutive minutes within six feet of a confirmed coronavirus case. Now, a close contact will be defined as someone who was within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period. State and local health departments rely on this definition to conduct contact tracing, the Post reported.

The new guidance arrives just as the country is "unfortunately seeing a distressing trend, with cases increasing in nearly 75 percent of the country," Jay Butler, the CDC's deputy director for infectious diseases, said during a rare media briefing Wednesday at CDC headquarters in Atlanta, the Post reported.

CDC scientists had been discussing the new guidance for several weeks, said an agency official who spoke on the condition of anonymity, the Post reported. Then came unsettling evidence in a government report published Wednesday: CDC and Vermont health officials had discovered the virus was contracted by a 20-year-old prison employee who in an eight-hour shift had 22 interactions -- for a total of over 17 minutes -- with individuals who later tested positive for the virus.

"Available data suggests that at least one of the asymptomatic [infectious detainees] transmitted" the virus during these brief encounters over the course of the employee's workday, the report said.

Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security in Baltimore, called the updated guidance an important change.

"It's easy to accumulate 15 minutes in small increments when you spend all day together -- a few minutes at the water cooler, a few minutes in the elevator, and so on," Rivers told the Post. "I expect this will result in many more people being identified as close contacts."

At the same time, it's not clear whether the multiple brief encounters were the only explanation for how the prison employee became infected, Rivers added. Other possibilities might have included airborne or surface transmission of the virus. She also noted that the new guidance "will be difficult for contact tracing programs to implement, and schools and businesses will have a difficult time operating under this guidance."

Third COVID Surge Spreads Across the Country

Meanwhile, a third surge of coronavirus cases now has a firm grip on the United States, with an average of 59,000 new infections being reported across the country every day.

That tally is the highest since the beginning of August, and the likelihood is high that the country will soon see the most new COVID-19 infections a day since the pandemic began, The New York Times reported.

This latest surge differs from the previous two: Instead of acute outbreaks in specific regions, such as the Northeast this spring and the South this summer, the virus is now simmering at a worrisome level across nearly the entire country, the Times reported. Colorado, Illinois, Kentucky, Michigan, Montana, New Mexico, North Dakota, Ohio, South Dakota, Utah, Wisconsin and Wyoming each set seven-day case records on Tuesday. Even New Jersey, which managed to bring the virus under control last spring, has seen a doubling in cases in the past month, the Times reported.

"It is a really dangerous time," Dr. Tom Inglesby, an infectious disease expert at the Johns Hopkins Bloomberg School of Public Health in Baltimore, told the newspaper. "The majority of states are on the rise. There are very few places where things are stable and going down."

Even more troubling is the fact that this latest surge is coming as cooler weather is forcing people indoors and many Americans report they are fatigued by months of social distancing and travel restrictions, the Times reported.

"We're seeing spread virtually everywhere," Ohio Gov. Mike DeWine said during a news conference Tuesday. In his state, 69 of 88 counties are now considered "high incidence," meaning at least 100 virus cases per 100,000 people in the past two weeks, the Times reported.

But instead of imposing new measures to curb the spread of COVID-19, Dewine said that, "The fastest way we can do it is not for me to issue some order that you can't enforce or would be difficult to enforce, but rather for every Ohioan to take this seriously," he said, grabbing his cloth mask and holding it up, the Times reported.

In North Dakota, which is leading the nation in new coronavirus cases per capita, hospitalizations and deaths are at a high, and just 20 intensive care beds were available statewide.

Luckily, the climbing case count has not yet translated to increased deaths: About 700 people are dying from COVID-19, on average, each day. So far, more than 220,000 Americans have died from the virus.

CDC Recommends Face Masks for Public Transportation

Seeking to slow the spread of coronavirus, the U.S. Centers for Disease Control and Prevention recommended this week that face masks be worn by everyone in all public transportation settings.

That includes both passengers and people working in stations, terminals and airports across the country, CBS News reported.

So far, the Trump administration has not issued any national mandate on face coverings, instead leaving that decision to state and local leaders.

In the new interim guidance, the CDC called masks "one of the most effective strategies available for reducing COVID-19 transmission." Wide use of masks helps protect those at higher risk of severe illness from COVID-19 as well as workers who frequently come into close contact with other people in airports, bus terminals, train stations and seaports, the guidance stated.

Most U.S. airlines, Amtrak and many other transport companies already require passengers and staff to wear masks, CBS News reported. The CDC urged passengers and workers on all airplanes, ships, ferries, trains, subways, buses, taxis and ride-shares to follow suit.

For months, research has shown that face masks help curb the spread of COVID-19. In the new guidance, the CDC said everyone "should wear masks that cover both the mouth and nose when waiting for, traveling on, or departing from public [transportation]. People should also wear masks at an airport, bus or ferry terminal, train or subway station, seaport, or similar area that provides transportation."

The guidance also urges transport operators to "refuse boarding to anyone not wearing a mask and require all people onboard, whether passengers or employees, to wear masks for the duration of travel," with exceptions for eating, drinking and medical disorders that prohibit mask wearing.

COVID continues to spread around the globe

By Thursday, the U.S. coronavirus case count passed 8.3 million while the death toll neared 222,000, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Thursday were: California with over 890,000; Texas with more than 885,800; Florida with over 762,500; New York with over 493,000; and Illinois with more than 360,000.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

Several European countries are experiencing case surges as they struggle with another wave of coronavirus infections and hospital beds begin to fill up, the Post reported.

In England, Prime Minister Boris Johnson has instituted a three-tier lockdown in a bid to slow a startling spike in coronavirus cases across the country. In the past three weeks, new coronavirus cases have quadrupled and there are now more COVID-19 patients hospitalized than before the government imposed a lockdown back in March, the Post reported.

Addressing the nation recently, Johnson warned Britons that the country's rise in cases was "flashing like dashboard warnings in a passenger jet."

Things are no better in India, where the coronavirus case count has passed 7.7 million, a Johns Hopkins tally showed.

Nearly 161,600 coronavirus patients have died in India, according to the Hopkins tally, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India's younger and leaner population.

Still, the country's public health system is severely strained, and some sick patients cannot find hospital beds, the Times said. Only the United States has more coronavirus cases.

Meanwhile, Brazil neared 5.3 million cases and had over 155,400 deaths as of Thursday, the Hopkins tally showed.

Cases are also spiking in Russia: The country's coronavirus case count has passed 1.4 million. As of Thursday, the reported death toll in Russia was over 25,000, the Hopkins tally showed.

Worldwide, the number of reported infections passed 41.2 million on Thursday, with over 1.1 million deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.