Ruminating on a recent event/exposure

More later, but COVID's still around

I recently supported a 2 week event several hundred miles from home. I was providing intrinsic medical knowledge and answering questions, among other duties. Busy time, and I thought I was back in my research days (lots of 4 or 5 hour nights, chronic fatigue, because of the various things I support for this). But… and there’s always a “but”…

At least 4 people at this event came down with influenza-like symptoms, and at least 3 took several days “off”. One left the event early when he became ill. Now, we always have extra personnel in case someone can’t perform their specialized duties so we were never short-handed… and we had other contingency plans if needed. That was good. One of those agreed to a home-test assay for COVID-19 and was flagrantly positive. Another told me, and not for the first time, that A) COVID was a biologic weapon, B) COVID illness was overblown, and C) that the flu is worse, and D) no, he wouldn’t take a test. He was ill and in bed for 4 days, and didn’t look good 2 days prior to that time-out, nor for the remaining 4 days of the event. The third politely declined a test, and tried to work through his illness. The fourth initiated a 4 hour drive after spending a day in bed; he reported arriving safely and was going to see his primary care doc, but was certain a test was unnecessary. For the record, I was asymptomatic, masked around those who were ill, but since I got home, I’ve tired easily and had a slightly productive cough. I didn’t think of the possibility I could be affected until well beyond the time when I likely had sufficient circulating antigen to see a positive on a lateral flow test.

Why’s this of interest? I believe the second individual mentioned above was likely our index case. The person who traveled with him complained of “allergies” that resolved to antihistamine the first time he took it, but not subsequently. His symptoms were very limited. I suspect one or the other of those transmitted it to the other noted participants. Pure conjecture, but it’s what I suspect. In my role, I could not compel anyone to test, and the locale we were in did not require reporting test results or suspected outbreaks.

At least one person, the one who tested, ironically, was up to date on his COVID vaccines and boosters.

We had at least 100 people involved in this exercise, so there was a significant spreading potential. I am also up to date, but now due for another booster. Technically, we hosted (this is the third year in a row) a superspreader event.

The one person who did test positive received Paxlovid and started improving within 36 hours of the first dose. However, he followed my advice and stayed home, isolating, until he had been symptom free for 24 hours without symptom modifying medications, and tested negative twice, with tests at least 24 hours apart. He started feeling better around day 10 of symptoms, but didn’t test negative for the first time until 2 days later, so his isolation time was, in fact, 13 days before he’d had 2 negative tests.

The current CDC guidance is a bit more lax than this, although they really don’t want you wandering about in public if you’re still symptomatic. However, there’s been prior evidence that, like the guy I relate here, there’s available, replicable virus for much longer than 5 days. CDC is recognizing that, although the virus is not done with us, a lot of the US population is done with the virus. They’re trying to find a place where people will take at least SOME precautions, rather than following the misinformation pipeline and ignoring precautions overall. I can understand this. but when my most recent example kept testing positive despite a 5 day course of Paxlovid for another full week, maybe, just maybe it’s time for CDC to add some additional words of wisdom.

I’m planning to get another booster. I should have done it before now. I didn’t because I’ve been pretty busy. Yes, really. Taking some classes, work around the house, my volunteer activities, and, of course, the 2 week gig. If I did have a mild case after exposure to what I’m convinced was at least 4 active cases, perhaps I should wait a couple of months. I’m likely to have titers drawn next week, and that’ll guide my decision.

A final thought from the TWIV Universe, with a tip of the hat to Dr. Daniel Griffin: No one is safe until we’re all safe.

Stay safe and healthy.