The state has reopened — what does that mean for me?

Alabama has started to reopen, but does that mean the risk of contracting COVID-19 has been eliminated? Epidemiologists from the University of Alabama at Birmingham School of Public Health answer questions about what reopening the state means, the impact it may have on people in urban and rural areas, what will happen to prevent the spread, and what you can do to protect yourself and your family.

Does this mean COVID-19 is gone?

The answer is no, according to epidemiologists Suzanne Judd, Ph.D., professor in the Department of Biostatistics, Bertha Hidalgo, Ph.D., associate professor in the Department of Epidemiology, and Cora E. Lewis, M.D., MSPH, chair of the Department of Epidemiology. As of May 12, there were more than 10,000 cases in the state of Alabama.

“Because we know that COVID-19 can be spread even by people who aren’t feeling sick, and because we’ve only tested about 2.7 percent of Alabamians, there are probably far more cases that we don’t know about,” Judd said. “Approximately how many? Well, studies conducted in Florida, New York and California suggest that the actual number of cases is probably six times the number of documented cases.”

That means, in Alabama, there might be approximately 41,200 COVID-19 positive infections. While that is less than 1 percent of the total population in Alabama, it means there are plenty of people who could spread the virus. This means that many more people could become sick in the upcoming months.

Since COVID-19 is still out there, how will we work to prevent people from getting the virus once businesses begin to reopen?

There are many strategies that can help you stay healthy while COVID-19 is still circulating:

• Wash your hands before you eat, wipe your eyes, blow your nose, bite your nails — basically wash your hands before you touch your face.
• Do not touch your face. When you leave home, keep your hands off your face.
• Try to maintain at least 6 feet of distance between yourself and others where possible. Respect others’ space so that, if they or you do accidentally sneeze or cough, there will be less risk of spreading the virus.
• Wear a face mask while in public. It is important for you to wear a face mask at all times in case you are a silent carrier. Silent carriers are people who have the virus that causes COVID-19, but do not know they are sick. Because you do not know who is sick, you have to assume everyone is sick, and live life accordingly.
• If you are sick, stay home. Even if you think it is just a cold, it could be COVID-19 because some of the symptoms are the same. Work with your employer to develop a plan so that you do not have to come into your workplace. If that is not possible, be sure you wear a face mask whenever you are feeling unwell.
• If you have been contacted by a health department official saying someone near you recently had COVID-19, stay home for 14 days. If it is not possible to stay home for 14 days, be sure to wear a face mask when you go out, and pay attention to how you feel over the next 14 days.

Is it OK to see family and friends in person now?

According to Hidalgo, it is best not to do so, especially if friends and family fall into high risk categories for COVID-19.

“We recognize that people are eager to see their friends and family. Our infection and death counts have not decreased, which means that our risk for infection and infecting others remains as high as it was before stay-at-home orders went into effect,” Hidalgo said. “If you have family members who are considered high risk, it is very important to continue physical distancing.”

People with higher risk for severe COVID-19 infections are those who have:

• Asthma
• Chronic lung disease
• Diabetes
• Serious heart conditions
• Kidney disease and on dialysis
• Severe obesity
• People age 65 years old and older
• People in nursing homes or long-term care facilities
• Compromised immune systems
• Liver disease

More information about high-risk groups can be found on the CDC website.

Will guidelines be different depending on if you live in a rural or urban area?

Whether you live in an urban or rural area, public health recommendations continue to be to maintain a distance of 6 feet whenever possible, covering your face when in public and frequent handwashing.

“Maintaining a 6-foot distance between you and others may be challenging in certain locations within urban areas simply because there are more people. However, just because there are fewer people in rural areas does not mean that COVID-19 will not spread in all areas. It is important to be very careful, no matter where you live. Physical distancing is especially important to consider in the context of gatherings, and especially in enclosed spaces. Close interactions with others is how the virus spreads most easily.” Hidalgo explained.

What is contact tracing?

Contact tracing is the process that health departments use to identify who has been exposed to an infectious disease like COVID-19.

“This is a vital part of our public health system and is routinely done during outbreaks of dangerous infectious diseases like measles or the novel coronavirus,” Judd said.

How will I know if I can trust the information if someone calls or texts me to say I have been in contact with someone with COVID-19?

An employee or volunteer from the health department will interview a person who has tested positive for COVID-19 and ask them where they have been in the past 10 to 14 days and with whom they have had contact. The health department staff member will then call, text or write to each of those people who have had contact with the person with COVID-19. The purpose of this is to let the person know they may have been exposed so they can self-quarantine for 14 days.

“According to the Alabama Department of Health, investigators will never ask for social security numbers or money, or try to sell products, which is what many scammers will do,” Hidalgo said. “If patients live in Jefferson County or Mobile County, they will be contacted by someone from

those health departments, and not the ADPH.”

This means that you will likely be contacted by someone from your local health department.

Hidalgo adds that you should never give someone your social security number, send money, or buy any products if you get a call related to COVID-19.

“When someone you do not know calls and begins to ask you questions about where you have been and tells you that you may have been exposed to a virus, it can be scary,” Hidalgo said.

Follow these steps to make sure you are receiving accurate information:

• Ask the person to provide identification about who they are and why they are calling.
• You can also ask to be provided with official documentation about who they are and why they are calling you.
• When in doubt, call the health department directly and ask if the person who called you is working for them as a contact tracer.

What do I do if I have been contacted by a contact tracer?

If you have been contacted by a health department official saying someone near you recently had COVID-19, you will be advised to stay home for 14 days. If it is not possible to stay home for 14 days, be sure to wear a face mask when you go out, and pay attention to how you feel over the next 14 days. If you become ill, seek a COVID-19 test. You should also consider reporting your symptoms in the UAB COVID-19 symptom tracker.

For more information about the novel coronavirus, visit uab.edu/coronavirus.

(Courtesy of UAB)