Nov 17, 2020 — Cases are rising everywhere in the North Country, and that’s put a lot of strain on county health departments.

“Our highest case week in the spring was 49 cases, and what we saw last week was 76 cases. This surge that we have currently is much larger than what we saw this spring," said St. Lawrence County Public Health Director Dana McGuire.

In St. Lawrence County, another 56 cases were reported over the weekend in addition to Monday’s totals.

McGuire spoke with NCPR about the COVID-19 surge, how the county is handling it, and what people should keep in mind heading into Thanksgiving.

St. Lawrence Co. public health director on COVID-19 surge

This transcript has been edited for length and clarity. 

RITCHEY: Governor Cuomo has singled out restaurants, bars, gyms and private parties at houses as the largest source for the spread. Is that true in St. Lawrence County?

MCGUIRE: We actually have seen quite a few cases due to gatherings and they don't have to be large. So between eight and 12 people. After Halloween, we did see this increase and we did hear about a lot of parties.

People are not always forthcoming about their activities. It's hard to know if it's because they don't want to share what they were doing because they weren't supposed to be doing it. But we do hear of this, and they don't have to be large parties. So that is one thing we've seen. We've had exposures at restaurants. I don't know if we've actually had transmission at restaurants, not that I'm aware of, but we did also have one or two cases just related to a bar.

RITCHEY: You’ve been sending out these exposure notices. And we've had some people ask, ‘What are the point of sending those out?’ So can you explain how exposure notices are part of your contact tracing efforts?

MCGUIRE: Yeah. So there's times where we don't always know who was at a location, and so we can't put a person in quarantine if we don't know that.

And when we're doing the case investigation, that person may not know who who was where, when. And we don't know if kind of masking was kept, or if the social distancing was in place either. So we would rather somebody know if you were in that location, if you start to have symptoms, because we have a lot of cases, too, that people have had symptoms. They could be mild or kind of more severe and they find out they're positive, but they didn't think that they had COVID-19.

So we do this so that if you do get symptoms or if you just want to know that you possibly were exposed, that you can get tested.

RITCHEY: I've noticed that most of these notices are for restaurants. Given what we know about indoor transmission, why hasn't the county moved to limit restaurants and dining and things like that?

MCGUIRE: So we're following state guidance. And so while we did do an issue of the state of emergency, at this point, it's really to raise the level of awareness in the community of where we are currently here in St. Lawrence County. ...It has to be in place so that when we want to do issues of, say, like a travel ban and things like that or stay at home orders, that needs to be in place first. But we're really following New York State guidance.

RITCHEY: Could you see, based on where the case count is going, that more restrictions will be coming down by the end of the month?

MCGUIRE: With the trends, yes. So across the state, there is an increase. And although we haven't been part of one of the micro clusters, I do see with the Thanksgiving holiday coming, you know, this is a holiday that we normally do do gatherings. And so it really is recommended that you only gather with your household.

And that's going to be challenging. But I'm going to say that if we had increases just in the last month with this holiday, with the Christmas time coming, all of this is really going to play into the increase that we're seeing.

RITCHEY: How is the county staying on top of contact tracing? Do you have more contact tracers than in the spring or are you able to hire more?

MCGUIRE: So we do have more that we had in the spring. Our entire department, all the staff do contact tracing. We have assistance from the five other county departments. ...So we have about 30 contact tracers. We also have the assistance from the state virtual team. And so right now, we're able to pass to that team 40 contacts per day.

The state is currently training more contact tracers. So by the end of this week, we will also be able to increase that as well.

RITCHEY: Is that enough?

MCGUIRE: Where we're going, we need more and more.

RITCHEY: How is testing capacity? Are people getting their results back in a timely way?

MCGUIRE: So with regard to the send out test, that's the PCR test, that is still the gold standard for the most accurate testing results. Those test results are still taking between three and 10 days. So there still is quite a variance and sometimes quite a length before you know what your status is.

We are getting more access to rapid testing. And so that is good. One of the things that is a challenge, though, is some of the places that do rapid testing don't report into the state system. So unless they contact us, and most places do but sometimes it's not right away, we don't always hear about those cases... as quickly. So that's one of the things that we're working on.

The other thing is the accurate ness of that test. So it's really like if you have symptoms and you get a negative test, that really still should should be followed up by the send out test. ...Sometimes you might get a result, but you might need to follow that up and then still wait for the test results.

RITCHEY: My final question is what you're doing for Thanksgiving. We talked a little bit about that being a concern for county health officials. You know, I know that people are really eager to see one another after being separated for so long. So how are you messaging that to people and talking about your own plans?

MCGUIRE: So I think we really need to be thinking about how can we celebrate with our own households and still reach out to all of the other family members that we may kind of usually do like an in-person visit to.

So I know in my household we're celebrating very small at home, but we're planning a Zoom meeting with both sides of the family on how we can see what meals are like. Talk about just some of the traditions that we have and things like that.

Some of the other activities you can think about is maybe not as standard, but doing things outdoors, thinking about different ways you can go about it. But if you can try to limit to 10 or less, or keeping it in your household, that would be the best.

RITCHEY: And the same goes for Christmas, I'm guessing.

MCGUIRE: Yes. And it's going to be really hard this year. But if we can put all these things in place this year, maybe next year, we can be all back to what we normally do.