Lori Walsh: You've probably already seen it pop up on your social media feed, San Diego State University researchers have released a report estimating the total number of COVID-19 cases tied to the 2020 motorcycle rally in Sturgis, South Dakota. The report has not been peer reviewed, but it's already making headlines nationwide. What makes it so shareable is that San Diego researchers are saying that as many as 260,000 COVID cases are likely tied to the rally by their estimates. The South Dakota Department of Health has reported just more than 120 confirmed COVID cases that can be tied to Sturgis via contact tracing. We'll talk about the politics of that report later on in the program with the Dakota Political Junkies, but first let's talk about contact tracing, COVID-19 here at home, and how the upcoming flu season intersects with the pandemic. Our guest today is South Dakota's Secretary of the Department of Health, Kim Malsam-Rysdon. Secretary, welcome back to the program. Thanks for being here.
Kim Malsam-Rysdon: Thanks for having me.
Lori Walsh: People are sharing this report far and wide already. I think it popped up on my feed 10 times yesterday. And yesterday, we were also talking to Dr. [inaudible 00:01:23] of Monument Health, and he used the phrase science by press. And so here we are a little bit ahead of our skis, I think, on this one. But let's talk about what this report says and what it doesn't say. From your public health standpoint, as you look through the report, which I'm guessing you probably have by now, what are some of the things that you want people to think about as they read through the 63 pages?
Kim Malsam-Rysdon: Well, yeah, I appreciate the opportunity to talk a little bit further about this, and I appreciate they already called out that this has not been a peer reviewed publication. And so I think that's an important step to understanding how valid some of these projections really are. But the approach that the authors used was an ecologic approach, which is not tied to what we know for actual cases. It takes some assumptions into play and just imports them into a model. In this particular case, it's making the correlation and causation of cell phone activity tied to people that may have attended the rally and when they went home and made some assumptions about that. So I've not seen other studies that go on to really estimate cases of COVID based on cell phone utilization. We do know that cell phone data can be used to get an estimate of social distancing and how much people are moving around. But to tie that to actual cases, I think there's some leaps that are made to be able to do that.
So, we also know that we've seen other impacts that have tied into COVID cases in our state. As you mentioned, we've seen about 124 cases identified as being related to the Sturgis rally here in South Dakota. The AP actually reached out to all other states to get a sense of what they were seeing for actual Sturgis cases. And by all accounts, we've not seen anything higher than... Well, we've seen less than 300 cases, I guess, across the country. So to go from 300 cases of real people to possibly 264,000 cases, I think is quite a leap. And I think it's also something that people that want to politicize COVID and how different states and jurisdictions are responding to it, I think that that is appealing to some people to try to think that the rally caused that many COVID cases. And I think that's why you're seeing it shared.
Lori Walsh: Another thing that we see often, and we knew going in, and we were talking about this in January in staff meetings and I'm sure you were as well and meetings with the governor and others, is just the use of social media and what you could kind of predict and project would happen in the days ahead. Another thing we're hearing a lot about, and I got a call this morning as well, is about contact tracing and the Department of Health. And I saw somebody, this person who called, said, "I saw a coworker who'd been gone for a couple of weeks. They were kind of still coughing. I said, 'You don't have COVID do you?' They said, 'Yes, I did. I've been gone for two weeks and now I've been cleared to come back to work.'" And this employee was wondering why didn't they get a call from the Department of Health if one of their coworkers was out with COVID? They had no idea. Every day, it seems like somebody is saying something about contact racing. So give us an update on how contact tracing is going and what people can expect from contact tracers. When will you get a call? When will you not get a call?
Kim Malsam-Rysdon: Yeah. So again, our key tools in our COVID response include testing and making sure people are getting tested. And then when they are positive, that we're able to do those investigations with those positive people and identify potential close contacts and then tell those close contacts that they need to quarantine to stay safe themselves and keep others healthy around them. So they're key aspects of a response. Here, since we've seen an uptick in some of our cases, we've surged another hundred or so staff to help with our investigation and contact tracing process, so to be able to keep up with some of those numbers. That's probably not unexpected. When we see a positive case, the way the Department of Health learns about that is from the laboratory that's actually processed that test. And so most people will hear from their provider who ordered the test if they are in fact positive. We then attempt to follow up with that person after we get the lab result. And our goal is to do that within 24 hours of getting that lab result.
What we tell people they can do in the meantime, between when they learn of their positive result from their healthcare provider and when we are able to contact them is start thinking about where you've been, think about places that you've been, people that you've come into contact with. A close contact is generally defined as a person that you've been around within a six-foot distance for at least 15 minutes. And so just start to record that kind of information, because when we do call that is going to be what we are going to walk through with you. It'll be everything from going to the grocery store, kind of what that might've looked like, your working situation, what that might look like. And then from there, we'll do follow up contacts with potential close contacts. Now in the case of an employer, if the person's working, it's very likely that we would contact that employer to get further information. But that can depend on the situation as well. So I do appreciate that some people want more information, but if there's not a close contact identified in a workplace, then there wouldn't be a reason for us to contact that employer. And so it'll kind of depend on the working situations that people have whether that employer becomes part of that picture or not.
In the case with schools, which obviously is a big thing right now with schools reopening and schools looking to provide education to kids and keep people safe at the same time, we have a process to work specifically with schools if there's a positive identified in a school setting so that we can get those kids and staff and teachers identified quickly and get through that process. So schools will be playing a pretty active role in helping us identify those close contacts to help kind of expedite that process there.
Once a person is identified as a close contact, then we have a team of people that reach out to them and provide them some information and guidance. And we're hoping people really follow that. Lori, if I can just make a plug, one thing that really does hamper our efforts is when people don't pick up the phone or they don't call us back when we leave a message. And so again, it's really important. It really helps us when people are responsive in that way. And it helps us just move through the process and get people notified.
Lori Walsh: I want to talk a little bit about privacy from a big picture standpoint. Because you and I spoke about this before, and as we see the increased politicization and people insulting each other and kind of calling each other out for behavior, whether it's saying someone's afraid and that's why they're wearing a mask or saying someone is inconsiderate and that's why they're wearing a mask, there's a lot of that going on. And this balance between privacy for the people who are infected and people's feeling they have a right to know if there's an outbreak in their classroom, for example, there's more at stake here than just a form and a HIPAA piece of paper. Are you seeing at your level, are you hearing from your contact tracers the sort of social consequences of COVID right now? There have to be stories that you can share with us to sort of see how are people reacting to this as it becomes part of their lives personally.
Kim Malsam-Rysdon: Yeah. I think it's easy to think of these things in the abstract until it impacts you and it impacts your family and you see that it can be a real hardship to have to stay home for 14 days and juggle just daily life when it can be pretty disruptive. And so I think a lot of people are surprised by how disruptive this can be, even if they don't necessarily get that sick. So we do hear those reactions. We hear people that just can't believe that they need to quarantine if they still feel okay. And that's because we know COVID can be spread by people that don't have symptoms at all. People can still be positive. And so I think that's hard for people to understand.
I think a lot of people also just really bristle at needing to follow those kinds of guidelines. It just maybe goes against the grain of some individuals. They kind of want to do their own thing and don't appreciate being told what the guidance is around some of these things. And we appreciate that. But our job is to make sure that we get the scientifically-backed guidance out to people so that they can make the best decisions for themselves with the information that we know to be true.
Lori Walsh: CDC recently changed that guidance to remove asymptomatic people from the people who should get tested. What are we doing in South Dakota? If you don't have symptoms, but you were in close contact, maybe even with a family member, should you get tested? What's your advice for asymptomatic people and testing?
Kim Malsam-Rysdon: Yeah, so that did cause some questions around kind of what that new guidance is. And the CDC did further clarify that asymptomatic people could still request and be considered for testing. In South Dakota, we do recommend that asymptomatic people who are close contacts to somebody in their household that is positive for COVID, that they should consider being tested so that they know their status. That situation has changed dramatically. If you recall where we were just six months ago in terms of testing capacity and some limitations with supplies and those kinds of things. So I'm very pleased to see that we have some capacity. The labs here in South Dakota, both with our healthcare systems as well as our state public health lab have really been able to manage their volumes well. And the turnaround times remain very, very timely. We're seeing results within 24 to 48 hours. So glad to kind of come around on some of those turnaround times. The out of state labs have done the same. So we want to see people tested. Anybody that has symptoms of COVID, and the symptoms, they're pretty wide ranging, which again can be kind of confusing for folks, but check out the website. If you feel like you have symptoms, you should call your provider, inquire about testing. If you're a close contact of somebody in your household who has tested positive, contact your provider to be considered for testing.
Lori Walsh: Last time you and I talked, you had goals for testing for your department, and the progress of those goals is posted on the COVID website for the State of South Dakota. How do you feel about reaching those goals personally? What are you seeing in your department about achieving those goals?
Kim Malsam-Rysdon: Yeah, so again, we set an ambitious goal to begin with. The federal minimum was to test the equivalent of about 2% of your population. And we set the bar at at least 5% and we've exceeded that I believe every month, starting in July. So we are seeing testing happen. That happens through individuals going to their provider. It happens through mass testing in certain communities or in certain particular locations. We're doing sentinel testing, which is a randomized testing of individuals who are asymptomatic in certain situations, including many schools as well as longterm care facilities, just again to try to stay ahead of COVID. So I think testing has come a long, long way.
What's also pretty exciting is that we're seeing more and more ways that testing can happen and easier ways, I would say, for people that need to be tested and less intrusive ways. So I think that's going to really help us continue to have good volume of testing. It'll be easier for people to get that done. And look for more developments to come here in the coming weeks.
Lori Walsh: I know I got my flu shot earlier than I ever get my flu shot because I'm a late flu shot getter by nature. And this year, as soon as they had them at my pharmacy, I was ready to get mine. Talk about how this intersects with flu season and what do you want people to hear about flu vaccinations right now?
Kim Malsam-Rysdon: Well, flu vaccinations, they're just really important. They are one of the best tools we have. It doesn't mean they're perfect. But they help people not get the flu, and they help people that get the flu not to have as serious of an outcome. So what will be really challenging I think this fall and into this winter is the fact that many symptoms of influenza can be very similar to what we know to be symptoms of COVID. And so having a flu shot is going to help people just stay healthier, have less confusion over what might actually be going on. And we really want to keep people out of the hospital and just maintain that capacity within our healthcare system so that we can, again, keep as many people healthy as possible and just not having those poor outcomes.
So please, people should consider getting their flu shots. Start as early as you possibly can. It does take a little bit of time for folks to build up the antibodies after they get the shot before they've got kind of that full effect. And so if in your community, if it's available now, I would highly encourage people to go get that. We're really hoping to see at least 60% of our adult population get the influenza vaccine this year. And South Dakotans have historically stepped up. And I'm very, very grateful for that. People do the right thing here, and getting your flu shot this year is going to be more important than ever.
Lori Walsh: What do you worry the most about? If you could wave a magic wand and fix one thing in regards to this pandemic, where do you think the efforts are needed the most? What keeps you up at night?
Kim Malsam-Rysdon: I would tell you a lot of things keep me up. We are really trying to what we call is keep COVID in the box. That's making sure that we've got enough testing happening. We want to see those test positivity rates lower rather than higher because that means we're testing at a rate that's high enough to be catching COVID before it spreads beyond the community level, combined with being able to keep up with those investigations and contact tracing.
And then the last thing, kind of the third leg of the stool is that people hang in there and that they follow the guidelines. I know it's getting old. It's getting old for lots and lots of people. I've had staff just working every single day for months. We passed our six month mark here this past weekend. And the staff at the Department of Health have been just working incredibly hard on behalf of folks across our state. And so I know people are tired, but we've got to hang in there. Vaccines are around the corner. And I'm very confident that we're going to see safe and effective vaccines for COVID, especially starting in 2021. And that's going to really help us really weather this entire pandemic. But we've got to kind of keep all those other cylinders going. And so we've got to keep that testing volume up. We've got to be able to maintain our investigations and contact tracing. And then we're really relying on people to do the right thing and do what they need to do to keep themselves safe.
Lori Walsh: And we'll just leave you with this. What's your advice to people as they make decisions about going to some of those larger events? The choice is up to South Dakotans. What do you want them to do? How do you want them to behave to keep the most people safe? What's your advice for people, especially when it comes to larger gatherings, whether that's a picnic or a concert or a fair or what not?
Kim Malsam-Rysdon: Yeah. So we know that your risk for becoming infected with COVID raises as you come into contact with more people. And so I think there's definitely ways that people can do things with others, that they can work and recreate and see family. But we've got to be safe about that. I saw an amazing thing, a good thing that was actually going through social media, which as you and I talked is not always the case, and it was how an elder care center in Rapid City built a way for people to get hugs. And people were wearing protective equipment, and it was really heartwarming. It was really sad that that was the way that they had to do that. But I think there are creative ways that we can manage through this pandemic. But if you can, try to stay away from other people. Keep minimizing that contact that happens on a daily basis and that alone is going to help you stay protected.
Wash your hands frequently. Again, that guidance has not changed. It's one of the number one ways that we know people will become infected is they're touching their face and it's being spread through that kind of contact. Wearing masks if you're in a situation where you can't maintain that social distancing. Masks in and of themselves don't prohibit a person from being considered a close contact, but they certainly help with the spread, especially if you're a person who might be positive and who's asymptomatic and not know that you're possibly spreading COVID. So those guidelines still remain. I'm just personally asking people to be diligent, to step back, think about the next couple of months, and re-up our efforts at taking good, responsible steps. I think by and large people in South Dakota have done that. But we're not out of the woods yet and we need that behavior to continue.
Lori Walsh: Kim Malsam-Rysdon is the South Dakota Secretary for the Department of Health. Thank you so much for being here with us today. We appreciate your time as always.
Kim Malsam-Rysdon: Thank you so much. Take care.