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Lewis & Clark Public Health shifting to quarantine recommendations

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HELENA — Public health leaders have said one benefit of getting the COVID-19 vaccine is that fully vaccinated people won’t have to quarantine if they’re close contacts to someone who tests positive in recent months.

But now, Montana’s local health departments are having to decide whether to change that policy, in light of a state law prohibiting discrimination based on vaccine status.

“We have had to make some adjustments to our operations in order to balance the CDC recommendations around quarantine and the restrictions placed on the situation,” said Lewis and Clark County health officer Drenda Niemann.

The US Centers for Disease Control and Prevention (CDC) issued updated guidelines this summer, saying close contacts who are fully vaccinated only need to quarantine if they develop COVID symptoms.

Instead, they said those people should get tested 3 to 5 days after being exposed to COVID and wear a mask indoors in public spaces for 14 days or until receiving a negative test result.

However, House Bill 702, approved by the Montana Legislature earlier this year and signed into law by Gov. Greg Gianforte, says government agencies may not deny someone “advantages” or “privileges” because of their vaccination status.

Niemann said Lewis and Clark Public Health concluded that having different quarantine rules for people who aren’t vaccinated wouldn’t be allowed under HB 702.

As a result, they’re no longer issuing quarantine orders for anyone. Instead, anyone identified as a close contact will receive a letter, asking them to follow public health recommendations: quarantine if they aren’t vaccinated, and masking and testing if they are.

“We’re relying on our community to do the right thing and follow the instructions provided because both isolation and quarantine are essential to slowing the spread and containing the virus,” said Niemann.

LCPH leaders felt their only other option under the law would be to require everyone to quarantine for the same period – something they felt wasn’t necessary because vaccinated people are less likely to carry or spread the virus.

“If we were to quarantine fully vaccinated individuals, we would have students out of school that don’t need to be and we’d have workers out of work that really don’t need to be – which has a pretty significant snowball effect in our communities, and it’s quite disruptive,” Niemann said.

Many health departments across the state are considering how to address this same issue. Some may take different ways forward.

The Missoula City-County Health Board voted Tuesday to continue quarantining unvaccinated close contacts, but not vaccinated contacts. Board members acknowledged that decision could invite a lawsuit because of HB 702.

For the next few weeks, it’s possible fewer close contacts in Lewis and Clark County will even receive the letter of recommendations.

LCPH is currently focusing its contact tracing on household members and people deemed to be at high risk for COVID.

Niemann says they shifted their strategy because they had scaled back their contact tracing staff dramatically and weren’t able to ramp back up fast enough to handle the recent spike in cases.

“If you know you have been exposed to somebody that is positive, you may not hear from Public Health,” she said. “Please follow the quarantine instructions that the CDC has put out.”

Niemann said they once had about 70 temporary staff working on contact tracing. They reduced that to around 8 as case numbers fell earlier this year. Now, they are interviewing about 20 new candidates.