Isolation Quarantine Plan For Stockbridge-Munsee Community

This Plan outlines the Stockbridge-Munsee Community’s overall approach of how quarantine and isolation status is applied during the COVID-19 public health emergency. The Tribe has authorized the issuance of isolation and quarantine orders for communicable diseases, like COVID-19, under Chapter 26A of tribal law.  
The Tribe reserves the right to modify this plan or actions taken under it at any time based on with developing guidance and best practices for COVID-19. Additionally, while this Plan outlines the overall approach, specific directions may differ as appropriate based on medical conditions.  

DEFINITIONS

    Close Contact: A person is considered to be a close contact of a person who tested positive for COVID-19 if they met any one of the following scenarios:

1)    Did you have direct physical contact with the person (e.g: hug, kiss, handshake)?
2)    Were you within 6 feet of the person for more than 15 minutes within a 24 hour period?
3)    Could the person have had contact with any of your respiratory secretions (e.g. Couched/sneezed on, contact with dirty tissue, sharing a drinking glass, food or towels or other personal items).
4)    Did you stay overnight for at least one night in a household with the person (i.e., household contact)?

    Indirect Contact: A person is an indirect contact if they have prolonged (15 minutes or more within a 24-hour period) contact with someone who is not positive, but is considered as having close contact (as defined above) to a person who tested positive for COVID-19.
    Household contact:  Any person who lives in or spent at least one night in the house of a person who tested positive for COVID-19 during the infectious period.
    Healthcare Worker: Tribal EMS and any person at the Stockbridge-Munsee Health and Wellness Center who provides care to patients to include Pharmacy staff. 

PERSONS UNDER QUARANTINE OR ISOLATION ORDERS 
NOTE:  Persons who are under quarantine orders due to a positive COVID-19 test are not released from quarantine until directed by the contact tracer or medical that they are released.

 
Persons who tested positive for COVID-19:  
Persons (both employees and non-employees) who tested positive for COVID-19 will be quarantined. If the person is under the Tribe’s jurisdiction, they and their household will be quarantined per Chapter 26A of tribal law.

 
If the person is outside of the Tribe’s jurisdiction, a quarantine recommendation will be issued. The local public health authority where they live in may issue additional isolation/quarantine requirements.

If a person is tested at a site other than the Stockbridge-Munsee Health & Wellness Center, the person must inform the SMHWC at 715-793-5087 of their test date and results.  
All persons who test positive will be contacted by contact tracers to identify who else may have been exposed to COVID-19.  Persons who tested positive shall provide all information to the contact tracer to include past travel, symptoms, and who they were in contact with. 

Quarantine will be discontinued once the person with the positive case meets the following:

    10 days have passed since symptoms first appeared or the positive COVID-19 test result

AND

    You have had no fever for at least 24 hours (that is one full day of no fever without the use medicine that reduces fevers)

AND

All symptoms have improved (for example, when your cough or shortness of breath have resolved) 

Employees will require medical authorization clearing them to return to work. 

Note: Those with severe cases of COVID-19 such as hospitalization or those with compromised immune system may be required to quarantine for 20 days instead or 10.  The determination will be made by a physician. 

Household Contacts of a person who tested positive for COVID-19: 
Household contacts will be subject to an isolation order. If the household contacts are under the jurisdiction of the Tribe, they will be isolated per Chapter 26A of tribal law.  

If the household contacts are not under tribal jurisdiction, an isolation recommendation will be issued.  Their local public health authority may issue additional isolation/quarantine requirements. Employees of the SMC, including North Star Casino employees are required to report instances when members of their household are confirmed COVID-19 positive to Occupational Health. 

All persons in a household of someone who tested positive will be contacted by contact tracers to identify who else may have been exposed to COVID-19.  Persons in the household of someone who tested positive shall provide all information to the contact tracer to include past travel, symptoms, and who they were in contact with. 

Isolation of the household contacts will be discontinued once the person meets the following: 

    14 days have passed since the person in the household was released from quarantine.

o    NOTE:  For people who continued to live in the same house, this 14-day timeframe begins at the end of the quarantine period for the person who tested positive (when they are released). This requirement is due to the fact that persons living with the infected person could be infected throughout the entire initial quarantine period when the person was infectious.

o   NOTE:  For people who do not continue to live in the same house (such as if they were a visitor for one night or the infected person is separated into an entirely separate area such as self-contained basement, camper, or cabin), then this 14-day period is begins as of the date of last contact with the person who tested positive. Community Health will need to accept that the separation is adequate in order to allow tracking under this provision.

And

  You do not develop symptoms (Fever, cough, shortness of breath, sore throat, muscle pain, loss of taste or smell). If symptoms develop during the 14-day period, you must report symptoms to the SMHWC (715-793-5087).  The SMHWC will relay the information to medical providers for further guidance as to a need for testing and isolation/quarantine status.

Employees will require medical authorization clearing them to return to work. 

People who have Close Contact with a person identified as having COVID-19 or those who had Close Contact (2 days prior or less) to a person who later tested positive for COVID-19. 

Employees who had close contact with a person known to have COVID-19 shall notify Occupational Health of the close contact and isolate themselves in their home.  Contact tracers will interview those with close contact to confirm the contact.  If the contact is confirmed, those with close contact will be tested for COVID-19.   If the results are positive the person will follow the guidance for Persons who tested positive for COVID-19. If the results are negative, the person will require to isolate themselves in their home for 14 days from the date of close contact with the person who tested positive.   

Non-employees who had close contact with a person known to have COVID-19 shall notify the SMHWC (715-793-5087) of the close contact and isolate themselves in their home.  Contact tracers will interview those with close contact to confirm the contact.  If the contact is confirmed, those with close contact will be tested for COVID-19.   If the results are positive the person will follow the guidance for Persons who tested positive for COVID-19. If the results are negative, the person will require to isolate themselves in their home for 14 days from the date of close contact with the person who tested positive.   

All Close Contacts- While in the 14-day isolation, all persons shall isolate themself at home and monitor themselves for symptoms. The person shall limit travel outside of the home to those trips that are absolutely necessary for food and supplies. The person shall wear a mask when making those trips and limit exposure to others in the household.  The person should contact the clinic at 715-793-5087 if they develop symptoms.  If symptoms become severe or life-threatening they should call 911 or go to the Emergency Room.

Close Contacts are released from isolation if they do not develop symptoms within the 14-day period while potentially infectious. 

Healthcare Workers 
 

Healthcare workers who test positive will follow the guidance described in the section titled 
“Persons who tested positive for COVID-19” 
Healthcare workers who wear appropriately fitted PPE (at minimum: N-95 or PAPR) are excluded from the isolation requirements for close contact or indirect contact.  Healthcare workers will report any suspect contact or symptoms immediately.  The SMHWC Medical Director or designee physician or nurse practitioner will determine when the healthcare worker can return to work or if an isolation period is required. 

Healthcare workers who have been fully vaccinated are exempt from close contact or indirect contact isolation requirements.  They will wear a fitted N-95 or PAPR unless they are the only person in a room with the door closed.  Healthcare workers will report any suspect contact or symptoms immediately.  The SMHWC Medical Director or designee physician or nurse practitioner will determine when the healthcare worker can discontinue use of the N-95 or PAPR or if an isolation period is required. 

PERSONS WHO NEED TO MONITOR HEALTH CONDITION 
 

People who have Indirect Contact with a person identified as having COVID-19 or those who had Indirect Contact (2 days prior or less) to a person who later tested positive for COVID-19. 

Employees who had indirect contact with a person known to have COVID-19 shall notify Occupational Health of the indirect contact.  Contact tracers will interview those with indirect contact to confirm the contact was not close contact.  If the contact is confirmed as indirect, the person will be required to test for COVID-19.   If the results are positive the person will follow the guidance for Persons who tested positive for COVID-19. If the results are negative, the person will be cleared for work, but shall monitor themselves for symptoms and notify Occupational Health if symptoms appear.  

Non-Employees who had indirect contact with a person known to have COVID-19 will be offered a COVID-19 test.  If the results are positive the person will follow the guidance for Persons who tested positive for COVID-19. If the results are negative, the person shall monitor themselves for symptoms and notify Triage at 715-793-5087 if symptoms appear.  

SELF-ISOLATION REQUIRED PENDING FURTHER DIRECTION 
 

Persons who have symptoms of COVID-19 (fever, cough, shortness of breath, fatigue, sore throat, muscle pain, headache, congestion or runny nose, nausea, diarrhea, loss of taste or smell).

  
Employees who have two or more symptoms of respiratory illness such as Fever, Cough, shortness of breath, fatigue, sore throat, muscle pain, headache, congestion or runny nose, nausea, diarrhea, loss of taste or smell shall isolate themselves at home and contact Occupational Health.  The employee will be required to test for COVID-19 or may be required to complete a 14-day isolation of which the last 24 hours must be asymptomatic based on medical direction. Employees will require medical authorization clearing them to return to work.

Non-employees who have two or more symptoms of respiratory illness such as Fever, Cough, shortness of breath, fatigue, sore throat, muscle pain, headache, congestion or runny nose, nausea, diarrhea, loss of taste or smell shall isolate themselves at home and contact Triage at 715-793-5087.  The person will be evaluated and treated as directed by medical staff.