Ellis County now has four confirmed cases of COVID-19.

The most recent two were made public about 1 p.m. Tuesday when the Kansas Department of Health and Environment released its daily update, and the report showed Ellis County with four cases.

The two new cases have a connection with each other and are a woman and a man in their 50s and 60s, according to a news release from Ellis County Health Department director Jason Kennedy.

“The positive cases were identified through contact tracing by the ECHD and testing was sent to a private lab,” said the release.

“The two new cases have not had recent travel to an area listed as a KDHE travel restriction,” the release said.

KDHE has issued travel quarantines for international travel as well as U.S. states that are COVID-19 hotspots, but not any areas of Kansas with a large number of cases, such as Johnson, Wyandotte, Sedgwick and Leavenworth counties.

The state health agency as of April 6 said “KDHE does not consider travel within Kansas as a criteria for travel-related quarantine.”

Ellis County’s new total of four cases was a bump from the two Kennedy reported Monday evening at the regular meeting of the Ellis County Commission.

“These are two independent cases,” he said of the first two cases. “Really no connection between the two of them.

“There is not a strong travel piece to either one of them, meaning that neither one of them has traveled outside of Ellis County or to a high-risk area. So we do believe that at this point at least their infection was acquired locally.”

The two are doing well and the health department follows up with them every day. Anyone in contact with them has also been notified, he said.

Contacts, as determined by KDHE, are people who have been closer than 6 feet for longer than 10 minutes, he said. Anyone identified through contact tracing is put into 14-day quarantine.

“We have not had as many as we actually expected, but we do have a few people in quarantine associated with each case,” Kennedy said. “However, we are following up with them just to make sure that they are OK and that they’re getting the medical care they need. Currently everyone involved really is doing very well. They’re in home isolation, home quarantine.”

Isolation and quarantine are the same thing, he explained to the commissioners. They both mean the person can have no contact with other people but can go outside for solo exercise.

KDHE, which originally required a blanket 14-day quarantine, on April 7 changed that to mandatory isolation for seven days after the start of symptoms, Kennedy said.

“So if they have symptoms on Monday, it’s seven days from Monday they’re in home isolation, or 72 hours post fever,” he said. “If they get to Sunday and they spike a fever on Sunday, then they continue to stay in isolation until they are 72 hours post fever without any fever-reducing medications.”

People who have had contact but haven’t tested positive for the coronavirus or aren’t symptomatic are placed in 14-day quarantine, Kennedy said, because the latency period of the virus is 2-14 days.

“If during that 14 days they show no symptoms or any reason to test, then they would be released from quarantine at the conclusion of that 14th day,” he said. “If during that time they show symptoms, then they would be directed to their primary care physician to get tested. Once they get tested then that changes. If they’re positive, then they go to an isolation order. If they’re negative, they stay in quarantine for the duration of the 14 days.”

County Commission chairman Butch Schlyer probed further into the amount of time.

“So a person could be exposed to this virus and be in a quarantine situation for seven days prior to having any symptoms, have symptoms for another seven or 10 days, and then wait seven more days after symptoms have abated?” he asked.

“Yes,” Kennedy said.

“So it can be an extensive period of time then?” Schlyer asked.

“Yes, it really comes down to if they stay asymptomatic, it’s 14 days,” Kennedy said. “If they test positive and stay asymptomatic, it’s a minimum of seven days. Now that is at my direction as the public health officer. If we see any indication that they might still have the ability to spread it, then we can extend that, but it’s a minimum of seven days or 72 hours post fever.”

For members of the same household, Kennedy said one member who tests positive could actually be out of isolation sooner than the rest of the family because they’re seven days post symptoms, or the 72 hours.

“The rest of the family, if they’re asymptomatic, they’re in for 14 days,” he said.

“If you have a family of four, and they actually all got it, you could be in isolation for two months,” said Commissioner Dean Haselhorst.

Kennedy said the time in isolation can add up.

“When we do contact tracing now, we go back 48 hours pre-symptom or pre day of test,” he explained, with contact tracing going back in some cases a month or so. “Even with just two cases, it is considerably labor intensive to run all of that down and find people.”

The commissioners approved Kennedy filling an open nurse position with an LPN, despite originally discussing hiring two part-time nurses a few months ago.

“What would have been conceivable a month ago, is truly not conceivable as far as operations right now,” Kennedy said. “And so it’s hard to make your plans now in the middle of the pandemic, for what it’s going to be like afterwards. But I will say prior to even the pandemic, we did utilize both nurses.”

Contact tracing isn’t new for the health department, he said.

“We have contact tracing that goes on year-round with other infectious diseases,” he said. “It’s just not quite as labor intensive and not quite as grand a scale.”

Commissioner Dustin Roths asked Kennedy if Ellis County will get access to antibodies testing for those who think they may have had a mild version of the virus.

While it’s available at the state level, Kennedy indicated it’s unlikely in Ellis County, where there are so few cases.

Other testing to confirm active cases, however, might become more available.

“There’s some hope on the horizon as far as the testing goes, there are several different processes for testing now, and so I think they are ramping up the testing and there will be some availability,” he said. “I just don’t know when it will make it to Ellis County.”