Lo­cal gov­ern­ments over­whelmed in race to trace COVID con­tacts

Cape Breton Post - - COVID-19 -

The soaring num­ber of COVID-19 cases in the United States has far out­stripped many lo­cal health de­part­ments’ abil­ity to trace the con­tacts of those in­fected, a step crit­i­cal in con­tain­ing the virus’ spread.

With the pan­demic claim­ing about a thou­sand Amer­i­can lives a day, many city and county de­part­ments say they lack the money and staff to ex­pe­di­tiously iden­tify peo­ple who have been ex­posed, ac­cord­ing to a Reuters sur­vey of 121 lo­cal agen­cies, as well as in­ter­views with dozens of state and lo­cal of­fi­cials, epi­demi­ol­o­gists and trac­ers.

The United States badly lags other wealthy coun­tries in con­tact trac­ing, in­clud­ing South Korea and Ger­many, which ramped up their pro­grams months ago. Con­tribut­ing to the fal­ter­ing U.S. re­sponse is the gov­ern­ment’s fail­ure to pro­vide ac­cu­rate and timely di­ag­nos­tic test­ing, some­thing other coun­tries were able to roll out much faster and more broadly.

On Alabama’s hard-hit Gulf Coast, health de­part­ment staffers are stretched so thin they are di­rect­ing in­di­vid­u­als who test pos­i­tive to no­tify any con­tacts them­selves, said Rendi Mur­phree, di­rec­tor of Mo­bile County’s Bureau of Dis­ease Sur­veil­lance and En­vi­ron­men­tal Ser­vices.

“Ev­ery­thing is over­whelmed,” she said.

Adding to the chal­lenge has been a sharp politi­ciza­tion of the COVID-19 re­sponse, with many Amer­i­cans, from Pres­i­dent Don­ald Trump on down, of­ten por­tray­ing maskwear­ing and other mea­sures as an in­fringe­ment of per­sonal lib­erty.

The United States has by far the world’s largest COVID-19 caseload, with over 4.6 mil­lion con­firmed in­fec­tions and more than 155,000 deaths. Yet pub­lic health mea­sures dur­ing the pan­demic have been largely de­cen­tral­ized, com­ing down to patch­work ef­forts by state, and es­pe­cially lo­cal, gov­ern­ments. Fed­eral fund­ing has proved un­re­li­able, caught up in fierce de­bate over the cri­sis.

Now, as part of log-jammed ne­go­ti­a­tions over new re­lief legislatio­n, Repub­li­cans and Democrats in Con­gress are ar­gu­ing over fund­ing pro­pos­als for test­ing and trac­ing that are tens of bil­lions of dol­lars apart. As of June, U.S. Cen­ters for Dis­ease Con­trol and Preven­tion di­rec­tor Robert Red­field said the coun­try had 27,000 con­tact trac­ers – about a quar­ter of what has been rec­om­mended.

Al­though some lo­cal health de­part­ments told Reuters their ef­forts have proved suc­cess­ful – and many said they were worth­while – sev­eral re­searchers de­scribed U.S. con­tact trac­ing over­all as too lit­tle, too late.

“You don’t clean up an oil spill with pa­per tow­els,” said Marc Lip­sitch, a pro­fes­sor of epi­demi­ol­ogy at the Har­vard pub­lic health school.

On this point, the Trump ad­min­is­tra­tion does not dis­agree. Ad­mi­ral Brett Giroir, As­sis­tant Sec­re­tary for Health at the U.S. De­part­ment of Health and Hu­man Ser­vices, told Reuters that given the spread of the dis­ease, mask wear­ing and other preven­tion mea­sures are more ef­fec­tive.

“It is re­ally im­pos­si­ble to con­tact trace,” Giroir said, un­til the num­bers come down.

The agen­cies re­spond­ing to the Reuters sur­vey serve at least 27 mil­lion res­i­dents in large cities such as Min­neapo­lis, Bos­ton, and Cleve­land, as well as smaller com­mu­ni­ties in­clud­ing Al­len­town, Penn­syl­va­nia, and Dare County, North Carolina. Col­lec­tively, as of last week, they ac­counted for at least 230,000 COVID19 cases and 7,300 deaths. The re­sponses cover the week end­ing June 22. Reuters fol­lowed up in late July with sev­eral de­part­ments, such as Las Ve­gas and Kansas City, Kansas, where of­fi­cials said cir­cum­stances had not im­proved.

From the early days of the pan­demic, pub­lic health ex­perts em­pha­sized the im­por­tance of con­tact trac­ing, a decades-old strat­egy aimed at in­ter­rupt­ing in­fec­tious dis­ease trans­mis­sion. It in­volves in­ter­view­ing in­fected peo­ple, iden­ti­fy­ing peo­ple whom they may have ex­posed to in­fec­tion and try­ing to keep those in­di­vid­u­als from pass­ing the virus to some­one else.

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