Health agencies forced to triage case investigations
Capital Region health departments are working to scale up their workforces as the strain of rapid coronavirus spread has forced them to prioritize case investigations and callbacks to people who’ve been exposed.
Albany and Saratoga county health officials noted their efforts to scale operations Tuesday, and urged people who are diagnosed with a coronavirus infection not to wait for a phone call from their county health department before deciding to selfisolate.
“If you have been diagnosed with COVID -19 and you have not yet received a call from the health department but you know of your lab test (result), look at our website at the isolation guidance and start to act accordingly until you hear from us,” said Dr. Elizabeth Whalen, Albany County’s health
commissioner.
Whalen said her department is getting a “deluge of calls” while also dealing with a large number of case investigations, and noted that many of the questions people are calling with can be answered on the county health department’s website.
“We’ve been scaling up to meet the demands as this has started, but with exponential growth sometimes there is a bit of a lag in getting trained staff on board to meet the needs,” she said. “So we are seeing now that we are starting to experience a backlog and to combat that backlog I would like to ensure that people are aware of our website.”
Saratoga County’s new health commissioner, Dr. Daniel Kuhles, said his department has been forced to prioritize case investigations as cases have soared and is following a hierarchy laid out by state and federal health agencies.
“Our cases have increased 145 percent ( between Nov. 24 and Dec. 5), and that’s straining both the laboratories, the health care system and the public health system,” he said. “And it’s certainly a challenge.”
The Centers for Disease Control and Prevention says that all confirmed and probable COVID -19 cases should be investigated. When resources are limited, however, local health departments should focus their investigations on high-priority “clients,” it says.
Priority 1 clients are likely to have exposed a larger number of people and/or are likely to have close contacts who could potentially expose many people, those at higher risk for severe disease, or critical infrastructure workers, the CDC says. Priority 2 clients may be at higher risk for severe disease and will need prompt risk assessment and linkage to any needed medical and support services, it says.
Rising caseloads have also increased testing turnaround times in New York from about one to three days to about five to six, Kuhles said. Positive results that are reported within six days of the onset of symptoms or specimen collection date are to be prioritized, he said.
“We are trying to focus resources where they can have the most meaningful public health impact,” he said.
Kuhles said his department is already making around 1,000 phone calls a day between case investigations, notifications and monitoring. The county is in the process of hiring more contact tracers to assist the 23 currently on staff, he said. His department is also in the process of bringing on virtual contact tracers who are sponsored and trained by the state Health Department, he said.
Record cases, hospitalizations continue
Efforts to scale operations and triage investigations come as cases of coronavirus continue to reach record levels in the Capital Region.
Daily coronavirus cases in Albany County topped 200 for the first time since the pandemic began, officials announced Tuesday. Of the 205 new cases confirmed overnight, contact tracers could only determine a source of transmission for 48 of them — a now regular phenomenon that officials attribute to growing community spread, people having multiple interactions with others while unmasked, and people refusing to reveal their contacts.
In Rensselaer County, 79 cases of the virus were confirmed Tuesday, beating the county ’s previous one-day high of 77 on Saturday.
Across the eight-county Capital Region, counties reported a total 502 new cases of the virus Tuesday and are averaging 433 new daily cases over a rolling seven-day period, another new high. The percentage of people testing positive for the virus over a seven-day average also continues to inch up and reached 4.8 on Monday, the last day for which data were available.
Whalen said daily caseloads are only expected to rise as new infections tied to Thanksgiving gatherings are confirmed. The full brunt of Thanksgivingrelated cases are expected roughly two weeks after the holiday, she said.
“We are seeing what I’ve been discussing as a concern all along, which is exponential growth,” she said. “We’re really starting to see our numbers pick up and pick up rapidly. And the particular concern is that this is happening as we get into the Christmas holiday. And of course at a national and county level we are concerned about a surge upon surge — so having higher numbers, potentially even double our numbers by Christmas or even before then.”
She urged people to take this into consideration when making Christmas and holiday plans.
“You can still make a difference with your individual behavior and in fact it’s really all you can do right now,” she said.
“Know that every time you interact with someone else you can do something to help this. Wearing masks helps. It will decrease the overall number of hospitalizations and deaths. It will decrease the amount of people that get infected. Keep your distance. Keep making sure that you are assessing with every time you go out whether it’s something that you need to do and, again, start to plan Christmas differently this year.”
While rising caseloads are leading to an increase in hospitalizations, Capital Region hospitals are not yet reporting capacity issues.
Area hospitals reported 234 coronavirus patients Monday, an increase of 14 from the day before and the highest number to date. According to figures published by the governor’s office Tuesday, area hospitals reported having 26 percent of beds available Monday. Out of 314 ICU beds in the region, 163, or 45 percent, remain available. Both of those statistics were calculated on a rolling seven-day average.
Another Capital Region resident died due to complications from COVID -19 on Tuesday. The victim was a resident of the Eddy Heritage House in Troy, which has been battling an outbreak since last month. The overall confirmed death toll in the eight-county region is now 435.
Our cases have increased 145 percent (between Nov. 24 and Dec. 5), and that’s straining both the laboratories, the health care system and the public health system. And it’s certainly a challenge.” — Dr. Daniel Kuhles
Saratoga County health commissioner