Hidalgo outlines plan for contact tracing
County judge will launch team aimed at stemming spread
As Texas prepares to return to public life, Harris County Judge Lina Hidalgo on Tuesday said she will assemble hundreds of contact tracers whose work along with increased coronavirus testing is aimed at helping temper any possible resurgence of COVID-19.
Hidalgo outlined the strategy in response to Gov. Greg Abbott’s decision on Monday to allow restaurants, malls, movie theaters and other businesses to resume Friday with limited capacity. While Hidalgo is worried that allowing people to congregate sooner than health officials here had planned for could cause the virus to persist, she said Harris County would do its best to adjust to the governor’s agenda.
“Frankly, I think containing this virus will be a tall order given the May 1 timeline,” Hidalgo said. “But we’re going to do everything we can, move heaven and earth to make it work.”
Abbott’s plan — which calls for expanded contact tracing through the state’s Health and Human Services Department — allows Texans to dine out, and in some cases go back to work about two weeks sooner than Houston health leaders had hoped. On Saturday, the number of Harris County cases is expected to peak.
To Houstonians, Hidalgo asked that social distancing and face cov
ering — a requirement as of Monday — continue as the best option to keep the virus at bay.
Hidalgo said she plans to recruit 300 more contact tracers to pinpoint where the virus is spreading and to whom. From there, tracers will ask COVID-19 patients to isolate and for the people they came into contact with to be tested.
Hidalgo estimates that one positive patient could have had contact with 20 other people.
Her strategy is separate from the tracing program Abbott outlined in a 66-page report as one of the rolling steps in re-opening Texas businesses. The state plan started this week by mobilizing about 1,000 contact tracers from public health workers, school nurses and medical students using a call center. By May 11, the number of tracers should be quadrupled, which is less than half the 8,834 contact tracers that the Association of State and Territorial Health Officials says the state should have in place to reopen.
A report by the association provides an estimate each state needs to rapidly identify, contain, support and retest individuals who are infected and have been exposed.
Hidalgo said her contact tracing plan was already in the works but the governor’s decision to lift some restrictions forced the county to speed up its timetable.
The nine-county Houston area needs 1,000 to 2,000 contact tracers under different modeling projections. Dr. Marc Boom, president of Houston Methodist, said 300 in Harris County is consistent with the lower range.
“Testing without very good contact tracing is not very useful,” said Boom. “The key is to have both in place.”
Dr. Paul Klotman, president of Baylor College of Medicine, said the estimated 300 tracers Hidalgo wanted for Harris County might be “a little low,” but called it “a start.”
Harris County Public Health currently has nine out of the 95 people tasked with COVID-19 response doing just contact tracing with a focus on “congregate settings and high-risk groups,” officials said
As of Tuesday, the county can test up to 1,600 people daily at municipal drive-thru and mobile sites. The number of new cases has plateaued as well, indicating some success with the current level of social distancing and protective precautions, according to Houston health officials.
Hidalgo warned, however, that the county is only equipped to handle up to 100 new positive cases per day. More than that would produce a spike that could jeopardize how the county manages cases, including the additional testing, hospitals admissions — even though Hidalgo said those numbers have since flattened — and contact tracing.
The county is slated to dismantle a $11 million medical shelter at NRG stadium that was never used.
“If we let our foot off the gas right now, the virus will inevitably come back, and it will come back with as much force, if not more force, as before,” Hidalgo said.
Tracing, she said, is among the steps in preventing a surge. The expanded team of contact tracers will be picked from a pool of existing county employees, qualified volunteers and some new hires. Harris County Public Health epidemiologists will help train them on how to track the path of a COVID-19 patient.
Hours after Hidalgo announced her contact tracing plan, the Commissioners Court approved the hiring of 43 new full-time positions to assist in training and managing those tracers.
Hidalgo was not yet sure how much the tracing program would cost because the number of volunteers would dictate how many more they need to hire. County officials hope the temporary hiring can be reimbursed through the CARES Act.
On Tuesday, the county was slated to send an internal memo to department heads on asking employees to be temporarily reassigned to contact tracing.
No department was identified as being exempt, though officials said that most public health and emergency management employees have been busy dealing with the pandemic.
Last week, Hidalgo said she would only consider easing Harris County restrictions on movement and commerce once the virus had reached its peak locally and widespread testing was available. The county judge has never provided a number for that benchmark in testing, even as testing capabilities have improved.
Abbott’s order from Monday struck down the portion of the Harris County measure that permitted fines of up to $1,000 for those caught not wearing masks in public. Hidalgo had urged law enforcement to use discretion when enforcing the order, and police said they would focus on distributing masks to bare-faced residents rather than citations.