Baptist system doing its own contact tracing
As Shelby County continues to see a steady increase in new COVID-19 cases — and high positivity rates suggesting many cases are not being identified — one of the resources that could help stymie the spread of the pandemic has been overwhelmed.
Shelby County Health Department Director Alisa Haushalter has said rapid case increases have stretched the department’s ability to contact trace quickly and efficiently. The department started reporting on the percent of cases it had successfully contact traced on May 20. At that time, it was 79%. As of Monday, it was 58%. The decrease reduces the ability to get a handle on the virus locally.
“Contact tracing is one of the best ways to limit the spread,” said Amanda Comer, a family practice nurse practitioner who helps run the Baptist system’s internal contact tracing program.
Comer and Lillian Ogari, program director of biomedical sciences and associate professor at the Baptist College of Health Sciences, have been spearheading contact tracing within the Baptist system since April.
Baptist’s initiative doesn’t replace the health department’s contact tracing program, in which health department employees try to contact every person who tests positive for the virus, find out who they have recently been in contact with and get in touch with those people to ask them to quarantine and get tested if they exhibit symptoms. But Baptist allows them not to have to wait for the health department.
“We knew that the health department was doing it, but we wanted to do it a little faster,” Ogari said.
If a Baptist employee tests positive, Comer and Ogari’s team immediately begins tracing all their contacts in the hospital, getting them into isolation and stopping the potential for the virus to spread throughout hospital staff, which could sideline employees at a time hospitals cannot afford to be short-staffed.
Contact tracing is so essential the city of Memphis has sent about 60 of its employees to work for the Shelby County Health Department as contact tracers. The council also established a committee to oversee contact tracing efforts, and it’s rare for Memphis to oversee a Shelby County program.
Patrons who dine at restaurants have to provide contact information for their party, to facilitate contact tracing in the event that someone at the restaurant tests positive for the virus. Before announcing fall classes would be online-only, Rhodes College had entered a partnership with Baptist for on-campus contact tracing to supplement what the health department would be able to do.
Comer and Ogari’s team at Baptist includes about 50 medical students from across the South, beefing up the hospital’s contact tracing ability while giving the students some of the clinical hours they need to graduate.
Their workload has fluctuated with the scope of the pandemic, much like the health department.
“At the beginning, it was very busy because we were peaking, the curve hadn’t flattened yet. We were very busy. Then the curve flattened a bit,” Ogari said.
That pace that picked up again in recent weeks, she said.
For months, the availability of testing well exceeded the demand for it in Shelby County. Recently, as cases have increased, so has demand for testing, but a shortage of some of the materials needed for tests has led to a bottleneck, with hours-long lines to get tested and days-long waits for results.
The tests being returned are showing high positivity rates, meaning not enough testing is being done to identify the prevalence of the virus, said Dr. Steve Threlkeld, co-chair of the infection control program at Baptist Memorial Hospital-memphis.
“Very simply, we need more testing. The more you’re able to test folks, the more you’re able to find it in your community,” he said.
A slowdown in testing mixed with an inability for county-wide contact tracing to keep up with the new cases being identified means it’s almost impossible to know how many cases there truly are in Shelby County.
Internally, rapid contact tracing has allowed Baptist to develop new practices that decrease the risk of transmission, including implementing the use of face shields.
“This contact tracing process has enabled us to have data... to protect not only the patients we serve but the employees,” she said.
The better-protected hospital employees are, the better protected the community is. As of Monday, 15% of Memphis-area acute care and intensive care unit beds were free. There are hundreds more beds that can be brought online if hospitalizations increase, but those beds can only hold patients if there are enough medical professionals to staff them. And Memphis, like the entire country, has a shortage of nurses.
County-wide, if contact tracing was able to keep up with the growing case rate, it could also help identify neighborhoods or workplaces that could benefit from targeted testing, which Threlkeld has repeatedly advocated for.
Comer stressed that contact tracing was essential in slowing the spread of COVID-19.
“If you get a call from the health department, or you get a call from us, please answer the phone,” she said.
Corinne Kennedy is a reporter for The Commercial Appeal. She can be reached via email at Corinne.kennedy@commercialappeal.com or on Twitter @Corinneskennedy