Burdened By Surging Cases, Pennsylvania Rationing Contact Tracing, Case Investigation Efforts
The Pennsylvania Department of Health is further rationing which coronavirus cases will receive calls from case investigators and contact tracers.
At a Tuesday news conference Michael Huff, director of testing and contact tracing at Pennsylvania Health Department, told reporters that more than 34,000 Pennsylvanians tested positive for the virus over the past week--yet less than one-quarter of these people were successfully reached by contact tracers.
These efforts are key to interupting disease transmission, however public health workers have been unable to keep up with the growing volume of infections.
“As the burden of COVID-19 worsens in an area, and the capacity to investigate new cases in a timely matter becomes more difficult or infeasible, health departments will prioritize which cases to investigate,” Huff said.
When a person tests positive for the coronavirus a case investigator gathers information on where they visited and whom they were with while contagious. Then a contact tracer notifies those places and individuals of the possible exposures.
The anouncement on the priorization of certain cases comes after more than of month of Pennsylvania reporting thousands of new infections each day.
Huff said contact tracers and case investigators had begun to triage efforts several weeks ago; but that the department is now using new guidelines from the Centers for Disease Control and Prevention that were released for health departments in "high burden" areas that are experiencing "surge or crisis situations."
Case Investigation and Contact Tracing Priorizations
• People diagnosed with COVID-19 in the past six days, based either on specimen collection or the onset of symptoms.
• Households contacts of a positive case who were expose in the past six days.
• Those who live, work or visit congregate care facilities, such as nursing homes.
• People who work in high-density workplaces.
• Those who attended high-density events.
• Individuals that are part of a disease cluster.
• Those who are at increased risk for serious illness.
• People exposed to the coronavirus in the past six days.
If more than two weeks have passed since someone submitted a sample that tested positive for the virus, Huff said “generally” that individual won’t be contacted by a case investigator.
“The challenge here is, over those 14 days, without knowing that the case exists, the potential is that case will spread,” he said. “Therefore, we’re unable to identify anyone who came in contact with those cases.”
Further hindering contact tracing and case investigation efforts is a lack of compliance by some members of the public. Huff said often people don’t pick up when public health workers call, while others refuse to answer questions.
“Clearly public trust is part of it, the fear of providing information to someone you really don’t know."
Huff said while the department is working to increase trust with the community, he also cited that certain members of the public are not taking the virus seriously.
“Public health controls are only as effective as the willingness of individuals to carry them out," he said.
However, with limited testing access and inconsistent messaging—particularly at the federal level—issues surrounding contact tracing and case investigation, as well as containment of the virus as whole, extend beyond individual choices.