The virus has spread so much that contact tracking can no longer contain it, but tracking is still useful | News

In Kentucky’s wide swaths, tracing people’s contact with the coronavirus was too widespread and no longer prevents it. Instead, it slows the incidence, at best.

It’s according to several local health officials, including Roanya Rice. She is the Director of Public Health for the North Central District Health Department, including Spencer County, and more than 10% of the population was virus-positive as of last week.

“It’s not the situation that we are now able to track and track the way we leave,” said Rice. “We no longer have the opportunity to do contact tracing to stop the spread.”

Some people do not welcome tracking contacts. This usually includes an official request to quarantine for 10 days in case of virus infection. Governor Andy Beshear said this week that there has been diminished cooperation with those who have been identified as recent contacts or who have had a positive reaction.

According to Sarah Jovest, director of the Lincoln Trail District Health Department, she and her staff feel that some people who test positive may not want to provide a list of recent contacts. I am.

“I feel like their contacts can be 100% untrue,” said Elizabethtown-based Best. “People don’t want to be quarantined, so I think they purposely exclude some of them.”

According to Beshear, some of the contact tracers arrive do not respond or self-isolate as requested.

“They can lead to another spike,” he said. “This is war. The number of Kentucky we either win or lose or we lose is all based on the number of battles we win or lose. Tired. Let’s go. Life It depends on it.”

Local health officials say most people work together when contact tracers reach out. They say there is only a rough, unscientific estimate of the percentage of people who are uncooperative, as the state recently provided a unified platform for health departments to track cases. The director estimated between 2% and 40% non-compliance if persecuted.

Matt Hunt, director of the Barren River District Health Department, said the uncooperative people in his eight counties were mostly asymptomatic. In his district, Barren County, more than 10% of the population was virus positive in the latest week of the White House Coronavirus Task Force report from 15 to 21 August.

“There are some things that deny the test results, [say] That is impossible, [they] Hunt said. “They are usually asymptomatic individuals. They are difficult conversations.”

Others use “dangerous worker exemptions” to refuse high-risk post-exposure quarantine. State Health Commission Stephen Stack announced Wednesday that it was “distorted” by removing the immunity for workers in food, healthcare, energy and other key industries on Wednesday, August 26. .. .. The Department of Health has discovered that people of all kinds claim to be critical infrastructure workers. “

Meanwhile, the state-wide director of health says that the virus has spread so much in the community that contact traces do not include the spread of the virus. Craig Humbeau of the Lexington-Fayette County Health Commission also said this was due to how the virus works. An important time to isolate people is when they begin to show symptoms. But many are asymptomatic.

“Normally [the contacts] It’s infectious a few days before symptoms start, and 25% of those are not infected,” Humbaugh said. “That means we have all those who may be infected by other people in the community. It builds on a sort of itself. When it’s time to contain it, this strategy is much more It’s easy.”

Kentucky has the money to hire 700 contact tracers and hired 550. This will secure 150 spots. Mark Carter, a state official who is leading the contact tracking effort, predicts that these new hires will occur by mid-October or mid-October, depending on the spread of the virus. I will.

“According to the Public Health Department for Statewide Tracking, there are enough trackers,” Carter said. “The main issues are masking and social distance. This puts a strain on traces. So traces are useful, but I don’t think they can stop the spread. I agree that it is in a mitigation stage.”

As many Kentucky people ignore mask obligations and social distance guidance that are difficult to enforce, health officials are saying that contact tracking is a viable action to fight the virus without a vaccine. I say yes.

However, funding for tracers will only be available until December and it is unclear whether Congress will provide more. Hunt, with Baren River’s Health Department in Bowling Green, wants his money to run out before he needs the most help.

“I want to go a few steps ahead,” Hunt said. “If you find a spike, rather than spending 25 or 30 to investigate a day, it jumps to 75, then I start thinking. Now we need to bring in more people.”

Contact traces play a role in fighting viruses even when they are not spreading. Clayton Houghton, director of public health at the Green River District Health Authority in Owensboro, said at least tracers provide important education about the virus. And that’s important for the Kentucky who were already living relatively isolated lives.

“We have people who are isolated, and we don’t have friends or family to help them,” Houghton said. “We have people who have real needs in terms of food and medicine. We can help with that. If we weren’t there they would certainly be isolated. It will destroy other people and put others at risk of infection.”

Another issue that may be added to non-compliance is the change in guidance from the Federal Centers for Disease Control and Prevention regarding who should be tested. According to Houghton, one of the changes that has recently returned is already back, causing confusion and resistance to departmental guidance.

“We contacted them and said they had contacted someone who was infected,” he advised to quarantine, Houghton said. “And they said, “Well, I just saw this morning on the CDC website that I didn’t have to do these things,” and that was a kind of misinterpretation. “

The CDC now says that people who are exposed but asymptomatic may “consider a test.” Kentucky authorities recommend that people without symptoms be tested because they can spread the infection.

Nonexistent number

By early September, most state health departments will need to track covid-19 data using a new technology called contact tracking and tracking systems. Currently, there is almost no data on viruses, except for the number of live positives.

“By next Monday (8/31), all but one of the local health departments will be CTTs, at which point we will be in a much better position to be able to report this data. Carter said. By the end of September or mid-October, I think the system will have available data. “

Many departments used paper charts to record cases during and even during the pandemic. Others used internal systems.

Most health department directors said they were constantly trying to keep track of new cases and contacts. I don’t have time to analyze.

In the Lincoln Trail area, this is a real disadvantage, according to Best. She wants to know the number of virus-positive contacts. She wants to know the percentage of people who do not answer the phone, and who are initially supportive but then do not answer the phone or email. She wants to know not only the numbers for her district, but the averages for the entire state.

“Knowing that there are 1,000 contacts will likely turn 20% of them into positives, which will help me plan,” Best said. “Alternatively, if the state average is 20% and my average is 40%, we may need to reconsider how we educate people about quarantine and quarantine. You might need to evaluate what you’re doing, because there’s no lack of it. When you look at the data, you get such a benchmark.”

And this information may only make contact tracking a more powerful tool.

Kentucky Health News is an independent news service of the Institute of Rural Journalism and Community Issues, headquartered by the School of Journalism and Media at the University of Kentucky, and the Foundation is supported by sound Kentucky.