Mecklenburg Trains School Nurses For 'Streamlined' Contact Tracing. But Experts Say More Is Needed
Mecklenburg County’s health department is training school nurses to help the seven staff members who perform contact tracing to try and slow the spread of COVID-19.
But experts say the county needs far more people doing contact tracing -- where investigators interview infected people to see who they might have infected over a two-week period. And they said Mecklenburg and other U.S. health departments need to be more aggressive with the tracing and should copy practices from countries like South Korea.
Mecklenburg County Health Director Gibbie Harris says her office has had to “streamline” its contact tracing during the COVID-19 outbreak. She said all interviews with patients are done by phone.
“At one point the state even said, 'We know that you aren’t going to be able to do much at all,'” Harris said. “But our staff has continued to do the contact tracing we need to do, especially for high-risk individuals.”
High-risk individuals are the elderly or people with underlying health conditions.
“If an individual went to the grocery store, we are not following up with everyone they may have contacted with, that they may have walked by in the grocery store,” Harris said. “But if they were in a work environment, or another environment where they could have potentially exposed people, that’s what we focus on.”
Mecklenburg County has had more than 1,100 people test positive for COVID-19.
Two infectious disease experts said it should be easier to do contact tracing today, since Mecklenburg has been under a stay-at-home order for three weeks.
“We need to know who these people are,” said Lee Riley, an epidemiologist at the University of California-Berkeley. “Are they just not following these directives? Or are they occurring in households where a member may be a first responder or be involved in work that involves close contact? Or are these new cases in certain neighborhoods where the message has been sent or publicized?
Riley and Jeff Shaman, an epidemiologist at Columbia University, said Mecklenburg needs to go deeper.
In South Korea, the government has used cell phone GPS data to recreate where people have been, as well as their credit cards to see what stores they visited.
“It's a bit invasive, and it flies in the face of what we think of in terms of civil liberties, but they are going into people's credit cards and they're going into their phones, and they're finding out where they went,” Shaman said. “And they're identifying their contacts based on that. And they're finding those contacts and they're testing and isolating them as well. That seems to be able to keep this thing in check.”
Robert Redfield, the director of the Center for Disease Control and Prevention, told NPR last week that the federal government plans to help local governments with contact tracing. He said the CDC has 600 people now helping states with this, but it’ll have to “substantially amplify” that.
But Riley, of Cal-Berkeley, says counties need to act on their own, and hire and train more investigators right away.
“We have all these unemployed people,” Riley said. “They could be trained to be public health workers to do contact tracing so that they can identify who the close contacts are and then sort of monitor them.”
Harris is skeptical of that.
“In theory that’s a wonderful idea,” she said. “In practice it’s very challenging. Because it’s complicated work. These are investigators. It’s not just a set of questions that you can run down through and collect the information. They really have to dig in and sometimes ask the next question and the next question to get to the answers that we’re looking for.”
In addition to having the manpower to expand contact tracing, the county and state say they are still short on tests to make it fully effective.
North Carolina Gov. Roy Cooper said on Twitter Friday the state has performed 73,000 tests for COVID-19, but said “we need more.”
This is an excerpt from the podcast Inside Politics: The RNC Charlotte. You can listen to the episode here.
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