Contact tracing an ongoing struggle for public health officials

Published: Mar. 10, 2021 at 7:47 PM CST
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CEDAR RAPIDS, Iowa (KCRG) - Thousands of Iowans who had COVID-19 were not contact traced during the November surge, but it wasn’t for a lack of trying.

Data, which our KCRG-TV9 i9 Investigative Unit received through a public records request, show that around 24,166 Iowans either refused or ignored contact tracers’ attempts to perform case investigations during the November surge. In comparison, 52,876 Iowans were contacted and completed an interview with contact tracers.

Contact Tracing in November
Contact Tracing in November(None)

However, the data the state provided i9 showed some people with COVID-19 were not contacted at all for contact tracing. 8,146 cases were closed without an investigation attempt because some jurisdictions were only investigating subsets of the population during the surge. Another 2,000 cases were not investigated either because of reporting delays from labs where a positive test would be reported 28 days after a test was performed.

Reporting delays from private labs also created discrepancies in COVID-19 positivty rates.

Sarah Anne Willette, who runs Iowa COVID-19 Tracker, said contact tracing allows health officials to better understand the spread of COVID-19 in their communities. She said it allows counties to identify trends and possible outbreaks. But, without contact tracing the virus can spread silently.

“If we don’t have contact tracing and we aren’t finding all these people who got reasonably exposed. They could then transmit unknowingly the virus to their friends, their co-workers, their family,” Willette said. “And that could create either a localized cluster in a zip code, a county-wide cluster, a district-wide cluster and we’ve defiantly seen that. Both with increasing positivity in individual counties and school data as well.”

The state doesn’t publish or pull a report on the number of investigations completed each day. But, the number of cases contact tracers can go through each day can vary because each case is unique. Last November, Iowa was looking for a private company to begin providing extra help contact tracing. The company awarded the contract was a donor to both President Donald Trump and Gov. Kim Reynolds.

Kelly Baker, who is an infectious disease expert at the University of Iowa, said with limited resources public health would its’ efforts on people most likely to be superspreaders, such as older people and those in high contact occupations.

“We do know that older individuals, older children and adults are more likely to be symptomatic and to transmit than younger children,” Baker said. “So from a prioritization standpoint, if I had limited resources I would certainly focus on those age groups that were more likely to be spreaders.”

The Iowa Department of Public Health said decisions on which cases to prioritize for investigation were made at the county level for investigation. Those counties, including Linn County, couldn’t call everyone with a known exposure that month because there were simply too many people to call.

Some individual counties, including Johnson, perform their own contact tracing. Sam Jarvis, who is a division manager, at Johnson County Public Health, said the county has likely seen similar response rates to contact tracers as the state. He said people not wanting to pick up the phone for an unknown or unlisted number might be causing the low answer rate. He also said contacts from politicians during the run-up to the election didn’t help answer rates either.

“If there is a number that isn’t listed or restricted or never seen it before or a different area code there less likely to pick it up,” Jarvis said.

Jarvis said a solution is to promote messaging about picking up the phone, regardless if you don’t know the number because it could be a contact tracer.

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