Aggressive contact tracing by state identifies new COVID cases

Coronavirus

A spike in COVID-19 case numbers on Sunday are largely due to a cluster of 17 Honolulu cases all associated with attending a funeral, according to the State’s Covid-19 joint information center.

The state said contact tracing also identified six cases in Leeward Oahu associated with known clusters, and all of the cases are in isolation.

In addition to the 23 Oahu cases, the Department of Health reported two new Kauai cases associated with a known cluster reported last week, one case on Maui, and a case on Hawaii Island with travel to Georgia.

State Epidemiologist Dr. Sarah Park explained to KHON2 how the process works.

“[Contact tracing] is absolutely critical because as soon as we know about any cases, whether it’s reported to us by a clinician or reported to us via lab result, we immediately act on those reports and the case is assigned to an investigator to find that person, interview that person, and to determine any close contacts,” she said.

She said the process begins within 24 hours of the positive result.  

“As soon as we determine that list of close contacts then we’re trying to contact those people to make sure that they know they’ve been in contact with someone and they need to be in quarantine,” she explained.

She said it’s critical to quickly identify the contacts so they can be isolated immediately and the likelihood they’ve exposed others is dramatically reduced.

“It’s critical because, as demonstrated with the case counts today, the nice thing for us, if there is any nice silver lining out of this, is that because we had done that a lot of these cases, or pretty much all of them were already in quarantine,” she said. “Because we had identified them and the testing that we were doing as part of our investigation just confirms that they not only had been exposed but actually had been infected.”

When a person is confirmed positive for Covid, and went to a large gathering, she said investigation teams meet with various households that might have attended the gatherings.

“They might admit that there may have been more sort-of closer contact, you know hugging, things like that, and when we hear those kind of trigger things and obviously our threshold for testing is finding those people,” she said.

“We get them tested, and that’s where you’ll see that upswing in case numbers, because we’ve identified them and tested and gotten yielded positives,” Dr. Park said.

She said sometimes the process isn’t as fast as it could be because finding the person’s contact information isn’t readily available.

“If it’s a lab report sometimes we don’t have that immediate contact information for the case, we have to go to the medical provider and get that information from the medical provider,” she explained. “If the report came from the medical provider in the first place and then we get a confirmation of the case then it’s a little bit easier because obviously the medical provider would have given us the cases information.”

She said a lot of contact tracing is based on the memory of the individual and then being able to reach those individuals by phone or e-mail.

“A lot of times my staff will try and reach people by e-mail first, if they have the email address to give them a heads up that they’re going to be receiving a phone call from them,” she said.

In the early months of the pandemic, getting a Covid test was difficult to do. She said that’s changed now and “just about everyone that we identify as a close contact in our investigation” can be tested.

On Saturday, Lt. Gov Dr. Josh Green said he wants to see more testing done for each individual case that comes back positive.

“One person can turn into 100 cases,” he said. “We need to make sure we’re testing 100 people for every positive case we have that’s where the success occurred in Korea.”

“New Zealand tests 270 people for every positive case they have and they really, really suppressed the virus,” Green said.

Both Dr. Green and Dr. Park said it’s concerning to see residents let their guards down so soon, especially before re-opening to tourism on Aug. 1.

On Friday, the Department of Health released a study showing many Hawaii residents don’t view the threat of Covid-19 as serious as they did back in April, and many are not following the health and safety guidance.

“It’s a concern, it’s a real concern and I think our community needs to understand that if we’re going to really reopen and reopen with confidence, it requires that our community continue to maintain the safe practices,” Dr. Park said.  

“These jumps up and down of case numbers before we’ve even reopened are concerning because what does it mean when we reopen if people are not maintaining safe practices?” she concluded.

Contact Tracing Training Program

The University of Hawaii-Hawaii State Department of Health Contact Tracing Training Program is seeking additional applicants with clinical healthcare backgrounds and and an undergraduate degree who are available to be activated by DOH as full-time contact tracers for up to three months in the near future. A smaller number of applicants able to serve part-time (at least 20 hours per week) will be considered.

These contact tracers will provide the supplemental workforce capacity to identify and facilitate isolating individuals who are sick or have been exposed to someone with COVID-19.  

You can Sign up here.

“Given the state’s reopening and rise in COVID-19 cases, our partnership will serve DOH and the people of Hawaiʻi by providing the needed contact tracing training programs,” said Aimee Grace, UH program lead. “We are now specifically seeking clinical healthcare professionals who are available to be activated by DOH full-time as contact tracers.” 

The UH-DOH program has reopened registration for Track 1: Contact Tracing Training for Clinical Healthcare Professional to meet this urgent need. The free, accelerated, one-and-a-half day online training course is open to:

  • Registered nurses
  • Nurse practitioners
  • Social workers
  • Pharmacists
  • Physicians
  • Physician assistants
  • Emergency medical technicians (EMTs)
  • Paramedics

While UH is providing the contact tracing training as part of the partnership, DOH will activate and manage any needed contact tracers. Once training has been completed, the contact tracers will be activated as needed for a short-term period of up to three months.  

Track 1 training for clinical healthcare professionals is being administered by UH Manoa’s School of Nursing and Dental Hygiene and has been developed jointly with DOH. Track 1 program lead Kristine Qureshi said, “The SONDH has an extraordinary team of individuals who are able, willing and ready to respond to the demand of training the number of contact tracers who are needed to support our state during this challenging time.” 

Signups are ongoing for two other training arms that are also part of the UH-DOH program: 

  • Track 2: Community Contact Tracer Training—A six-week training program for those with undergraduate degrees but who do not have clinical backgrounds, and are available for full-time activation by DOH after program completion.
     
  • Community Health Worker Training—Requires a high school degree or GED.


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