The spike in COVID-19 infections in Pennsylvania has prevented state investigators from contacting all positive cases, reflecting an evolving reality and a hampered public health response to the pandemic.
State investigators traced about 10% of the 32,676 COVID-19 infections between Dec. 10, 2021, and Jan. 9, according to state data provided to LNP | Lancasters online. By comparison, about a third of the cases between early June and early July were investigated – or just 6,336.
Without contact from a public health professional, the more than 1.1 million Pennsylvanians who rely on the COVID Alert PA app will not receive accurate information about possible exposures. The app requires HIV-positive people to enter an interviewer code.
The surge in cases has also led investigators to focus on cases of particular concern – those associated with long-term care facilities, those among people under 18 or over 65 as well as clusters.
“After a positive test result, public health professionals attempt to reach as many people as possible to find out where they have been and who they have contacted to advise of potential exposure,” Maggi said. Barton, spokesperson for the Pennsylvania Department of Health. , said in an email.
Barton added: “While case investigations and contact tracing are an important part of the COVID-19 response, public health professionals are unable to contact everyone as cases represent in average more than 25,000 cases per day.”
The average daily number of COVID-19 infections has exceeded more than 20,000 since Dec. 22, 2021, according to state data.
Pennsylvania has nearly 500 contact tracers statewide, 237 in the jurisdiction of the state health department, which includes Lancaster County.
Contact tracing is universally considered an essential strategy to prevent the spread of infectious diseases like COVID-19.
“Even as more Pennsylvanians are getting vaccinated every day, case investigations and contact tracing remain critical in our response to COVID-19,” Acting Health Secretary Alison Beam said in July during publication of the department’s monthly report on contact tracing.
State investigators for this report looked at infections from June 10, 2021 through July 9, 2021, conducting 6,336 investigations, which accounted for about a third of positive cases.
The state health department does these surveys for counties, like Lancaster, that don’t have a local health department.
The positivity rate in Lancaster from January 7 to 13 reached 38.2%, indicating an extremely high rate of transmission.
The World Health Organization recommends a rate below 5% to control the spread.
“Unfortunately, during extreme community spread, contact tracing becomes impossible due to widespread disease transmission,” WellSpan Health spokesperson Ryan Coyle said in an email. “We encourage anyone with symptoms with known exposure to get tested as soon as possible.”
The way contact tracing works is that a public health professional contacts people who test positive for COVID-19 to gather information and provide guidance.
The state had provided monthly updates on its contact tracing efforts, but those stopped in July.
The department “didn’t have the bandwidth” to continue updates, Barton said.
“The virus will become endemic”
In the 30 days between Dec. 10, 2021, and Jan. 9, Pennsylvania recorded nearly 248,000 cases of COVID-19 that public health professionals failed to investigate.
With so few people reached by state investigators, much of the contact tracing effort falls on the public.
“Most healthcare organizations are understaffed and overwhelmed right now, so the staff to do contact tracing just aren’t there,” said Jenni Black, quality and compliance manager. at Union Community Care, in an email.
Black added: “When a person knows they have been in close contact with someone with COVID-19, they are more likely to be cautious around high-risk loved ones and other people in general.”
Union Community, a federally licensed healthcare center, was among the first organizations in Lancaster County to conduct contact tracing using a Google map.
The county’s effort to trace possible COVID-19 contacts and exposures ended in May 2021.
Patients who test positive – if they know of known contacts – are encouraged to tell close friends, family and neighbors when they first started feeling ill as well as the two days before symptoms .
“At this point in the pandemic, contact tracing has a different role,” Dr. Amesh Adalja, an infectious disease physician and principal investigator at the Johns Hopkins Center for Health Security, said in an email to LNP | Lancasters online.
Adalja added: “He should really focus on unusual events, a super spread situation and not something to do in every case. The virus will become endemic and public health measures must reflect this reality. »
All public health officials with whom LNP | LancasterOnline took the floor, repeated the same refrain: that being fully vaccinated with a booster dose remains the best defense against serious diseases.
“Now is not the time for our community to let our guard down; continue to wear a mask, socially distance, wash your hands, avoid large gatherings and get vaccinated and receive a booster if you qualify to protect yourself and your loved ones,” said Dr. Michael Ripchinski, clinical director of Penn Medicine Lancaster General Health, said in an email.