The delta wave of the coronavirus has overwhelmed Nevada health districts responsible for informing close contacts of people who test positive for COVID-19 that they may have been exposed to the disease.
“In the last few weeks with the peak, we unfortunately have a backlog again,” said Devin Raman, senior disease investigator at the Southern Nevada Health District.
District disease investigators interview people who test positive to determine who they may have been in close contact with when they were contagious. Contact tracers then notify these close contacts of their exposure, so they can self-quarantine or take other steps to stop the spread of the disease.
By adding staff, automating some functions and other measures, the Clark County Health District is less behind schedule than in the wave last summer.
“This is not where we were hoping to be at the moment, eight months after the vaccine became available,” Raman said.
Raman says the close contact notification timeframe can be several days or more, depending on a variety of factors, including how quickly the person who tests positive returns calls to the health district.
New cases, although on the decline, have exceeded an average of 600 per day in the county over the past week, forcing the district to prioritize cases handled first by its 250 contact tracers. With the return of children to school, top priority is given to cases involving school-aged children.
Priority school cases
With these cases, “early notification allows parents and guardians to intervene quickly by proactively making complex decisions for their families, reducing exposure in classrooms,” said Stephanie Bethel, representative of the health district, in an e-mail. “If a contact is made aware of an exposure, they are more likely to self-quarantine and / or monitor themselves for symptoms of COVID and get tested.
Bethen said people who test positive are notified via text message within 24 hours of receiving test results, provided their contact details are correct.
“The notification advises close contacts who might be asymptomatic to stay home if they are not vaccinated or if they are showing symptoms to stay home as well.”
The Clark County School District, which is working with the health district to track possible COVID-19 exposures, declined to comment, instead directing a reporter to an FAQ on its website.
Report positive COVID-19 results to [email protected]
Despite efforts to speed up notification in school-related cases, some teachers have complained about notification delays.
At a Clark County School Board meeting on August 26, educator Hannah Comroe called on the district to be more transparent with the number of COVID-19 cases by school and district-wide.
She also said it was necessary to be faster in contacting families so that COVID-19 did not continue to spread throughout the school.
“Those who are in close contact with others who are confirmed positive are not notified until a few days later,” Comroe said. “This is unacceptable.”
Bethel said health district and school district staff were working side-by-side to complete the tracing as quickly as possible.
“The teams work together to investigate case reports and contacts that may have been exposed on campus or at school district-related events, and that are received directly by the school district,” Bethel said by e- mail.
The health district “also works with the school district team to investigate cases that are beyond the reach of the school district team and are generated from the health district’s contact tracing and case investigation efforts.” . “
The health district has dedicated nine of its contact tracers to work directly with the school district.
“The health district does not provide the identity of the index patient or the location of the exposure to protect the privacy of the individual,” Bethel said. “The Clark County School District is notifying close contacts in addition to distributing mass notifications to notify individuals of an exhibit on campus.”
The success of contact tracing depends on the cooperation of the people involved. It is very important that “parents and staff respond to contact tracer calls and disclose their school district affiliation during the contact tracing investigation,” Bethel said.
On Monday, the school district’s online dashboard reported 2,295 cases of COVID-19 since July 1, including 393 this month.
“Not very efficient”
Contact tracing isn’t new, but it has drawn public attention to COVID-19, a disease that has defied efforts to stop its spread.
“Public health organizations have used contact tracing for decades to stop the spread of infectious diseases, including HIV, measles, syphilis and tuberculosis as well as COVID-19,” Bethel said.
But Raman said the high volume of COVID-19 cases poses a unique challenge that limits the effectiveness of contact tracing.
“It’s not very effective, no,” she says. “Contact tracing is more effective for diseases that spread slowly through close contact. Because that’s when we have the time… to reach out to the contacts and do this intervention quickly, before it has time to spread to many people.
“The problem with COVID is that it spreads very easily, very quickly, and over a long period of time. And so it is very difficult to stay on top of contact tracing which is why we only see huge peaks and waves of it all over the place. Because it is very, very difficult to interrupt the transmission of an airborne disease like COVID. “
Kevin Dick, a health official in Washoe County, the most populous county in northern Nevada, shares Raman’s concern.
“Our disease investigators are simply overwhelmed,” he said in a statement. “We have a dedicated staff working seven days a week reaching breaking point under very difficult circumstances to reduce the spread of COVID-19. Contact tracing is not designed to be effective when COVID-19 is prevalent in the community and with so many new cases arriving. “
Despite his qualms, Raman believes that contact tracing is helping curb COVID-19 cases in the community and in schools.
“I hope we will continue to improve as the school year progresses,” she said. “But it’s definitely a challenge, probably one of the most difficult things we’ve come across as an agency.”