As virus cases spike, Louisiana struggles with tracking work
BATON ROUGE, La. (AP) — Seeing a new surge in coronavirus infections, Louisiana is struggling with the critical tracking work needed to combat the spread, as contact tracers face unanswered calls, privacy concerns and distrust from elected officials.
Only 59% of those who have tested positive for COVID-19 since mid-May have responded to phone calls from contact tracers, according to the latest data from Louisiana’s health department, and only one-third answered within the crucial first 24 hours after the test results.
As more of Louisiana’s businesses have reopened and new virus cases have spiked, infectious disease experts describe a robust contact tracing program as essential.
“Contact tracing’s a basic public health tool. It’s really important for us to identify people who’ve been exposed to a disease, to test them and, if need be, quarantine them until the results are back, and if necessary, put them in isolation if the result is positive,” said Patricia Kissinger, an epidemiology professor at Tulane University’s School of Public Health and Tropical Medicine.
Gov. John Bel Edwards’ administration has signed $20 million in federally financed contracts with call centers for the tracking. Nearly 400 people are trained and making calls.
But people don’t always answer unknown callers. Some don’t want to share information, fearful of how it will be used. Others don’t want to give phone numbers and names of contacts, said Theresa Sokol, Louisiana’s acting state epidemiologist, who oversees contact tracing efforts.
In some instances, test information received doesn’t include a phone number, and the contact tracer has to comb through databases to find one, she said. Sometimes the numbers provided don’t work. Some people refuse to be interviewed. While only 4% of the people reached by Louisiana’s contact tracers have outright refused to participate, some who answer the phone offer little information.
“There are a concerning number of people that are not reporting any contacts to us,” Sokol said. “They’ll say, ‘I have not been within 6 feet of anyone for more than 15 minutes.’ There might be people for whom that is true, but I think it might be that some people are reluctant. They may very well think, ‘Oh, it’s not necessary. I’m going to tell people who might have been exposed myself.’”
Sokol said that eliminates other benefits of contact tracing, beyond tracking exposure risks. The state also uses those calls to connect people with grocery and prescription delivery, testing information, temporary housing, cleaning supplies and personal protective equipment.
Louisiana contact tracers’ calls get answered, on average, more than two days after they get information about the positive test, according to health department data. They average another 37 hours to reach people identified as coming into close contact with those infected.
COVID-19 spreads so fast that, ideally, contact tracers would reach 75% of the potentially exposed people within 24 hours after learning about their exposure, said Perry Halkitis, dean of the Rutgers School of Public Health.
“Every day makes a difference,” he said.
He added: “One day’s ideal; two days you probably could live with it. Once you get to three or more days, the benefit of contact tracing is really lost because people are out in the community doing what they do — and spreading the virus, potentially.”
Some of Louisiana’s tracking is undermined by a suspicious public concerned about privacy rights.
Conservative GOP state lawmakers said they’ve heard officials will threaten to arrest those who refuse to comply. Some lawmakers have continued to spread the idea even though Edwards has repeatedly said he doesn’t intend to penalize people who don’t respond.
“When will we say enough is enough? Will that be when COVID-19 trackers come to your house and pulls your family members out of your house?” Republican Rep. Danny McCormick asked House colleagues Thursday.
Edwards, a Democrat, has appealed to people to be “good neighbors” by participating. He’s stressed that everything told to contact tracers is confidential. He’s noted that public health agencies have used contact tracing to combat the spread of other infectious diseases for decades, drawing little attention before the pandemic.
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up within weeks. But for some, especially older adults and those with existing health problems, it can cause more severe or fatal illness.
About 55,00 cases of COVID-19 have been confirmed in Louisiana residents, and the actual infection rate is expected to be much higher. Nearly 3,100 Louisiana residents have died.
In recent days, 850 to 1,350 newly confirmed cases have been reported daily and hospitalizations have continued to grow, worrying public health officials that Louisiana’s once successful efforts to slow infections are being undermined by a complacent public ignoring recommended precautions.
“If contact tracing is effective, that will bring the number of cases and number of hospitalizations down over time,” said Susanne Straif-Bourgeois, an epidemiology professor at LSU Health Sciences Center New Orleans.
Louisiana’s state health officer Jimmy Guidry acknowledges the tracking work is falling short of goals.
“Is it as good as we would like? Well, obviously not, because some people are not taking this seriously,” he said. “It’s better than not having it, I’ll say that.”