Pennsylvania has granted Lancaster city emergency approval to perform contact tracing, which is a key public health strategy to slow the spread of COVID-19 by tracking down and warning people of exposure to an infected person.
Lancaster becomes the first Pennsylvania municipality without its own health department to get such an approval from state Health Secretary Dr. Rachel Levine.
“I believe we are their guinea pig,” Mayor Danene Sorace said. “We’ve been pushing for the ability to get going with this effort, recognizing that time is of the essence.”
Gov. Tom Wolf last week acknowledged that the state Health Department lacks the funding to ramp up contact tracing to the level experts say is needed to safely reopen the state. The health department employs 131 community health nurses statewide, several of whom work in Lancaster County.
Training begins this week
The state Health Department this week will begin training city workers on how to make the sensitive calls to people who may have been exposed to a virus that, according to the county coroner, has killed more than 150 people across Lancaster County.
As of Monday, how many will get training hasn’t been determined, Sorace said.
After the video training is completed, city workers will begin calling Lancaster residents who were identified as having been in close contact with someone who tested positive recently for the new coronavirus. Close contact is being defined as within 6 feet for 10 minutes or more.
The tracing specialists will also call the contacts of any city resident who tests positive, whether or not the potentially exposed contact lives in Lancaster.
The Health Department won’t be releasing the identity of infected people to the city, only the names of the infected person’s contacts.
Under state law, only a state-certified county or municipal health department has jurisdiction over contact tracing, neither of which Lancaster County has.
But Levine approved the city’s request to provide the service under the direction of the city’s board of health, which is a panel of volunteers chaired by Dr. William Fife, a family physician with Penn Medicine Lancaster General Health.
In addition, Dr. Jeffrey Martin, who chairs Penn Medicine Lancaster General Health’s family and community medicine department, will consult.
Sorace said she’ll request reimbursement from a federal $95-million appropriation to Lancaster County for coronavirus relief.
The city’s initiative could serve as “a springboard” for countywide contact tracing, Sorace said, “though this would be up to the (county) commissioners.”
“Robust contact tracing effort is key to any economic recovery,” Sorace said, “and has been highlighted as such in every plan at the national, state, and local level,” including a draft economic recovery plan prepared by the Economic Development Company and Lancaster Chamber.
“The benefit of doing this will only improve if it is countywide because the coronavirus has no sense of municipal boundaries,” Sorace said.
But the city is at particular risk because of its higher population of poor and homeless individuals.
Fife said a potentially exposed person will be asked to stay home for 14 days, if possible. The goal is to call that person every day for two weeks to find out if symptoms are appearing and if the person needs food or other assistance while they are staying home.
As Lancaster city prepares to begin contact tracing, nonprofit Lancaster Health Center began contact tracing March 30 after its first patient tested positive.
As of Monday, a total of 170 of the center’s patients have tested positive. Its contact tracing specialists have contacted 450 households and employers to warn them of potential exposure.
The specialists talk to the contacts about the risks of further spreading the virus, even if they do not feel ill, Nicole Specht, the center’s spokesperson, said.
The contacts are encouraged to stay home and stay at least 6 feet away from others for 14 days, Specht said. If they develop symptoms, they are asked to isolate themselves and contact a primary care provider.
Specht said the health center looks to partner with the city in its initiative.