LC covid-19 update 2

Lancaster city Mayor Danene Sorace participated in a COVID-19 news conference April 22, 2020, outside the Lancaster County Public Safety Training Center. The mayor has obtained permission from the state to launch a contact tracing effort.

THE ISSUE

As LNP | LancasterOnline’s Jeff Hawkes reported this week, the Pennsylvania Department of Health “has granted Lancaster city emergency approval to perform contact tracing, which is a key public health strategy to slow the spread of COVID-19. ... Lancaster becomes the first Pennsylvania municipality without its own health department to get such an approval from state Health Secretary Dr. Rachel Levine.”

Contact tracing is just what it sounds like.

A person with COVID-19 is asked to recall every individual with whom he or she has been in close contact — that is, within 6 feet for 15 minutes or more — while infectious.

Then those individuals are notified about their possible exposure to COVID-19. They are advised to stay at home, maintain social distance from others and monitor themselves for symptoms. If they become ill, they’re asked to notify public health officials.

Contact tracing is akin to throwing a lasso around the deadly and highly contagious novel coronavirus in an effort to minimize its spread.

Importantly, no one’s privacy is compromised during the process. As the Centers for Disease Control and Prevention’s contact tracing principles state, “contacts are only informed that they may have been exposed to a patient with the infection. They are not told the identity of the patient who may have exposed them.”

Contact tracing is a tried-and-true public health practice. And it will be essential to the safe reopening of our economy and society.

In the absence of a vaccine, it is “really the big public health tool we have to control transmission of COVID-19,” said Crystal Watson, a senior associate at the Johns Hopkins Center for Health Security.

“We don’t know exactly how many people are still susceptible to COVID-19,” Watson said in an interview posted on the Hopkins website, “but we’re relatively confident that it’s a very large percentage of our population. So if we reopen and we don’t have the capacity to find each case, isolate them, then trace their contacts and put them in quarantine, this virus will start to circulate widely again in our communities.”

And then, she said, “we will see again a big surge of cases, a surge of hospitalizations, and a surge of deaths.”

That would be crushing.

As we’ve said repeatedly, we believe contact tracing and more widespread testing are prerequisites to reopening Lancaster County’s economy. They are also factors the Wolf administration will consider when determining when counties will be permitted to reopen.

So we’re immensely grateful to Lancaster city Mayor Danene Sorace for launching a contact tracing effort.

The state health department will train city workers on how to make calls to those who may have been exposed to the novel coronavirus. As the CDC notes, these calls require excellent “interpersonal, cultural sensitivity, and interviewing skills.”

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,” Hawkes reported.

Lancaster Health Center has offered to partner with the city. The center has been doing contact tracing since March 30, when its first positive case of COVID-19 was confirmed in a patient. As of Wednesday afternoon, that nonprofit health center had contacted 511 households and employers.

Sorace told Hawkes that she believes Lancaster city is serving as a “guinea pig” for the commonwealth. “We’ve been pushing for the ability to get going with this effort,” she said, “recognizing that time is of the essence.”

Kudos to Sorace for pushing for permission to launch the city’s effort.

It wasn’t a slam-dunk that such permission would be granted.

As Hawkes reported, “Under state law, only a state-certified county or municipal health department has jurisdiction over contact tracing, neither of which Lancaster County has.”

What the city does have, however, is a board of health, a panel of volunteers chaired by Dr. William Fife, a family physician with Penn Medicine Lancaster General Health. Levine approved the city’s request to provide contact tracing under the direction of that board.

How Lancaster County might overcome its regrettable lack of a health department is unclear. (It’s a lack that costs us in countless ways.)

Sorace told Hawkes the city’s initiative may serve as “a springboard” for countywide contact tracing. She noted that “this would be up to the (county) commissioners.”

The commissioners, who recently hired a public health emergency adviser, must figure out how contact tracing can be done across the county.

Because it remains uncertain just how the Wolf administration will ensure it's done across the commonwealth.

As Spotlight PA reported this week, “local health departments and the state’s public health nurses — whose ranks have been decimated by years of budget cuts — are tasked with the work-intensive job” of contact tracing.

Levine said she’ll circulate a contact tracing plan by Friday. As Spotlight PA reported, the state effort will be “led by public health nurses and also include county and municipal health departments, private health systems, and new hires and volunteers.”

Krys Johnson, assistant professor of epidemiology and biostatistics at Temple University, told Spotlight PA previously that the state needs at least 2,000 contact tracers. The state health department employs just 131, though an additional 16 employees have been enlisted to assist with tracing. (Spotlight PA is an independent newsroom powered by The Philadelphia Inquirer; LNP Media Group is among its partners.)

A "robust contact tracing effort is key to any economic recovery,” Sorace told Hawkes, “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 of Lancaster County and the Lancaster Chamber.

Said the city’s mayor: “The benefit of doing this will only improve if it is countywide, because the coronavirus has no sense of municipal boundaries.”

Indeed. If Lancaster County is going to return to anything resembling normal life and business, it’s going to take the resources of the entire county. And the tenacity and sense of urgency that Mayor Sorace has exhibited.