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Boone County Health Department Scrambling To Keep Up With Contact Tracing

As mid-Missouri experiences a rise in coronavirus cases, the Health Department is struggling to keep up with contact tracing.

The county reported 39 cases Thursday, the highest number in a single day during the entire pandemic. Missouri surpassed 1,000 deaths Tuesday.

“Our contact tracing efforts have quickly become overwhelmed, and positivity rates continue to climb,” Stephanie Browning, director of Columbia/Boone County Public Health and Human Services, said in a news release Thursday.

The positivity rate — the percentage of tests that come back positive — rose to 12% this week, according to a news release. The first week in May, it was 0.4%.

The Health Department has set a goal of attempting to contact every patient within 24 hours after being notified of the positive test, said Scott Clardy, assistant director of the department.

After that, the department works to notify anyone who might have come into contact with that patient while they were contagious.

“That’s been our goal up until this point,” he said. “I don’t know that we’re going to be able to reach that, certainly, with all the cases that we got (Thursday).”

Clardy said the department was caught up as of Monday on reaching out to COVID-19 patients and their recent contacts. However, the 39 cases from Thursday have overwhelmed the department’s contact tracers. He said that, realistically, the department may have to change its goal to reaching out to patients within 48 hours instead of 24.

The Health Department has also had to scale back on its check-ins with patients. In the beginning of the pandemic, patients were contacted every day for the entirety of their isolation. Now, with so many active cases, department staff only do daily checks on patients with severe symptoms, or if the patient has difficulty getting groceries, paying rent or attending to necessities of that nature.

To handle the increased caseload, the department has been training more of its staff to do contact tracing, Clardy said. They’ve brought in department retirees and people from the community with a background in public health. Starting next week, they plan to get city staff from outside the department trained to assist.

Another way the department is trying to alleviate the problem is through a new data collection software program called REDCap. The software provides contact tracers with an easy-to-view database of all the people they need to reach.

A text message feature that allows the software to automatically text contacts and patients so contact tracers don’t have to is not yet operational.

Too social

Clardy attributes the recent uptick in COVID-19 cases to lapsed social distancing.

“The real issue is that we have people out in the community, particularly people under the age of 30, who are not practicing good social distancing,” Clardy said. “They’re getting together with their friends, and next thing you know all eight of those people or all 10 of those people have symptoms and maybe testing positive, and in the meantime, they’ve gone out and been with other people who may end up testing positive.”

Clardy emphasized the need to do better in social settings.

“I realize that’s hard to do with household contacts, but going out and socializing and drinking from the same cup and hugging and touching, those are not things we need to be doing right now,” he said.

Clardy said young people contracting the virus is a more serious problem than it may appear because they don’t usually become very ill.

“The problem is that because they either don’t have symptoms or their symptoms are slight, and they think they might just be (having) allergies, they end up spending more time around other people who could be very vulnerable to bad outcomes,” he said. That would include grandparents, a relative with diabetes or a friend with a compromised immune system.

“So, (young people contracting the virus) isn’t just an issue for that group,” he said. “It’s an issue for everybody.”

Clardy also thinks people need to be more careful while they’re awaiting test results. People should go home and isolate until they get their results, Clardy said, and if those results are positive, they must stay isolated until the Health Department can call them and give them further instructions.

He said it would be very helpful if people who test positive started making a list of anyone with whom they might have had contact within the past few days.