Lewis County Shifts Away from Contact Tracing as Cases, Hospitalizations Surge

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After a surge in positive COVID-19 cases, local public health officials announced Thursday that the county will no longer be conducting full contact tracing investigations. The process was taking too long, creating a backlog that delayed the dispersal of information to the public. 

“There’s been heated discussions on the state level about this,” Public Health Director J.P. Anderson said. “The decision does not come lightly.”

According to the Department of Health, contact tracing can “identify people who may have been exposed,” and “helps public health track and prevent the spread of COVID-19.” Now, instead of typical contact tracing, Lewis County will reach out to those who test positive as soon as possible and encourage them to reach out to close contacts themselves. 

Last week, data reporting issues and slow contact tracing efforts, exacerbated by a surge in cases, led to a county-wide backlog of 90 cases that hadn’t been reported to the public. Although Mathematica — the company contracted by the state to contact trace — vowed last week to prioritize Lewis County’s cases, Deputy Public Health Director John Abplanalp said that only lasted so long. Abplanalp noted that cases grew exponentially, but “they can’t add staff exponentially.”

Earlier this week, as Mathematica struggled to keep up with cases, Lewis County made the decision to begin calling positive cases themselves. Taking on the responsibility, Anderson said, will put a “great strain” on local public health officials, who are currently scrambling to train more employees to conduct those positive case interviews. In a Thursday report, Public Health and Social Services spokesperson Ed Mund announced that “due to the sheer number of backlogged cases received Monday,” it would likely take officials to the end of the week to assign each case to one of three county commissioner districts.

According to Anderson, neighboring counties are beginning to take on similar strategies, asking infected individuals to call their own close contacts in order to speed up the response by public health. 

Abplanalp noted that although each infected individual in Washington infects, on average, about one other person, the spread is not evenly dispersed. Put simply, most community spread is caused by a small number of infected people. The county’s rationale is that prioritizing reaching out to those few people quickly will be more effective than conducting full contact tracing investigations for every positive case, most of which won’t end up infecting many people. To ensure a targeted response, officials will prioritize school-aged residents and those who work in congregate care settings. 

Anderson said that now, what’s essential to stamping down COVID-19 is “broad community buy-in” to things like social distancing and masks. 

Across the street from his meeting with county commissioners, Public Health and Social Services changed their marquee to read “Keeping schools open needs more than hoping. #maskup.”

In a plea for county leadership to model good behavior and encourage compliance to new COVID-19 restrictions, Anderson invited Dr. Kevin Caserta to speak. Caserta is the chief medical officer for Providence Medical Group Southwest Washington, which oversees St. Peter Hospital in Olympia and Providence Centralia Hospital — the two main sites Lewis County patients are admitted to if their COVID-19 symptoms warrant hospitalization. 

Caserta reported that in the last five to six weeks, the two hospitals have more than tripled the amount of COVID-19 patients they are caring four, getting “well into the 30s” between two locations. About a quarter to a third of those typically require critical care, he said. 

Caserta described a recent conversation he had with a nurse working with those patients. 

“She described it as just discouraging where she’s working so hard, additional shifts, overtime, working herself to the point of exhaustion, and not to have our community support these basic, simple measures to protect themselves, to not overload the healthcare system,” Caserta said. “So anything our county leaders can do to keep people safe, to model the appropriate behavior, is very very necessary.”

County Commissioner Edna Fund thanked Caserta and noted that her own family will be heeding the governor’s call to cancel holiday gatherings. 

“We came to the conclusion just 15 minutes ago, there’s now way we could do it, and so we’re planning to do our Thanksgiving dinner over Zoom,” she said. “So the word is getting out, and it’s a decision we all need to take seriously.”

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