LOS ANGELES (AP) – California's ambitious plan to double the current number of coronavirus tests is being coupled with a massive campaign to track everyone who might be infected by each new person who is positive for the virus.
Governor Gavin Newsom said on Monday that, as part of state plans to reopen business, California wants 20,000 people to track contacts that require perseverance, resourcefulness and a little investigation.
"It's more complicated than you think," said Dr. George Rutherford, an epidemiologist at the University of California, San Francisco, who helped design a training program for the new workforce. “They have to be very creative to find people. It's a lot of detective work. "
Newsom mentioned plans for the program almost three weeks ago, when he discussed creating an "army" of 10,000 workers who would need to screen more than 10 people for each person found who tested positive for the virus. At the time, he estimated that they would track 2,000 to 3,000 new cases a day if the state reached its goal of testing 60,000 a day.
So far, less than 3,000 people are doing the job in about two dozen of the state's 58 municipalities.
County health departments often screen people potentially infected with sexually transmitted diseases or tuberculosis, but this has never been done on that scale.
A recent review by the US Associated Press found that many states fall short of targets to track cases and struggle to train enough people for the task, which the federal government also considered essential to reopen business.
In the early days of the outbreak, counties tried to track down who came into contact with an infected person, hoping to control the spread of the fast virus. People suspected of being ill were placed in quarantine and people with whom they were in close contact were told to isolate themselves.
But since the virus has spread more widely, this work has become difficult to do on a large scale. The San Francisco Bay Area counties, followed by Newsom, adopted a mitigation strategy that still required most people to stay at home and keep a safe distance from others. While some counties are opposing these orders, others have gone even further in demanding facial coverage in public.
In Los Angeles, with more than 10 million people, the county continued to try to track those associated with each new case of the virus, said director of public health Barbara Ferrer last month. Once the volume of cases took off, he began to instruct each infected person to notify his friends, family and co-workers about his status.
"Obviously, we don't reach everyone, because sometimes we don't have the right phone or telephone numbers and sometimes people don't want to talk to us," said Ferrer. "But we reach somewhere between 80 and 90% of the people for whom we have a positive result in the laboratory".
The benefit of having most residents at home for almost seven weeks now is that the number of close contacts is limited to an average of 3.5 people in the bay area, representing mainly family members or roommates, Rutherford said. But it is still a challenge to track down acquaintances they may have seen or a neighbor whose name they don't know.
As an example of how time-consuming work can be, the University of California, Davis hired four full-time employees last month to track the contacts of all infected employees in his health care system – at a time when he only discovered one employee infected daily, said Dr. David Lubarsky, executive director of UC Davis Health.
"Usually, this kind of thing takes longer than expected," said Lubarsky. "But, unfortunately, there are a ton of underutilized and unemployed individuals out there who could undoubtedly be convinced to take on a new role during the pandemic."
Dr. Sonia Angell, state director of public health, said that the initial employees as part of the state's effort would be transferred to public officials.
In San Francisco, where the health department went from a team of 10 to 140 people tracking by phone, many were librarians whose buildings had closed.
"They have nothing going on" Rutherford said. "But they are great. They can speak (different) languages, they are very skilled. So it works."
Rutherford said it takes about 20 hours to train someone to do the job through a virtual learning platform. Most of the time is spent, however, providing feedback as trainees make calls.
Associated Press reporter John Antczak contributed to this report.
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