VDH Outlines Contact Tracing Initiative

by James A. Bacon

Virginia’s COVID-19 contact tracing program will be organized around case investigators, contact tracers, and regional surge teams, all of whose efforts will be supplemented by technology, said Virginia Department of Health (VDH) officials in a media teleconference this morning.

VDH had 129 people doing contact tracing for infectious diseases such as tuberculosis and STDs before the COVID-19 outbreak. The department has boosted the number to about 470 by reassigning departmental personnel, and could add another 1,300 through new hires, said Mona Bector, deputy commissioner of administration.

In a related initiative, VDH officials said the state is close to selecting a technology company that will enable Virginians to download a smart-phone app that will alert them if they have come into close contact with someone infected with the virus. The GPS-enabled app also will provide data that makes it possible to map hot spots.

“Contact tracing is a fundamental component of public health,” said Marshall Vogt, VDH Division of Immunization’s epidemiologist. “It’s something we’re very familiar with. It’s something we do day in and day out to prevent the spread of infectious disease.” New funding will enable the department to expand what it already does.

Building that capability will take time to hire new employees, train them, and get them into the field. “Our internal aim is to get this up and running within weeks,” not months, Bector said.

Aside from data managers and administrators, the new hires will fall into two broad groups: case investigators and contact tracers. The case investigators will work closely with people who have been tested positive for the virus. They will look at lab results, inquire about the settings where they might have acquired the disease, ask whom they might have been in contact with, and gauge the level of risk associated with the case. The job of the contact tracers is to track down the contacts and inform them of their possible exposure. VDH officials also referred without elaboration to regional “surge” teams that will respond to outbreaks.

Employees in the contact-tracing force will work at home, work in work centers, or go into the field, as needed. They will be equipped with laptops and/or tablets, mobile phones, and personal protective equipment. While a public health background is desirable for new employees, also crucial is an ability to communicate well and build trust. Bilingual ability is a bonus.

At present, public health officials are prioritizing certain categories of cases, mainly those dealing with nursing homes, public safety groups, and health  providers. The goal will be to respond to all confirmed cases. Individuals who have been exposed to COVID-19 carriers will be assessed to see if they have symptoms, may be tested themselves, may be referred to a health care provider, and may be asked to self-quarantine. If individuals are reluctant to isolate themselves, their contact tracers will explain why they should. In extreme cases, the state may compel them to quarantine themselves.

“We find that most people are very compliant,” said Vogt. If they aren’t, “there are processes in place” to issue orders.

The contact-tracer force will collect and analyze large volumes of data, and their efforts will be assisted by Artificial Intelligence. VDH also has been looking at a proximity tracking app. A major factor in choosing a provider will be the ability to protect peoples’ privacy.  

“We haven’t picked an app yet,” said Bector, “so we can’t provide details on what it can do.”

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25 responses to “VDH Outlines Contact Tracing Initiative

  1. so the big question is why the “open up now” folks are not supporting this.

    why?

  2. A decent start although sending a contact tracer into the field should be an absolutely last measure. “Hi! I’m a contact tracer. A person who has tested positive for COVID19 told us that she spent an hour kissing you last Thursday. I’ve come to speak with you face-to-face to inform you that you may have been infected.” Bilingual ability may be a plus but a positive antibody test may be a requirement. There must be some way to use technology to keep the contact tracers from having to go out to the field. Maybe technology. If only there were some way to use the smart phones people carry to figure out who was in the vicinity of the infected person at different points in time. Oh wait …

    https://www.baconsrebellion.com/wp/courts-authorizing-reverse-location-warrants-in-virginia/

    On a broader note – the biggest health issue of our lives needs to be attacked with technology. Yet Ralph Northam, King of all Luddites, decided to demote Virginia’s Secretary of Technology to a non-cabinet role. Virtually every decision made today by our state government has a technology component. Some decisions, like Amazon in Arlington or contact tracing, have major technology implications. Wouldn’t it be nice to have somebody in the cabinet meeting with a deep understanding of technology? Like there was with McDonnell and McAuliffe.

    Virginia voters need to resolve to never, ever, ever elect another member of Virginia’s plantation elite governor.

    • You’re just not going to get 100% return on contact tracings.. but that’s not the point. The point is that you find as many as you can… the more you find – the better.

      We keep looking at these issues as if they are all or nothing.

      It reminds me of the solar thing. It’s not that solar will ever replace other generation – it’s that solar can replace SOME of it so that you use less of the polluting kind.

      same thing here.. you will not find 100% but you don’t need to either.

      If you find 5 out of 10 – you’ve caught 1/2 of the potentially infected.

      re: ” On a broader note – the biggest health issue of our lives needs to be attacked with technology”

      what technology – doing what?

  3. “It’s something we’re very familiar with. It’s something we do day in and day out to prevent the spread of infectious disease.” This from a VDH epidemiologist. Seriously.

    If anyone believes this program will actually improve public health under VDH supervision, they are substituting hope for experience.

  4. I mentioned in an earlier post that I did a contact tracer training course and subsequently applied for tracer position, just to see how it worked. The course makes clear that contact with infected persons is attempted by all manner: telephone, email, text, and in-person. A hospitalized patient on a ventilator won’t be much help, especially if they have no entourage. In nursing homes, there is little question with regard to whereabouts of patients, it is the staff you have to press through.

    The job openings I found were all through Adecco Staffing, but were shown as city-specific; I saw a post for opening in Chesapeake, separate one for Norfolk, another for Va Beach. @sherlockj if VDH is the employer, I wonder why they are advertising by city. Work for tracers is remote (only an investigator would to in-person outreach) so it wouldn’t matter where I am tracing, geographically, only for investigators (requirements for those posts include some health experience). For tracers pay is $17 per hour.

  5. Lift-

    Your questions, of course, are all very good ones. Extremely good answers to those questions are found here:

  6. They should employ the newly released prisoners… send them to vulnerable households. Seems very SJW to me… beside they’re all safe and on the up and up.

  7. They could certainly be employed to do phone and email.

    And for that matter, so can other unemployed.

    Why are we paying unemployed without asking them to do some of this work anyhow?

    Work provides dignity to most folks. They just need a job like we did with CCC…. when the economy recovers, they can go back just like the did in CCC days.

  8. Here is an account of how one city in New Jersey has apparently been successful in contact tracing: https://www.nytimes.com/2020/05/21/nyregion/contact-tracing-paterson-nj.html?searchResultPosition=1

    So, it can be done. There has to be someone with organizing skill put in charge of getting it done.

    • This is GOOD! Thanks Dick!

    • Here is how I understand this issue.

      As mentioned earlier, testing and contract tracing is a well accepted and an often critically important practice for containing and eradicating certain highly contagious and highly lethal diseases. These diseases, for example, include EBOLA, Tuberculosis, HIV, and Smallpox.

      The efficacy of mass contact tracing, however, has been questioned now in cases where the spread of the disease has been fast and wide, inflicting large cohorts of people of all sorts, and where its symptoms and adverse consequences are not manifest in ever larger numbers of infected people comprising ever larger segments of the general population, particularly where those at risk of severe harm, including death, are found to be limited to or primarily focused on, identifiable and much smaller cohorts of citizens. Say the elderly with severe commodities who are congregated densely, or who can otherwise be efficiently protected by other more practical, less expensive, and less intrusive means that impact far less adversely on the rest of society, its social, mental, physical, economic heath. But, in certain more limited cases of such disease, contract tracing also can be practically used in confined locations, particularly early in an outbreak.

      But, the wider and longer such outbreak lasts in such circumstances, the harder or more impractical or impossible, it is to contain spread by contact tracing, and the higher are the cost of trying to do so, for many reasons, including according to many, the harder it becomes to safely lift the mass quarantines, due to the lose of natural imunities that would by then be in place.

      There is growing literature on these issues. One example, chosen randomly is linked in below.

      https://science.sciencemag.org/content/368/6491/eabb6936

      • Above comment as to contact tracing in this pandemic, included “Say the elderly with severe commodities who are congregated densely, or who can otherwise be efficiently protected by other more practical, less expensive, and less intrusive means that impact far less adversely on the rest of society, its social, mental, physical, economic heath.”

        Here is example of mounting costs claimed by some doctors.

        https://video.foxnews.com/v/6158257955001#sp=show-clips

  9. ” We propose an app, based on existing technology, that allows instant contact tracing. Proximity events between two phones running the app are recorded. Upon an individual’s COVID-19 diagnosis, contacts are instantly, automatically, and anonymously notified of their risk and asked to self-isolate. ”

    Now, imagine, that this would be what many restaurants would require to seat you. Ditto for Higher Ed attendance or to work in other workplaces or attend a sports event.

    I’d bet that a lot of people would do this in a heartbeat.

  10. Think long and deep on an app that would do this, its consequences and its impacts on our society, our culture, our rule of law, our freedoms and rights, our entire way of life, and how others could so easily expand this and abuse us, all that is what is at stake here:

    ” We propose an app, based on existing technology, that allows instant contact tracing. Proximity events between two phones running the app are recorded. Upon an individual’s COVID-19 diagnosis, contacts are instantly, automatically, and anonymously notified of their risk and asked to self-isolate. ”

    • sure. ALL of that would be on the TOS that most of us readily agree to when we put new apps on our phones.

      right?

      And if a business wants to protect its workforce – that might well be a condition just like a background check is or consent to monitor their emails, social media activity, etc.

      And if restaurants and other businesses wanted to make that a condition of entering the restaurant – again – it’s a choice people make just as they do when they agree to be searched to get on an airplane and people do agree as a condition of safety.

      And this poll seems to indicate that people ARE concerned about the virus – and may well accept this approach to give them more assurance of safety.

    • Has anyone drilled into detail of what Israel has done? I have followed their numbers because population size is similar to Virginia, number of cases is similar, but deaths are a fraction of ours. Government freed itself to use location services of smart phones not for tracing so much as a tool for reinforcing stay-at-home order. Brouhaha ensues. That’s my Cliffs Notes version.

  11. Here is a companion piece to my comments, the latest reporting from the Washington Post on the Pandemic hot off the press, the pandemic hot spots flare across the nation with openings.

    The lead in:
    The latest

    “On Wednesday, Montgomery, Ala., Mayor Steven Reed announced his city was facing a crisis: the hospitals were out of ICU beds. “Right now, if you’re from Montgomery, and you need an ICU bed, you’re in trouble … our health-care system has been maxed out.” Reed said. The news came as a research team warned that a second wave of coronavirus infections was likely in the South — Dallas, Houston, southeast Florida, the entire state of Alabama — where reopening has happened rapidly, and other counties with cases on the rise. …

    For more crisis reporting see:
    https://s2.washingtonpost.com/camp-rw/?trackId=596ce2449bbc0f208666d65f&s=5ec6e744fe1ff654c2e32782&linknum=1&linktot=52

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