Virginia to Hire 1,000 Contact Tracers. What Will Their Priorities Be?

by James A. Bacon

Virginia is committing $58 million in federal emergency aid to expand contact tracing of people testing positive for the COVID-19 virus, reports the Richmond Times-Dispatch. The epidemic-fighting tool will be all the more necessary as Virginia eases its Vulcan Death Grip on Virginia’s economy and people begin moving around more freely.

“As we interact more, there will be more opportunity for [positive cases] to infect others,” Virginia State health Commissioner Norman Oliver told the Senate Finance & Appropriations Committee yesterday.

The state health department already uses contact tracing to prevent the spread of sexually transmittable diseases, tuberculosis and other communicable diseases. “This is what local health departments do every day,” Oliver told the committee. Hiring 200 communicable disease investigators and 1,000 contact tracers will cost an estimated $7 million to $8 million a month. 

The RTD article did not say how the activities of the contact tracers would be prioritized, presumably because Oliver did not tell the committee. Twelve hundred people sounds like a lot — and maybe it’s more than enough to handle the job. But consider that the number of new COVID-19 cases every day has ranged between 700 and 1,300 over the past couple of weeks. Roughly speaking, that’s one new case per contact tracer per day.

Some cases will be easy to handle. Patient X might have caught the disease while hunkering down at home. The contact tracer might have to track down no more than two or three family members with whom the patient had come into contact. Patient Y might be more complicated if he had, say, gone grocery shopping at the Kroger, bought some light bulbs at the hardware store, and picked up some medications at the CVS. The task gets way more complicated if Patient X has spent time with co-workers in the office or socialized with friends, all of whom must be contacted.

As an side, does the contact-tracing protocol require all of these contacts to be tested? Whatever the answer to that question, one can see that contact tracing for the corona virus is a labor-intensive task. It’s one thing to contact a person’s sexual partners — often a small number of readily identified individuals — in the effort to quash an outbreak of syphilis. It’s another to contact everyone a COVID-19 patient has come into contact with over the past week.

The point is this: The Virginia Department of Health may not be able to follow up on every positive COVID-19 test. In that case, there are two possible courses of action: (1) Treat all cases the same, dealing with them on a first-come, first-serve basis until a huge backlog builds up, or (2) set priorities. It would be wise to develop a list of priorities before a backlog occurs.

Hopefully, the department has thought through its contact-tracing protocols for COVID-9. Some logical questions:

Should the VDH prioritize contact tracing in nursing homes and correctional facilities? Clearly, those are locations where the virus has the potential to run out of control. Or, conversely, are the quarters so confined and access to the facilities so controlled that nothing useful is gained by ascertaining whom a particular COVID-19 patient came into contact with?

Should VDH prioritize regions like Northern Virginia where the virus has penetrated most deeply into the population, on the logic that such regions are where the need to slow the spread is the greatest?

Conversely, should the department focus on areas like Western Virginia where the virus has not made deep in roads in the hope of snuffing it out?

I have another thought: Use the contact tracers to identify and categorize the circumstances in which the virus spread. What percentage of the population likely contracted the disease at home? From family members? From friends? While running errands to the grocery store or drug store? In restaurants (should they ever reopen)? In the workplace? In trains, buses, airplanes and other forms of public transit? At the beach? While jogging outdoors? While pushing elevator buttons or opening door handles? In many cases, we may never know the answer. But in some cases, perhaps, we will. Such information would be of tremendous value in crafting public policies to combat the virus — and in informing the public where the greatest risks are.

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17 responses to “Virginia to Hire 1,000 Contact Tracers. What Will Their Priorities Be?

  1. Contact tracing is highly appropriate for certain infectious diseases, and its highly inappropriate for other infectious diseases, the flu for example, except in very limited populations, say nursing homes. This is because rapid and wide spread infections will easily overwhelm testing capacity and its tracers, and will quickly turn an open society into a police state.

    In America, many people will refuse this State coercion (unless cowed and intimidated), rendering tracing and quarantine results useless and highly damaging, despite and because of police state tactics.

  2. So there’s no point in tracing or testing even, let’s just ‘let ‘er rip’ through the population until covid runs out of victims? Sweden here we come.

    • Outside of major metro areas that have an array of surveillance apparatus it will not be effective. There is no possible way to track the people that someone who walked into the Giant and is positive interacts with and or distributes their viral load along the way.

      It’s like putting up a lost and found poster once they leave a monitored area, this isn’t NYC.

    • “So there’s no point in tracing or testing even, let’s just ‘let ‘er rip’ through the population until covid runs out of victims? Sweden here we come.”

      Close, Acbar. But incomplete. We must protect the vulnerable as well as we reasonable can. And follow Sweden. Then we come out far far better in many many ways than I current course, which if not corrected may well destroy the rest of our children future, just as we’ve damaged so much of it already .

      To learn from someone who knows what they are talking about, who is honest, and refuses to scare people for private agendas, you can start with this prince of a man who happens to be a Nobel Prize winner. see below

  3. The patient Y situation will most likely be what is occurring. While this method was highly effective in South Korea it most likely will not be here. As it’s effectiveness in SK was predicated upon the mass surveillance that occurs in that nation, that is coupled with facial recognition software.

    That’s how the contact tracing was also conducted on Humphrey’s. Outside of NYC the level of surveillance required to operate effectively does not exist.

  4. Contact tracing is reasonable and necessary. It’s reasonable because the number of viral particles required to become infected can’t be passed by walking past somebody in the grocery store. Studies estimate that you need to be in the proximity of an infected person for at least 50 minutes to be infected if the infected person is not talking (or sneezing or coughing). If the person is talking you could be infected in five minutes although that is a worst case scenario. A lot of potentially infected people could be identified without the need to know everybody a person who tests positive has been exposed to.

    It’s necessary, even if not compulsory, because right minded people want to know whether they have been exposed. Right minded people will get tested and self-isolate before becoming modern day Typhoid Marys (or COVID Kevins). Frankly, people who are told they have been exposed to the virus and do not get tested then spread the virus should be liable for damages from those they infect.

    It’s necessary because it’s fundamental to reopening and staying open. I would vastly prefer to eat in a restaurant that mandated a “check in” for anybody wanting to dine there along with mandatory reporting back to the restaurant of anybody who tested positive during their infectious phase while eating there. If I was in the restaurant while somebody who tested positive ate there I’d want to know. The restaurant really should also note the place at the table and the placement of the table within the restaurant for every patron. If I was eating 12 feet away from a person who tested positive I’d be “on notice”. The first signs of unusual fatigue, lack of taste pr smell, dry coughing, etc would send me looking for a test. If you don’t like those rules then don’t patronize the restaurants which enforce them.

    • “Frankly, people who are told they have been exposed to the virus and do not get tested then spread the virus should be liable for damages from those they infect.”

      I think you’re going to have a hard time getting a Doctor to sign off on that, it’s even like pulling teeth for medical professionals to get tested in that instance.

    • Don, here is excellent look into subject at hand. This is another very sharp, highly informed and honest guy. The big question here now in my mind is how long will this virus last. To grossly over simplify is the above Nobel prize winner right on this issue or this immediately guy below. I don’t know, and likely too it depends, given what we don’t wrong already. Likely we will soon find out. This also speaks to contact tracing in highly informed way.

      See:

      • To correct what is immediately above.

        Don, here is excellent look into subject at hand. This is another very sharp, highly informed and honest guy. The key question here now in my mind is how long will this virus last. To grossly over simplify, is the above Nobel prize winner right on this issue or this guy immediately below. I don’t know the answer, and likely too it depends, given what we done wrong already. Likely we will soon find out sooner than we think. This guy below also speaks to contact tracing in a highly informed way.

  5. So.. what do most folks in the field of epidemiology say?

    contact tracing is messy and won’t be 100% effective but to not do it at all especially for workplaces is problematic.

    They’re doing contact tracing at the White House even!

    They’re doing it in meat packing plants.

    And I found out this morning that they are doing it dentists offices if an infection is discovered in a patient or a staff person (and I presume at other medical facilities) (however, at least so far, personnel in dental offices cannot get testing unless they are symptomatic – you’d think that those folks would be priorities… for testing and contact tracing).

    Like Jim reported – VDH already does contact tracing and have for years. It’s proforma for many infectious diseases already.

  6. Tracing STD’s is a whole lot easier (as it requires inserting Tab A into Slot B) than CV which is blowing in the wind….

  7. Maybe we should all welcome the future, go ahead get our Neuralink implants, and let Big Brother keep track of us all.

  8. What will their priorities be? A regular state pay check, and if they play their cards right, a full time state position with future VRS pension….some I’m sure will be diligent about the job.

  9. April 6 Virginian Pilot/Daily Press:
    “The Peninsula and Hampton health districts’ epidemiologists are following 1,000 people who’ve been in contact with the 217 — and growing — number of individuals who have tested positive for the new coronavirus.

    “That shows the virus is so widespread that contact-tracing alone isn’t an effective way to contain the disease, said Dr. Steve Julian, the new Peninsula Health District director who is overseeing both districts’ coronavirus efforts.

    “The strategy going forward is to step up public health workers’ efforts to keep the virus out of the community’s many nursing homes, Eastern State Hospital and other psychiatric facilities and hospital emergency rooms.”

    I just asked the Eastern area VDH PIO what Dr. Julian says now. Not holding my breath for an answer.

    • And here’s how contract tracing is actually being used right now – which is to try to keep businesses open … even as the virus is infecting workers.

      The alternative to NOT doing contact-tracing is to stand by and watch more workers get infected until the business has to close down – like we are seeing across the country in meat packing plants… as well as other manufacturing plants.

      Contact Tracing is how you find those infected, isolate them, and let the rest of the workers continue to work and the business to stay open.

      Those who say just let the virus run it’s course are not connected to reality… if we do that – the virus will spread and will cause more businesses to close even as they try to re-open.

      from FLS in Frederickburg (note this that bad old “media” that we say is biased and panics the public, etc, etc, blah, blah, blah:

      “Five office workers at a manufacturing facility in Caroline County tested positive for COVID-19 last week and have been quarantining at home. Meanwhile, the CVS on Chatham Heights Road in Stafford County is closed today for cleaning after an employee there tested positive. And, workers with the local health district continue to investigate their own outbreak after a nurse tested positive on Monday.

      In the Caroline case, none of those with confirmed cases of the novel coronavirus worked on the manufacturing floor of the Modular MEP Facility in Ruther Glen, said Regine de la Cruz, vice president of marketing and communications with M.C. Dean Inc., which owns the plant.

      She said that as soon as the first person tested positive, the company followed safety protocols to isolate the employee, conduct contact tracing and inform all workers. The main office building was closed for five days, and in addition to daily cleaning, the company hired a third party to deep clean the site, de la Cruz said.”

      https://www.fredericksburg.com/news/caroline-plant-stafford-cvs-and-local-health-district-dealing-with-covid-19-cases/article_42eb582b-82ba-5466-9649-2ce8899a0e9e.html

  10. “That shows the virus is so widespread that contact-tracing alone isn’t an effective way to contain the disease, said Dr. Steve Julian, the new Peninsula Health District director who is overseeing both districts’ coronavirus efforts.

    “The strategy going forward is to step up public health workers’ efforts to keep the virus out of the community’s many nursing homes, Eastern State Hospital and other psychiatric facilities and hospital emergency rooms.”

    Carol, I believe Dr. Steve Julian has stated the truth, and suggested the proper steps, plus I suggest he insure other highly vulnerable people are protected. But the virus is out of the bottle and cannot be put back in. It will run its course. I think it would be a mistake to start locking down large numbers of people down by reason of contact tracing.

    This I take solely from the 5 or 6 videos I’ve posted to date on Bacon’s Rebellion, I suggest people review those videos and decide for themselves.

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