July 7, 2020
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Contact tracers, from left to right, Christella Uwera, Dishell Freeman and Alejandra Camarillo work at Harris County Public Health contact tracing facility Thursday, June 25, 2020, in Houston. Texas Gov. Greg Abbott said Wednesday that the state is facing a "massive outbreak" in the coronavirus pandemic and that some new local restrictions may be needed to protect hospital space for new patients. (AP Photo/David J. Phillip)

Tracking coronavirus cases is difficult amid a new surge

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Houston (AP) – US health departments that use contact tracing to control coronavirus outbreaks are trying to strengthen their ranks in the face of an increasing number of cases and resistance to collaboration with the infected or infected.

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Because there are too few specially trained contact tracking tools to cope with the growing workload, one heavily damaged Arizona county relies on the participation of members of the National Guard. In Louisiana, people with a positive test usually wait more than two days to respond to healthcare providers, leading to illness. crucial time for distribution. Many tracers have difficulty overcoming suspicion and apathy in order to convince people that compliance is critical.

Contact Tracking – tracking people who tested positive and everyone they contacted was not easy, even with home orders. Tracers say it is now exponentially harder when many restaurants, bars and gyms are full and people get together with family and friends.

“People are probably undermining their guards a bit … they think there is no longer a threat,” said Grand Travers, Michigan, health officer Wendy Hirschenberger, who was warned by health workers in another part of the state that they were infecting tourists. visited vineyards and bars in her area.

Her health department was able to persuade local residents who visited these facilities to quarantine.

Hirschenberger was fortunate that she received this information – this was only possible because the tourists collaborated with contact trackers. But this is often not the case.

Dr. Anthony Fauci, the country’s leading infectious disease specialist, said on Friday that contact tracing simply doesn’t work in the US.

Those who test positive do not collaborate because they do not feel sick. Others refuse to test even after exposure. Some never call back. And others simply object to the exchange of any information.

Another new issue: More young people become infectedand they are less likely to feel sick or believe they are dangerous to others.

While older people were more often diagnosed with the virus in the early stages of a pandemic, data from the Centers for Disease Control and Prevention show that the picture changed almost immediately after the onset of the condition. Now people from 18 to 49 years old are most often diagnosed.

On Monday, the United States reported 38,800 new confirmed infections, the total number of which exceeded 2.5 million, according to the Johns Hopkins University. For several days now, daily recorded cases in the United States broke the record set in April. This partially reflects increased testing.

Some states have been taken by surprise and are trying to quickly increase the number of contact trackers.

“Right now, we don’t have the capacity to do the work we need,” said Arkansas Governor Asa Hutchinson recently, announcing that she wants to use federal funds to help with coronavirus to increase contact tracing to 900.

Arkansas already has 200 doing the work, but the number of infections has increased by more than 230%, and the number of hospitalizations since memorial is almost 170%. Businesses that shut down due to the virus were allowed to reopen in early May, and this month the state further relaxed its restrictions.

According to Dr. Umaira Shah, Executive Director of the Harris County Public Health Department in Houston, in addition to requiring more staff to increase the incidence of the disease, contact tracking teams should also build trust in people who may be worried or scared . crowded hospitals.

This is difficult to do if infected people do not answer calls.

In Louisiana, only 59% of those who tested positive since mid-May answered phone calls from contact trackers, according to the latest data from the state health department. Only one third responded within the first 24 hours after the test results. Tracers receive a return phone call, on average, more than two days after receiving information about a positive test.

Perry N. Halkitis, Dean of the Rutgers School of Public Health, said COVID-19 is spreading so fast that contact trackers must reach 75% of potentially infected people within 24 hours of exposure to successfully combat the spread.

“Is it as good as we would like?” Well, obviously not, ”said Dr. Jimmy Guidry, Louisiana State Sanitary Inspector. “It’s better than not having it.”

According to health investigator Mackenzie Bray, followers in Utah’s capital, Salt Lake City, have faced doubling jobs and weakening collaboration since the economy reopened. One person who didn’t answer the phone told Bray that he didn’t want to waste her time because they and their contacts were not at high risk — a dangerous assessment because the person may not know the history of their contacts, Bray said.

Making people act on the advice of tracers is also not easy. In the Seattle area, only 21% of those infected say they were isolated the day they got symptoms. According to Dr. Matt Golden, a doctor from the University of Washington, who on average investigates cases at the King County Department of Public Health, people take an average of three days from the onset of symptoms to testing.

According to him, since people become infected two days before the onset of symptoms, this means that many spread the virus within five days.

According to Marcy Flanagan, Executive Director of the Maricopa County Department of Health, in the disaster-affected Maricopa, Arizona district, officials hired 82 people to support contact tracing, which allowed them to reach 600 people a day.

However, according to the counties, the average daily number of confirmed infections increased to 1800 per day from 200 in May. That means the county must leave the remaining cases to the Arizona colleges, health agencies, and the National Guard, Flanagan said.

All of them must sort the data: each infected person in an automated text asks to fill out a survey in order to assess the level of his risk, and tracing people contact by phone only with those who seem to be at high risk, or work in conditions that can cause dangerous flash, such as an auxiliary residential facility.

Tracking contacts is key to preventing the worst outcomes, said Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention, and current president and CEO of Resolve to Save Lives, a nonprofit organization that works to prevent epidemics. But the explosion of cases in the US made it virtually impossible for even the most well-equipped health departments to keep up, he said.

According to Frieden, contact tracing is “a proven and real public health function.” “If the health department calls, pick up the phone.”

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Webber reported from Fenton, Michigan, and McCombs from Salt Lake City. Associated Press reporters Andrew De Millo of Little Rock, Arkansas; Carla C. Johnson in Seattle; Melinda Deslate in Baton Rouge, Louisiana; and Terry Chea in San Francisco contributed.

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