ZPodium Forums Federal windfall may not fix contact tracing woes

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    “We still think it’s an important component of monitoring the pandemic,” said John Dunn, Tennessee’s state epidemiologist. “We want to maintain our capacity to respond appropriately.”

    States have been lobbying for more resources since the pandemic began last March but the money never came in sufficient amounts to stand up the kind of programs needed to deal with the pandemic’s summer and fall surges. There also was no national strategy for either testing or tracing, raising questions about whether a top-down approach by states was even possible.

    “There’s a discussion about whether we should simply create a social norm for people to do contact tracing themselves,” said Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials. “We might have to rethink contact tracing entirely.”

    For now, officials are focusing on the immediate task at hand. Only 20 percent of Americans are fully immunized, 30 percent of Americans remain vaccine hesitant and more contagious strains are proliferating around the country.

    “We still think it’s an important component of monitoring the pandemic,” said John Dunn, Tennessee’s state epidemiologist. “We want to maintain our capacity to respond appropriately.”

    Biden as a candidate promised to hire at least 100,000 public health workers and pitched rigorous contact tracing as a key part of his plan to reduce the virus’s spread.

    The need has been underscored by surging daily case counts that are up 20 percent since mid-March and governors from both parties rushing to loosen public health restrictions. With more students returning to in-person instruction, youth sports and other group activities, public health experts have stressed that contact tracing will be particularly crucial for tracking outbreaks among kids and the unvaccinated, especially in congregant settings.

    But health workers can only trace if they’re notified about a person’s positive test result. That’s not guaranteed as more rapid at-home tests come onto the market without requirements that the results be reported to public health authorities.

    “It’s not a pregnancy test,” Lori Freeman, chief executive officer of the National Association of County and City Health Officials. “We need to care about what people do with their results and how we will mitigate this disease.”

    Freeman and other public health officials say they also remain in the dark about when the $48 billion promised under the American Rescue Plan will arrive, and whether there will be restrictions on how it can be used.

    “The reality hasn’t hit the street yet about what these resources are going to look like at the local health department level and what flexibility they’ll have to use these resources to meet their unique needs,” Freeman said.

    A spokesperson for the Department of Health and Human Services said that the Biden administration is additionally sending out $100 million for the country’s Medical Reserve Corps and giving local health departments a separate $2.25 billion specifically for testing and tracing for high-risk and underserved populations.

    Several state officials said they hope to invest some of the money in the kind of public health infrastructure that will prove useful even after the pandemic. Public funding for health departments has been decimated over the last couple decades and many local officials, wary of funding cliffs, are looking at improving their surveillance capabilities.

    Dunn, the Tennessee epidemiologist, said some of the funding could go to state labs so they’d be better able to sequence viruses, including variants of the coronavirus.

    David Scrase, New Mexico’s health secretary, said newly trained public health workers, beyond contact tracing, could reach out to people who are vaccine-hesitant.

    “The messaging will change,” he said. “I see it becoming more assertive, more directed.”

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