This is my second post on the press conference Rich Fitzgerald and Dr. Bogen gave on July 7, 2020. The first can be found here, in which I talked about staffing challenges to Allegheny County’s contact tracing program.
Inadequate staffing may not be the biggest challenge for Allegheny County’s contact tracing program. Time is essential with effective contact tracing, and every day of delay before infected people are identified and isolated results in avoidable infections. Chart 16.b of this article on how to implement a successful contact tracing program shows that a 3 day delay in isolating contacts can make a difference between a successful and a failed contact tracing program.
Dr. Bogen said that there has been an increased delay in obtaining test results due to shortages in some of the national labs due to the rise in cases in other parts of the country. After the test results come back they need to be put into the state database before Allegheny County can begin tracing, which Dr. Bogen said may take three days.
As an example of the amount of delay, the test results reported by the state database at noon on July 8, 2020 for Allegheny County were based on test samples taken between June 23 and July 5, 2020, per the Post Gazette. So currently the delay from obtaining the test sample until tracing begins is at least 3 days and up to 15 days. For comparison, South Korea’s contact tracing program was able to obtain results and begin tracing on the same day the test sample was taken starting early in the pandemic. 15 days is past the point at which contacts would need to isolate, making contact tracing almost pointless.
There were articles in both the Wall Street Journal and FiveThirtyEight today about the increase in testing delays. The number of tests per day in the United States has been steadily increasing, and at the end of May and early June there was comparatively timely processing of test results. However nationally the number of cases has grown in the past few weeks much faster than test capacity has increased.
In the Wall Street Journal article, Dr. Fauci was quoted as saying, “If you’re going to do contact tracing and the test comes back in five to seven days, you might as well not do contact tracing because it’s already too late.”
The primary responsibility for addressing these problems is probably at the state and federal level. However, Allegheny County should evaluate whether anything can be done to improve turn-around time in our area. This may include publishing data on which labs have the fastest test processing time, and making arrangements for labs or patients to contact the county directly before a result is uploaded into the state database.
Rich Fitzgerald and Dr. Bogen should push Governor Wolf and State Secretary of Health Dr. Levine to to improve state database timeliness.
Allegheny County may need to maintain strategically targeted business closures until these problems are addressed at the state and federal levels.
These logistical challenges should not be an excuse to delay fixing Allegheny County’s contact tracing staffing problems. Allegheny County should have enough staff ready so that when these problems are fixed it is in a position to implement an effective contact tracing program.
