Analysis: Louisiana Virus Tracking Effort Hits Roadblocks
BATON ROUGE (AP) — Louisiana’s work to track coronavirus cases, to help slow the spread of the outbreak, can’t keep up with the state’s pace of new infections or overcome the lack of useful information provided by the thousands of people who have tested positive for the virus.
Health department officials have used details they’ve gathered through the phone calls to pinpoint a few hundred coronavirus outbreaks, but they also acknowledge they have run into significant limits with the effort. For those people they reach, nearly three-quarters don’t provide details about close contacts they had.
“I wouldn’t say that it’s failing. I would say that I would want it to be much more effective,” said Alex Billioux, Gov. John Bel Edwards’ chief public health adviser, when asked about Louisiana’s contact tracing program.
Infectious disease experts consider a robust contact tracing program as essential to help battle the pandemic, and the Edwards administration has about 650 people actively making calls through $20 million in federally financed contracts with call centers.
Even with hundreds of people working the phones, the state has completed interviews with only 64% of those who tested positive for the coronavirus since mid-May, according to Louisiana Department of Health data. Thousands of others have fallen through the cracks.
For about one-third of positive tests, labs aren’t providing the health department with enough information to contact those infected, Billioux said. But a larger problem involves the sheer scale of Louisiana’s outbreak.
“When you have days that have thousands of test results reported, it’s really hard for us to get to everybody in a timely fashion. That’s one limitation, just getting to folks,” Billioux said.
Only 25% of people answered contact tracing calls from the state within the crucial first 24 hours after receiving the test results. That’s the time period when public health officials suggest speed is critical to get people to quarantine and to track down anyone else who might have been exposed. The average time Louisiana’s contact tracers are reaching people is 78 hours after test results are received — and sometimes those test results already have lagged for days.
And while only a small percentage of those infected with the virus are outright refusing to participate when reached by a contact tracer, most respondents who answer the calls aren’t providing information about who might be at risk for infection.
The health department says more than 70% of the people Louisiana reaches through contact tracing say they haven’t recently come into close contact with anyone, defined as within 6 feet of someone for 15 minutes or more.
The suggestion that thousands of people who tested positive for the virus didn’t encounter anyone in close contact, Billioux said, “seems to boggle the mind.”
“Nearly three-quarters report that they have had zero contacts since their illness began. Quite honestly, that’s impossible,” Jennifer Avegno, the doctor who leads New Orleans’ health department, said Wednesday. “Seventy-five percent of people — it’s unlikely that they have interacted with zero people in the preceding few days.”
For most people, the highly contagious coronavirus causes mild or moderate symptoms. For some, especially older adults and those with existing health problems, it can cause more severe or fatal illness. More than 4,300 Louisiana residents have died from the COVID-19 disease caused by the coronavirus.
Some people who test positive for the virus worry about sharing information and how it will be used, even though contact tracing has been employed for decades in other disease outbreaks and federal health privacy laws require protection of the information. Conservative GOP state lawmakers have publicly described suspicions of Louisiana’s contact tracing effort, possibly further undermining its success.
In some instances, health department officials say people who have tested positive appear to think they can personally — and quietly — reach out to their contacts and notify them privately of their risk. But that doesn’t take into account people they came into contact with in stores, restaurants and elsewhere.
Billioux stressed individual benefits of contact tracing beyond the larger tracking effort. The state uses those calls to connect people with grocery and prescription delivery, isolation information, cleaning supplies and personal protective equipment.
Avegno implored people who have tested positive and are called to disclose whom they have been in contact with: “Contact tracers are specially trained in privacy standards, and they are not going to disclose anything personal, or get you in trouble.”
By AP reporter Melinda Deslatte