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With Testing In Place, Kentucky Turns To Contact Tracing As State Reopens

Ryan Van Velzer

Kentucky is racing to mount widespread testing and contact tracing to manage the spread of the coronavirus with little more than a week left before restaurants reopen their dining rooms.

To date, the state has conducted more than 100,000 tests. Gov. Andy Beshear said there will be enough weekly testing in May to meet a White House official’s recommendation that states test at least 2% of the population per month.

But it’s not enough to know who is testing positive. That’s where contact tracing comes in. Contact tracing is the systematic identification of everyone who might have been exposed to a person with COVID-19.

Testing and contact tracing work in tandem during a pandemic: The only way to stop the spread of the virus is by identifying who has it and who they may have exposed, then getting those people to quarantine for 14 days —the length of time it may take for symptoms to appear.

“There’s likely going to be a time where you are going to have been exposed to someone who was positive,” Beshear said, “And when someone calls you and tells you that, you may have to self-quarantine.”

The state’s plan is to hire 20 of its own contact tracers then contract others to work alongside the state’s 61 local health departments.

The staffing contracts will last until the end of 2020, while the state will provide the data collection system, which is still under development, according to a request for proposals issued May 5.

In total, Kentucky estimates it needs to hire about 451 contact tracers to work alongside local health departments, or about 10 workers per 100,000 residents, records show. Workers with a background in public health, medical science, nursing or a school of medicine are preferred.

The bulk of the work is split into two categories:

  • 89 communicable disease investigators who track down people who may have been exposed
  • 362 contact tracers who notify those who have been exposed and check-in to make sure they are self-monitoring and not developing symptoms.

In addition, the state plans to hire about 135 “social support connectors” to help people in quarantine coordinate grocery and prescription deliveries.
Assuming all of those workers are in place in the next couple weeks, Kentucky will still not meet the recommendations from the National Association of County and City Health Officials.

The association recommends states should have 15 professionals per 100,000 residents in non-emergency situations, but given the magnitude of COVID-19, it is doubling that recommendation to 30 per 100,000 residents.

Dr. Gonzalo Bearman, Chief of infectious diseases at Virginia Commonwealth University, says a staged re-opening is important, but contact tracing is critical to controlling an outbreak of any infectious disease.

“To do that, you really have to have a robust public health platform to get that done,” he said. “It’s not just Kentucky, but much of the United States does not have a robust public health platform for contact tracing.”

The less prepared the state is, the higher the risk of a resurgence of the virus, Bearman said.

Cases of Covid-19 have plateaued, and state is moving forward with reopening the economy against the advice of infectious disease experts who have said states should wait to see a 14-day decline in cases before reopening.

Gov. Andy Beshear said the state’s phased reopening plan is designed to give health officials enough time to increase testing and contact tracing.

“Our goal is to reopen Kentucky’s economy in a gradual and safe way,” Beshear said during a question and answer session with the Courier Journal on Wednesday. “At the same time, we acknowledge we are still in a worldwide health pandemic the likes of which none of us have ever seen.”

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