State and local public health authorities have yet to build a completely robust system for tracking contacts four months after the coronavirus began sweeping Oregon, according to public records released Tuesday.
The Oregon Health Authority said in May that health officials would need at least 631 full-time contact trackers, which are key to reducing the spread of the virus by identifying who may have been exposed to known infections. Authorities later said the number would likely increase to “800 or more positions.”
The actual count from June 12? “About 600 people,” the health authority revealed Tuesday.
Records released by the Oregon Health Authority also appear to show that 11 counties still lacked the trackers that state officials initially declared each “must have” before gradually easing restrictions on stay-at-home orders. That includes Multnomah, Washington, Clackamas and Marion counties, where the state’s highest number of infections are found.
Dr. Thomas Jeanne, the state’s assistant director of health and epidemiologist, said state and county public health authorities have made great progress. The number of workers available to track contacts has quadrupled, he said, since they identified the first infection on February 28.
“I think this is a good step forward for us as a state,” he said. “It is really encouraging to see him. But we still have not finished.
The release of the worker counts comes three weeks after The Oregonian / OregonLive submitted a request for public records for the data. State officials previously said they did not know how many trackers were working, but that they would survey counties to find out.
Oregon’s contact locating ability has already been impacted despite relatively few cases compared to other states, with 7,274 confirmed or suspected infections. A recent outbreak at a Lincoln County seafood facility on the Oregon coast, for example, sent officials fighting to increase staff to stem the spread of the virus.
The statewide benchmark of 631 contact trackers is based on 15 workers per 100,000 residents. Some public health experts have said the number should be double that of the pandemic.
Gov. Kate Brown allowed several Oregon counties to move forward with the reopening despite failing to meet the lowest benchmark, provided each county submits a personnel plan. Authorities argued that there was no point in demanding workers in areas with few cases.
While there is not a correct number of tracers, and many variables are at stake, one estimate suggests that Oregon may need 1,209 workers based on recent trends including record-level infections in the past two weeks.
That projection assumes that each infection is investigated and each infection has 10 contacts. Cutting both metrics in half still shows that Oregon might need more than 700 tracers.
“That suggests there may be some work to be done,” said Candice Chen, an associate professor at George Washington University who participates in the estimates.
The George Washington University and two national organizations, representing agencies and public health officials, created the online estimator. An analysis by National Public Radio using that estimator last week suggested that Oregon was one of the seven states with enough tracers.
But the estimator is updated daily, based on infection counts.
Chen said it is possible for Oregon to survive on 600-something trackers if state and local public health agencies can work together seamlessly.
“There are many unknowns,” he said.
Public health officials use contact tracing to slow the spread of communicable diseases. Workers called case investigators interview someone who is infected, asking detailed questions about when they got sick and who they may have exposed. Workers called contact trackers use that information to notify people who were in close contact with the infected person and advise them to quarantine the home.
The count released by Oregon on Tuesday distinguishes between trackers and researchers, to include all workers, according to national projections.
Jeanne, a deputy epidemiologist from Oregon, said “not implausible” 1,200 or more could eventually be needed statewide.
But Jeanne also said that “there is no timeline or number” for more staff, acknowledging that she was unaware of the 800-worker figure previously disclosed by the state in a draft plan. Officials never finalized that document.
“We met the initial goal and will expand as necessary,” he said, insisting that Oregon had achieved its original goal.
The Oregon Health Authority did not state in its press release that it outnumbered 631 full-time workers, however, it announced in a carefully worded statement that “the current statewide total of county and state contact trackers now it is approximately 600 people. “
That includes nearly 100 state employees who are “ready to assist counties with case investigation and contact tracking in the event of an outbreak.”
The account also came with several caveats.
He listed up to 63 workers in Multnomah County, for example, despite the fact that 19 of them are only part-time and equal to just 6 full-time employees. It also included 45 volunteers or college students in Lane County and several workers who had not yet been hired in various jurisdictions.
Meanwhile, four counties did not provide updated worker counts beyond what was initially shared in April.
The sum of all listed workers, by county, amounts to approximately 565. The Oregon Health Authority was unable to say how many of its 100 additional listed workers had followed up on contacts, although some have been assigned to outbreaks in Lincoln and Union.
Meanwhile, officials in the Portland area acknowledged that they are still working to hire and train trackers.
Kate Willson, a Multnomah County spokeswoman, said authorities plan to meet the state’s goal for the county of 122 full-time equivalent workers by the end of July.
Washington state listed Washington County with just 68 workers, down from the 90 needed. A spokeswoman, Mary Sawyers, said the total staff should reach 86 in early July.
Clackamas County had just 29 full-time equivalent workers, according to the state, well below the required 63. A county spokesman declined to say when the county would reach its benchmark, but wrote in a statement that “we will continue to hire as time passes.”
Marion County officials, who reportedly only have 30 of the 52 workers needed, did not respond to a request for comment.
More contact trackers appear to have helped Oregon investigate infections.
State officials set a benchmark that investigators should try to contact someone with an infection within 24 hours, 95% of the time.
Workers regularly failed to achieve that until May, according to state statistics. But now the benchmark is regularly exceeded.
However, it remains to be seen if it is a really useful indicator.
Jeanne, the state’s assistant director of health, was unaware of the precise definition the state was using. She assumed that officials needed to speak to the person, not simply try to communicate with someone.
“I don’t see how that’s very helpful,” he said of the follow-up to whether anyone had just left a voicemail.
An agency spokesman later confirmed that the metric tracks only one “contact attempt.”
– Brad Schmidt; [email protected]; 503-294-7628; @_brad_schmidt
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