Rebecca Holcombe calls on Gov. Scott to ensure the state has sufficient capacity for contact tracing as schools reopen

COVID-19 is here. We need to prepare for a surge in the fall. Events in southern states have made clear just how quickly the virus can spread. 

Meanwhile, the budget for the Vermont Department of Health (VDH) suggests that it has 300 fewer workers than it did in 2008.

We are lucky to have competent and hardworking employees at the VDH, who are focused on keeping us safe.  However, they are already overstretched as they respond to COVID-19, and it is unclear whether there are enough of them to keep ahead of any potential COVID-19 surges that may come later this summer or fall.

Now is the time for aggressive action to ensure that the VDH has sufficient staffing and systems to respond to simultaneous surges in different regions of the state. VDH must have the numbers and flexibility to carry out robust efforts to track and trace the virus, so it doesn’t get out of control here in Vermont. 

Our health and economic vitality depend on making sure the Department of Health has the capacity and systems to respond quickly and effectively to any risk. Given evidence that many people who are infected and spreading COVID-19 do not show symptoms, an extremely robust program, with the ability to scale up and respond rapidly, is necessary.

We shut our state down to prevent our hospital system from being overwhelmed. Preventing out-of-control spread will require continued caution by Vermonters, including wearing of masks, hand washing, and physical distancing. But citizen action alone won’t prevent this virus from spreading. 

Some initial signs suggest we may not be ready for a surge, nor taking enough steps to prevent one.

We need enough capacity at the Vermont Department of Health to test, track and trace the virus in the face of a surge.  And we need consistent and proactive messaging from the governor on prevention and mask use.   

The National Association of County and City Health Officials estimates we may need 30 workers per 100,000 people during the COVID-19 pandemic to support COVID-19 contact tracing. The  Mullan Institute at George Washington University estimated Vermont needs 101 contact tracers to be prepared for a surge.   Recent reporting suggests VT has 53 tracers—about 8.5 per 100,000 people. While different reports recommend different numbers, by any measure, we will need more than we have to contain the virus in the face of a surge. 

In addition, I have heard from many doctors that currently there are delays in getting test results, even at a time when we have relatively low numbers of infection. Will the state have the capacity to scale up testing and provide the rapid results needed to contain the spread in a surge? 

As schools and childcares reopen, the VDH must have the capacity to track and trace potential COVID-19 exposure in multiple regions, and ensure access to quick results from testing. 

Governor Scott has a responsibility to address these questions:

  1. Does the VDH have sufficient capacity, and will new staff be trained sufficiently trained in advance to manage a robust contact tracing program and contain the virus?
  2. Does the state have sufficient capacity to expand testing and provide rapid test results when higher levels of testing and more contract tracing is needed in the fall?
  3. How many contact tracers do we have, and what is the plan to “flex the system” or expand capacity in a surge?  Are these contact tracers dedicated to contract tracing, or are these employees with other jobs, such as managing chronic diseases, so that pulling them on to contract tracing may create other risks? 

Finally, other governors have mandated mask use to curb local surges. But mandated mask use also helps prevent surges in the first place. Instead, Vermont has focused on encouraging people to stay away, even as evidence suggests people are coming to Vermont. Mandated mask use will be more effective at curbing transmission than requests to stay away, and won’t unintentionally reinforce xenophoic harassment of visitors, particularly visitors of color from other states. It is time for the Governor to provide consistent messaging on mask use. 

References:

  1. https://www.cnbc.com/2020/06/29/cdc-says-us-has-way-too-much-virus-to-control-pandemic-as-cases-surge-across-country.html
  2. https://www.mynbc5.com/article/how-does-contact-tracing-work/32828991#
  3. https://www.google.com/url?q=https://www.businessinsider.my/texas-virgina-vermont-accused-of-misleading-coronavirus-data-2020-5&source=gmail&ust=1593519414397000&usg=AFQjCNEu_HzwKCx9PAOA1ApwKCiGY3SI5A