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San Diego's Contact Tracing Program Not Keeping Up With Virus Surge

 July 7, 2020 at 10:19 AM PDT

Speaker 1: 00:00 San Diego County has effort to maintain control of the coronavirus. Pandemic is failing with a surge in cases since mid June, this is happening as the County continues to ramp up its contact tracing program in hopes of slowing the spread. But KPBS, investigative reporter, Claire Traeger found it has some big limitations. Speaker 2: 00:20 Every day. Osmo Elsa bag goes to work and gives people bad news. And I'd say I'm calling because you were recently exposed to someone who tested positive for COVID-19. Alibaba is one of nearly 500 contact tracers working for San Diego County. It's her job to find a notify people who were likely in contact with someone who's tested positive for the coronavirus. They have to monitor their symptoms twice a day. They have to check for fever. We go through the whole list of symptoms. There's like fever, difficulty breathing, cough. There's, uh, you know, there's a whole list that we go over with them and we send them out to them to, um, we encourage them not to do things like share utensils or share bedding, uh, to wear face covers around each other. Elsa bog estimates. She's made hundreds of phone calls, but all her hard work may not be having the desired effect. Speaker 2: 01:11 Cases have been surging in the County with daily counts, approaching 500 and the total tally over 15,000 yet the county's contact tracers have only reached about 9,000 County residents who are identified as a close contact of someone with the virus. No, the last time they were within six feet without a face covering for longer than 15 minutes. That's probably only about 6% of all the County residents who've been exposed. Plus the County does not know how many of the people contacted actually followed the public health order and went into quarantine. It's turned out to be much more difficult to standardize across the state. Andrea [inaudible] is an epidemiologist at UC San Diego and to put, to sew together from various institutions and make it happen. She and other epidemiologists say a regime of widespread wearing a face coverings, social distancing testing, and contact tracing is the only safe way to slow the spread of the disease until a vaccine is available. Speaker 2: 02:19 Contact tracing has proven effective in countries with authoritarian systems like China, and those with populations that are generally more compliant with government authority like South Korea or Germany, but in the U S San Diego county's program is just one of many that are struggling. And NPR survey found that only seven States in Washington DC have enough contact tracers to contain outbreaks. California currently has 6,000 contact tracers statewide about half of what it would need. According to the survey. Hi, I'm calling from Mariella back at her desk. The contact tracer Al Shabaab is working the again, hi, Mariella Asma. I'm calling from the County of San Diego's public health department. How are you? Nine out of 10 times. The person's like, yes, I already know who it is. It's so and so that's because the person with COVID-19 is a family member or close friend, but other times she's greeted with real anger. Speaker 2: 03:17 Um, sometimes the person's like, Oh, wow, like they're more understanding. And they're willing to listen. Other times people are really angry and, you know, they refuse to even listen or complete the interview until you tell them who the person, you know, who infected them, what or who they were exposed to us. And we can't do that. This is just one of the limits. [inaudible] on a contact tracers power. They're not reaching all the people they need to reach. They can't force the people. They do reach to give them information and they can't force those. Who've been exposed to stay home. Jeff Johnson, the head of the county's contact tracing program acknowledges the limitations. Speaker 3: 03:57 We really want them to quarantine themselves. And, um, and that is the recommendation. And, uh, that's one of the reasons we keep in contact with them, you know, if they are threatening to, um, you know, to go to work, then, you know, we, you know, we will have to talk with them and, and kind of advise them otherwise, you know, if they went to work, then we might have to, you know, call their employer and just kind of, um, work with our HR department maybe, and just make some soft, friendly recommendations. Speaker 2: 04:28 If a person does develop symptoms or test positive for COVID-19, the County then has the authority to force that person into quarantine. And if the person refuses, Speaker 3: 04:39 We have somebody from the County, uh, in, in, in some cases has been a Sheriff's officer actually physically, uh, issue it. And like I said, that's been very, very rare. Speaker 2: 04:52 Another reality that could be limiting the program's effectiveness is a lack of bilingual contact. Tracers Al Sebagh speaks Arabic in addition to English, but not many other contact tracers speak a second language. There's currently one other contact tracer on staff at the County who speaks Arabic and 41 who speaks Spanish just under 10% of all the contact tracers, three contact, tracers, speak, Chinese, one speaks Vietnamese and eight speak Tagalog or Filipino Alibaba ABOG says many of the calls she makes are to people who speak Spanish. So she uses software called language line that does the translation for her. So, um, do you have difficulty breathing? Do you have any loss of smell or taste? She plans to continue going to work and helping people through the challenging phone calls they received until contact tracing is no longer a thing. Probably when a vaccine comes out, I'm guessing Clare Trek, Asser KPBS news. Joining me is KPBS investigative reporter, Speaker 1: 05:58 Claire Tresor and Claire. Welcome. Thank you. This sounds like one of the most frustrating jobs in the world. How well have the contact tracers you spoke with been trained for this job? Speaker 4: 06:11 Yeah, so they did a really fast hiring period. Um, they, they tried to bring in people as quickly as they could, uh, San Diego County and then they got them trained up. So I think they had about 17 hours of training. Some of it was in person where they actually go into the County operation center. And then a lot of it is, um, a virtual training that they, they do at home. And really, I mean, they were taking people with a wide variety of backgrounds. I think, you know, medical experience would be, uh, ideal, but anyone who is able to just ask questions and kind of have that patient, um, demeanor, which I think you would need to be making all of these calls, uh, had had a shot at it. Speaker 1: 06:57 How does the tracing work? In other words, when someone tests positive for COVID who gathers the information about who that person has been caught in contact with. So that's, Speaker 4: 07:09 That's exactly what the, what the contact tracer does. So if you test positive, then you expect a call I'm from San Diego County and they go through your basically your last two weeks with you to say, okay, you know, Maureen, what, what have you been doing? Did you go out to eat? Uh, did you go to a party? Did you spend time with anyone? Have you gone into work? Um, and they get as much information as they can about all of the people that you have been in contact with. And then they go about calling those people and you get that scary phone call that says, hello. Uh, someone you've been in close contact with has tested positive. Speaker 1: 07:51 Is it ever okay for the person who has COVID she basically say to the contact tracer, you know, I'll call up my own friends and acquaintances. You don't need to bother. Speaker 4: 08:00 I mean, I think that you could say that, but, um, the County is still going to need to reach out to people directly Speaker 1: 08:08 Is the contact tracing system lagging because it takes so long to make contact with people, or is it the sheer volume of new cases that they're trying to keep up with? Well, Speaker 4: 08:19 Right now, I think it's both, um, you know, for the first few months of the program, it seemed like they were able to pretty much stay on top of all of the calls that they need to make. But one of those County triggers is, um, is that they are able to initiate new investigations within 24 hours. And they say they want to be able to do 70% or above, which basically means, you know, there aren't so many cases that the contact tracers they have on staff, um, can't keep up with all of them. And now it's dipped to 57%. So that's actually one of the, one of the triggers that we talk about at the County. And then it is also difficult for them to get people that they do call to call them back, you know, pick up the phone or hand over information. Speaker 4: 09:05 So I think they said that about two thirds of the time, they're able to get those contacts from people that they call. But, um, you know, that means a third of the time they aren't able to, why can't the contact tracers reveal the name of the person who tested positive. That seems to be a sticking point for some people, right? I think it's just a, uh, medical, um, privacy issue where, you know, you, aren't going to just give out, um, medical information and, you know, it could actually be a safety concern if, if someone's really upset with someone, for, um, for being sick and potentially infecting them. But I will say that in other places, uh, they give out a lot more information. They don't reveal the names of people who've tested positive. But for example, there was this story about a, um, a hairstylist at great clips in Missouri and she tested positive. Speaker 4: 09:56 Um, they didn't say who it was, but they said, you know, if you were at this business between this time and this time on this day, you know, you should really go into quarantine or get tested. And San Diego County is not giving out any information like that really. Um, publicly, they don't, you know, they'll say there have been outbreaks at businesses or restaurants, but they aren't saying where, or what time or anything like that, so that people can know, you know, whether they're at risk or whether they need to follow up themselves. Now, it's not really surprising that as you say, more autocratic, governments have better success with a program like this, but is there any kind of followup that can be done to find out if a person is obeying quarantine in San Diego County? They said at first they said they only call on the first day and then at the end. But then they said, well for, um, people with more health risks, maybe we'll call more often, but they aren't really doing that call every day that I think would, would encourage people a little bit more, to be honest and stay home if they needed to. I've been speaking with KPBS, investigative reporter, Claire triglyceride, Claire. Thank you. Thank you.

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Contact tracing is meant to be one of the big strategies that will allow San Diego County to finally slow the spread of the coronavirus. But it has some big limitations.
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