Pennsylvania to hire 100 covid contact tracers to replace 1,000 – experts say not enough

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The Wolf administration will hire at least 100 contact tracers as it rebuilds its exhausted squad, a dramatic downsizing from the start of this year and a number well below what experts believe Pennsylvania needs to contain the spread. of COVID-19.

The new $ 9 million program will be administered by Boston-based Public Consulting Group, which the state chose after the previous company was fired for failing to secure the personal information of 72,000 people.

Contract documents show that the Pennsylvania Department of Health could request up to 200 additional contact tracers as well as additional support staff if needed. These workers will complement 145 public health nurses and 250 people employed by municipal health services. “Health systems and schools are known to conduct their own contact tracing efforts,” a spokesperson for the health ministry said, although he did not specify how many do.

Given the rapid spread of the delta variant, combined with a slowdown in the vaccination rate and less mitigation efforts in place, the number does not appear to be enough, said Chrysan Cronin, professor of public health at Muhlenberg College. .

“I just don’t think it’s going to be nearly enough,” she said.

Contact tracing is a public health tool used to contain outbreaks of infectious diseases by alerting people who may have been exposed to an infected person.

The process is initiated by case investigators, who contact people who test positive for COVID-19 to find out who else they have been in contact with. This information is then transmitted to the trackers, who call these contacts and ask them to be tested and quarantined to avoid potentially spreading the virus.

Based on the size of the population and the number of daily cases, Pennsylvania needs at least 1,954 contact tracers, according to a tool produced by the George Washington University Institute for Workforce Equity.

“When we were more careful and people weren’t going out without masks and eating inside restaurants, it was probably easier to trace contacts because maybe each person was only in close contact than with one. handful of people, ”said Edward Salsberg, a researcher at George Washington University who worked on the tool. “It can be more difficult now when people are more likely to have gathered or eaten out.”

When the pandemic first emerged in the spring of 2020, Pennsylvania depended on a reduced force of 131 state-employed public health nurses to provide contact tracing in areas without a local health service. The Wolf administration significantly increased its capacity last summer when it hired Insight Global to recruit over 1,000 new contact tracing staff.

But even with this larger workforce, investigators struggled to reach more than a quarter of people who tested positive within 24 hours last fall, while many Pennsylvanians did not respond to phone calls from contact tracers.

“People don’t want to answer the phone. … People don’t realize how important it is to give the information we need to make sure we can control the disease, ”said Michael Huff, then director of contact tracing and testing for the department of health, in November. “It is a challenge for all states in the country. “

The program suffered another setback in May when the health department was forced to fire Insight Global after some of its employees stored the information of 72,000 people – including names, counties of residence, details of the program. COVID-19 infection of a person and other health details – in unsecured Google Drive files accessible on the Internet.

The hundreds of contact tracers hired through Insight Global stopped working for Pennsylvania in June. In a hearing with state lawmakers in late July, Keara Klinepeter, deputy executive secretary of the Department of Health, said 12 members of the Pennsylvania National Guard were conducting contact tracing as the state moved to a new program.

Their work will continue until Aug. 20, a department spokesperson later told Spotlight PA.

Public Consulting Group will hire 50 contact tracers by the end of August, according to contract documents. Another 50 tracers, as well as additional investigators and case supervisors, will be added by mid-September.

The company will also hire a data security, privacy and compliance officer who will “monitor and ensure compliance with all aspects of contract data privacy and security,” according to the Department of Health. ‘State.

In a statement, a spokesperson for the health ministry said officials had used data on the volume of cases and contacts throughout the pandemic, as well as information on call centers, to determine new staffing levels.

“These figures were determined based on discussions with epidemiologists and analyzed trends throughout the pandemic,” the statement said. “Starting with 100 contact tracers provides a solid foundation of trained personnel to handle the initial planned work. “

Asked about expectations for contact tracers – how many calls they would make per day, for example – the spokesperson said in a statement that each outreach attempt is different and could require multiple calls, varying in number. questions or additional time to connect. contact with social assistance services.

“For these reasons, there is no single standard for the expected number of calls or contacts per day,” the statement said.

More control as the state retreats

State lawmakers wondered how the health department selected Insight Global and Public Consulting Group, and whether the process used to hire the companies was transparent enough.

Insight Global was initially hired in July 2020 for $ 22.9 million through a expedited procurement system that allows state agencies to bypass the usual public tendering process to procure emergency services.

The cost ultimately rose to $ 58 million as the department added staff to the program, purchase orders registered with the Pennsylvania Department of the Treasury. The health department has paid Insight Global $ 28 million so far, but a suspension has been placed on future payments because the dispute related to the data breach is handled.

State lawmakers reviewed new contract with Public Consulting Group during the hearings at the end of July after PA spotlight reported that the Department of Health was using the same emergency procurement process to hire the company to take over the program.

In a letter following those hearings, two Senate committee chairs asked the department to provide “specific data quantifying how the contact tracing program has improved the trajectory of the number of COVID-19 cases in the Commonwealth.”

Lawmakers have also asked for details of Insight Global’s data breach and the contract with Public Consulting Group, including how Pennsylvania’s contact tracing program compares to other states using the company.

The health department had not responded to follow-up questions on Tuesday, said Jon Hopcraft, chief of staff to Senator Kristin Phillips-Hill, R-York, chair of the communications and technology committee. Hopcraft said on Friday that a response arrived in the afternoon, a day after the story was originally published, and that senators “would review the information over the weekend.”

Pennsylvania isn’t the only state to scale back its contact tracing program since the spring, when cases nationwide began to decline and vaccines became widely available.

But states that are serious about contact tracing should maintain a workforce at least equal to what they had last fall and winter, said Crystal Watson, assistant professor of public health at Johns Hopkins University which conducted a national survey of contact tracing programs. since April 2020.

“I think it’s still very important and it saves lives, and it’s a tool we should be using,” Watson said.

Neighboring New Jersey, which has a smaller population than Pennsylvania and also works with Public Consulting Group, began scaling back its contact tracing program in June, but still has 1,646 contact tracers. The health department is monitoring new cases of COVID-19 and the workload of contact tracers, and could resize the program if necessary, a spokesperson said.

Even the best-staffed programs might struggle to keep up with the rapidly growing number of cases, Watson said.

States may need to consider ways to triage cases for contact tracing, prioritizing environments such as schools, nursing homes, other community living facilities such as prisons and prisons. , or environments where people work closely together, such as meat processing facilities that experienced significant outbreaks at the start of the pandemic.

But Watson said relying solely on contact tracing to control outbreaks caused by the delta variant “is unrealistic.”

“I think we are seeing in some southern states that if we do not take any further action, we are going to see significant epidemics,” she said.

The Wolf administration was not considering a statewide mask mandate on Monday, Acting Health Secretary Alison Beam said. Masking requirements in schools and businesses, such as restaurants and entertainment venues, are decided locally.

Instead of, administration focuses on vaccinating more Pennsylvanians by supporting small local clinics and by subsidizing community groups carrying out awareness activities.

About 64.5% of adults in Pennsylvania are fully vaccinated, according to data from the Centers for Disease Control and Prevention.

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