ST. LOUIS — The head of the city health department’s communicable disease effort says she feels confident in the department’s contact tracing effort — seen as a critical tool in containing the spread of the coronavirus as businesses begin to reopen.
Franda Thomas answered questions Tuesday afternoon during an online hearing called by the Board of Aldermen’s Health and Human Services Committee.
Alderman Sarah Martin, D-11th Ward, asked if funding were not an issue, would the city need more contact tracers to identify individuals potentially infected by someone who tested positive for COVID-19.
“We are OK right now. However … we are being very watchful of what may come as far as an increase in cases,” Thomas said. “We are poised and ready to bring on additional staff, even if it’s in an interim or part-time capacity.”
Thomas said the city has what is equal to 10 employees working full time on contact tracing as well as access this summer to more volunteers from area medical schools and interns.
Some aldermen are concerned because the city’s staffing is much lower than that deployed by other governments. St. Louis County Health Department and the Kansas City Health Department each are hiring as many as 100 contact tracers.
National public health guidelines also call for at least 30 contact tracers per 100,000 population, which means the city would need 90 tracers, and many as 194 given the city’s high infection rate and percentage of people in poverty.
Other concerns include the city’s low count of residents being monitored under quarantine. The city saw 451 new cases during the first two weeks of May, but only 61 people were under quarantine at the end of last week. That compares to St. Charles County, which saw 88 new cases and had 370 in quarantine.
“There have been times when there have been far fewer people being monitored than new cases get reported the next day,” said Alderman Annie Rice, D-8th Ward.
Thomas explained that many of the city’s cases involve residents in “congregate living facilities,” and those numbers are not included the numbers that the city is monitoring.
“Those are being monitored by that facility,” Thomas said, “because they can provide a more skilled assessment on a daily basis.”
For those they are monitoring, the city uses the help of a software program that checks in two times a day through email and requires responses that include temperature and information about symptoms. Residents without email receive phone calls.
“That frees up a lot of manpower,” Thomas said.
Alderman Cara Spencer, chair of the health committee, asked Bert Malone with the Missouri Public Health Association to speak at the hearing. Malone is also the former deputy director of the Kansas City Health Department and volunteers there as a contact tracer.
Malone warned that once more people go back to work and visit businesses, contact tracing will become more challenging. There will be more contacts to chase down, and people will become busier and harder to reach. He also warned that volunteers will be harder to come by.
“You cannot build a program on volunteers. You are going to have to have an investment in staff,” Malone said.
Thomas said that staff members trained in contact tracing are currently devoting efforts to COVID-19, while needs for testing and education outreach for other diseases such as sexually transmitted infections have not been as high or feasible.
Malone warned of a summer outbreak of syphilis, shigellosis or cryptosporidiosis.
“Those folks are going to have to deal with those outbreaks and you are going to be behind the eight ball and needing to recruit and hire and train individuals immediately,” he said.
“My advice would be to try to get resources available from local government to allocate towards reaching a number of contact tracers that will help you control this outbreak,” he said.
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