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COVID Investigators Overwhelmed as Virus Cases Surge
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Saturday, November 7, 2020
 

STORY BY KAREN BOSSICK

PHOTO BY SARA GORBY

COVID investigators can’t keep up as the number of Idahoans being infected with the coronavirus surges.

South Central Public Health District investigators are clearing about 300 cases a week. But they’re receiving more than a thousand a week, with SCPHD reporting more than 200 cases a day since Monday, Nov. 2.

That compares with 60 cases a day across all of the district’s eight counties at the end of September.

In one month's time our cases more than doubled,” said Logan Hudson, the Public Health Division administrator for SCPHD. “This isn't a gradual build. It was a flood and it's impossible to double or triple staffing overnight.”

“For every case we clear, another four are already on our desks, added SCPHD Investigator Mehli Marcellus. “Even working seven days a week we can’t keep up.”

They’re not alone as Idaho has recorded record breaking tallies of more than a thousand new cases each day for the past four days--1,330 on Friday after 1,265 on Thursday. Central District Health, which includes Boise, expects to surpass a record 1,500 cases this week. And investigators in Idaho’s Panhandle say they’re struggling to keep their heads above water.

“Levels of community transmission are making the critical work of investigation and contact tracing diluted,” said Katherine Hoyer, public information officer at Panhandle Health District. “Simply put, we need the cooperation of our community members to do all they can to reduce their risk and protect themselves, their loved ones and fellow community members.”

The surge in cases is forcing health districts to prioritize investigative calls by age to ensure they are reaching the people most at risk for severe symptoms and those most likely to spread the disease.

But a growing number of people are not getting a call from their offices. Those who are awaiting a test result or who receive a positive test result are asked to take their own proactive measures to protect themselves and those around them. That means isolating while waiting for test results and, if positive, warning close contacts that they need to quarantine right away.

A few Blaine County residents told Eye on Sun Valley that they volunteered to be contact tracers and wondered why they haven’t been called with the need so high.

The short answer, said Hudson, is that the health district doesn’t need contact tracers.

We need investigators. These are the people who make the initial investigation call. They sometimes inform the case about their diagnosis and then ask a series of questions about demographics, where they think they got the disease, who they have been in contact with, and a whole lot of other questions. We collect data on contacts. These get put into an electronic contact tracing system and is done automatically,” he said.
The calls can take up to an hour at a time and require an enormous amount of data entry. Investigators need to be able to work at least 10 hours a week, if not more, because the training is very time consuming. And many of those who have volunteered have said they can spare only a few hours.

“We are hiring new staff as quickly as possible, but it takes time to find qualified applicants, interview, wait for their availability, and train the new hires,” Hudson said “Additionally, our public health district does not have unlimited funds and finding the infrastructure, such as laptops and desk space is difficult. Very few people are allowed to work from home because of the extremely sensitive nature of these investigations and the requirements we face to ensure medical privacy.

“Finally, we are finding more and more people who refuse to answer their phones or provide us with the information we need to perform investigations and contact trace. That also causes delays in the work we do.” 

BLAINE COUNTY REMAINS IN THE CRITICAL RED ZONE

Blaine County remained at the highest level of risk, according to the Blaine County Dashboard that was released Friday.

And Friday only added to the total as the county recorded 16 new cases for a total of 979. The county has recorded 49 new cases in the past three days.

Its average new case rate has been in the critical zone for several weeks and continues to increase. During the past seven days it averaged 33.5 new cases per 100,000 residents, down just slightly from 34.1 last week.

The positivity rate—the percent of people testing positive out of those being tested is 13.58 percent. It was 10.0 percent last week. The county needs to be under 5 percent to have low risk of transmission. Idaho’s positivity rate is currently second in the nation, meaning COVID-19 is very prevalent—out of control.

Concern about the ability of hospitals to treat COVID-19 and other patients ranges from moderate at the local level to high at the regional level. St. Luke’s Wood River was treating two COVID patients on Wednesday; St. Luke’s Magic Valley, 46.

Those between the ages of 30 and 39 tallied the most cases during the week of Oct. 25-31 with 14 testing positive.

Others:

40-49: 11

18-29: 7

14-17: 6

70-plus: 5

50-59: 4

60-69: 3

11-13: 2

0-4: 1

5-10: 0

South Central Public Health District continues to investigate outbreaks in Cove at Cascadia, a long-term skilled nursing facility in Bellevue formerly known as SafeHaven.

The surge in Blaine County and Idaho mirrors that of the United States, which had a record high 102,831 new cases on Wednesday, then reported a new high of more than 121,000 new infections on Thursday, then more than 126,000 on Friday.

Presumed President-Elect Joe Biden offered a stunning forecast Friday night as he told the nation that health experts have told him the nation could soon be recording 200,000 new cases a day.

Ada County added 1,330 new cases for an average of 39.45 cases per 100,000 people during the week of Oct. 25-31. It posted 243 new cases on Friday. And that’s “an alarming place to be,” said Kimberly Link, the communicable disease control manager for Central District Health.

 Link added that it’s clear that measures in place are not sufficient. The CDH is asking those under its jurisdiction to live as though there were stay-at-home orders in place. Just being out in the community right now offers a risk of COVID, Link added.

Hudson said the spread of the disease points towards small gatherings and family spread, all of which involves people hanging out together and taking the disease home. As cases mount so do deaths. Idaho recorded eight new deaths on Friday for a total of 679.

“Our hospitals are strained, our investigators can't keep up, and case counts only continue to rise around the district,” he said. “We need to embrace virtual options or social distancing. We need to embrace mask wearing. We need to embrace our social responsibility to stay home when we are sick and get tested if we are showing symptoms of COVID-19. We HAVE to work together because public health and our hospitals cannot do it alone.”

INVESTIGATIONS WITHIN THE SOUTH CENTRAL PUBLIC HEALTH DISTRICT:

1.3 cases completed each hour

301 investigations completed each week

1,000-plus cases reported each week

July spike resulted in 1,300 cases

October spike resulted in 4,300 cases.

Anyone awaiting a test result should:

  • Stay home and monitor your health – stay away from others in your household whenever possible. Watch for fever, cough, shortness of breath or other symptoms of COVID-19. Symptoms may appear 2-14 days after exposure.
  • Think about the people you have recently been around and in what environments.
  • Answer the phone call from the health department if they are able to reach out to you.
  • Helpful Resource: https://www.cdc.gov/coronavirus/2019-ncov/downloads/php/318271-A_FS_KeyStepsWhenWaitingForCOVID-19Results_3.pdf

If you test positive you should:

  • Stay home except to get medical care; do not visit public places.
  • Take care of yourself – get rest, stay hydrated.
  • Stay in touch with your doctor – seek care if you have any emergency warning signs or if you think it’s an emergency.
  • Contact those with whom you have had close contact with to let them know they may have been exposed to COVID-19.
  • Avoid public transportation, ride-sharing or taxis.
  • Helpful Resource: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/index.html

 

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