J.B. Pritzker says IL is doing fine with COVID contact tracing. So where’s the data?
Illinoisans can look online for pretty much anything they want to know about coronavirus — hospitalization numbers, where to get tested or case counts in their region.
What’s not clear is how well the state is doing at informing people who have been exposed to coronavirus, also known as contact tracing.
“They’re keeping track of all the other metrics, but I see nothing at all on contact tracing,” said Abigail Silva, a public health professor at Loyola University in Chicago who led an effort to help local health officials with COVID-19 tracing.
Health experts say contact tracing is essential to slowing the virus’ spread and to ascertaining when it’s safe to reopen portions of the economy or shut them down.
Yet few details on Illinois’ efforts are readily available to the public. The Illinois Department of Public Health did not respond to a request for information about contact tracing metrics.
One benchmark that would answer questions about the state’s goals is unavailable. That’s whether Illinois health professionals have reached out to 90% of cases within 24 hours of a positive test result. It was one of the requirements for Illinois to move from Phase 3 to Phase 4 of its five-phase reopening plan. It’s not clear if the state has reached that goal.
Gov. J.B. Pritzker has repeatedly defended the state’s work, which includes an $80 million contact tracing effort announced in May and pilot programs in St. Clair and Lake counties.
“I look at the numbers once a week and how we’re doing in contacting the numbers that we need,” Pritzker said at a news conference in Collinsville last week. “We’re doing quite well in that we have 1,600 contact tracers across the state, and we’re going to build that up to 3,000 in the end.”
But tracers hoping to help are still waiting for a phone call from the state.
After learning about the need, community colleges and universities statewide started to train hundreds of people who hoped to become tracers. Experts such as Silva leveraged their resources to make ready. But she said her group, the Contact Tracing Corps, is still waiting to hear from the state after submitting an interest form more than a month ago.
“We’ve been waiting. People want to do it and they’re interested,” Silva said.
Illinois Governor J.B. Pritzker’s response
Pritzker said a claim that Illinois had dropped the ball on contact tracing was an “inaccurate portrayal.” State Rep. La Shawn Ford, D-Chicago, said the state hasn’t met its promises to dramatically increase efforts statewide, Chicago PBS station WTTW reported in June.
“We got on this very early,” the governor said, “starting with the fact that we already had contact tracers in the state when the pandemic broke out. ... So, we had across the state hundreds of people doing contact tracing. What we needed to do was make this thousands, not hundreds. So, we did that.”
While Pritzker defended the state’s efforts, his office announced last week it’s looking for help from outside organizations and a contractor.
Boston-based medical charity Partners in Health will provide technical assistance and advice to Illinois. The organization earned praise for its work in Massachusetts, which provides daily data on tracing capabilities.
Then the governor’s office announced health officials are seeking help from community organizations. In the next few weeks, $50 million will go to 57 local health departments. They will use it to partner with local groups that can better “reach people who may be at higher risk of infection, but hesitant to talk with health officials,” said Dr. Ngozi Ezike, director of the Illinois Department of Public Health.
This is the type of work Silva, the Loyola Professor, has already done. Her group developed a free course available online to provide soft skills and cultural competency to contact tracers. She hopes the grants will empower organizations such as hers to help strained public health departments.
“We very much know contact tracing is our bread and butter, but we can’t do it ourselves,” Silva said.
Transparency and testing
The Illinois Department of Public Health is finalizing funding for the other 40 local health agencies statewide, according to a statement from the governor’s office. All said, the state will have distributed $215 million in local grants since the pandemic began.
But it’s not clear what effect the millions have had on contact tracing efforts.
Partners in Health could help Illinois reach levels seen in Massachusetts. The charity helped ramp up the state’s tracing collaborative, which has reached roughly 86% of the nearly 27,000 confirmed cases and 21,000 of their contacts in Massachusetts.
Massachusetts also includes a status for contact tracing on its daily update, telling residents whether their efforts are increasing, holding steady or decreasing.
Kellie Steele, a medical student helping with Loyola’s contact tracing collaborative, hopes the state will follow the lead of states like Massachusetts in its transparency about contact tracing. But Illinois isn’t the only state failing to provide that information, she added.
“It’s a really common theme,” Steele said. “So many states are slow, states aren’t sharing the data, or just trying to find how many contact tracers states and counties have hired is nearly impossible.”
While contact tracing can help contain outbreaks such as the one that started earlier this month in the metro-east, it becomes less effective when test results take more than a week to come back.
Results can take at least five days in St. Clair County as labs are “indundated,” said Barb Hohlt, executive director of the county health department. In St. Louis, it has taken three weeks for some tests to return, St. Louis Public Radio reported. If a person doesn’t isolate while they’re waiting for the results, they could unknowingly spread the disease, making contact tracing nearly useless.
“Reaching those cases within 24 hours is really critical, otherwise we miss an opportunity to ask them to quarantine and then (reach) their contacts before they get sick and start spreading,” Silva said.
Contact tracing pilot programs
Two local health departments have enjoyed an upgrade to their contact tracing technology thanks to state-funded pilot programs: Lake County in northern Illinois and St. Clair County in the metro-east.
St. Clair County will receive $4.9 million over a year to hire contact tracers and to implement a computer system that sends data directly to the state health department, Hohlt said.
The county has hired four contact tracers since they received the first few installments of the pilot program money and plan to hire “as many as we need,” Hohlt said. In all, the four new tracers adds to the 16 staffers within the agency already tracking coronavirus cases.
Tracers reach out to each positive case. As of Sunday, St. Clair County had reported 3,473 confirmed cases. Each of those individuals could have zero or more than a dozen contacts. They follow up with each person for as long as they’re showing symptoms and then two weeks after. Or if a person isn’t showing symptoms, tracers keep in contact with them for 10 days.
Since the pandemic began, St. Clair County reported 2,398 people have completed 14-day quarantine — each of those cases an example of successful contact tracing. Each case requires untold hours of work, depending on how many contacts that person has.
Counties already reported infectious disease data to the state through a digital portal. But the pilot programs paid for a system written specifically to track everyone a coronavirus patient came into contact with.
St. Clair County health department staffers still need assistance from state experts with the new software, developed by San Francisco-based Sales Force, Hohlt said.
“We’re so busy trying to keep up, but we’re doing the best,” Hohlt said. “We’re in-putting the information and they’re helping us run reports to try to find common denominators.”
The software helped county health experts understand the extent of COVID-19’s spread in St. Clair County. Since the Fourth of July, the metro-east region has seen a dramatic uptick in coronavirus cases. Hohlt said her department narrowed it down to family gatherings over the holiday weekend, out-of-state vacations and people going out in public more.
But much of stopping the virus’ spread comes down to personal decisions. The health department and county leaders can only do so much to stop people from getting together. Time and time again, county officials have pleaded with residents to wear masks.
“We’re pleading with the community to go all in together to win,” Hohlt said. “So, let’s do it.”
This story was originally published July 28, 2020 at 5:00 AM.
