The Hawaii Government Employees Association has filed a grievance against the state Department of Health alleging that there are only 15 epidemiological specialists on Oahu and three on the neighbor islands to perform contact tracing for thousands of potential COVID-19 cases.
The grievance, which was emailed to state Department of Heath director Bruce Anderson on Friday, was filed on behalf of employees who are performing or have performed COVID-19 contact tracing, field swabbing and outreach response duties.
The state DOH said Monday that it was not available for immediate comment.
The union alleges that far fewer employees are working in contract tracing than DOH has publicly indicated and that they are overworked. According to HGEA’s grievance, epidemiological specialists have been working daily overtime, including weekends and holidays. The union said some employees were mandated to work six-days a week and were required to answer and respond to phone calls during non-work hours and participate in last-minute meetings about newly assigned cases.
“Our members have been working incredibly hard to keep up with contact tracing but it has become an impossible task,” HGEA said in a statement on Monday. “The steady surge in cases over the last couple of weeks could have been mitigated if the DOH had brought on additional staff more quickly. This grievance represents the tip of the iceberg of a much larger public health problem.”
HGEA’s grievance also alleges that some of DOH’s epidemiological specialists were required to perform field swabbing and outreach response without official guidelines, protocols or proper training. Further, union members were, “simply provided personal protective equipment (PPE) and directed to go out and swab or to report to positive COVID-19 persons homes to collect medical specimens.”
HGEA’s allegations are in direct contrast to comments made by Anderson during an Aug. 3 media briefing and by State Epidemiologist Sarah Park during an Aug. 6 hearing of the Senate Special Committee on COVID-19. Both said the state has about 105 active contract tracers that could be increased as needed.
Anderson said DOH can tap other staff members, public health nurses and Hawaii National Guard members. He added that the state has a bench of about 450 tracers that had been trained at the University of Hawaii. But as of last week, only about 20 contact tracers had been hired from this partnership, which was funded with $2.5 million in CARES Act money.
The grievance continues an ongoing debate in Hawaii on whether the state has enough contact tracers — the people hired to locate everyone who comes in close contact with a person who has tested positive for COVID-19.
Hawaii Lt. Gov. Josh Green said Monday that Hawaii needs at least 400 to 500 contact tracers to handle the current increase in cases.
Recommendations vary, but George Washington University proposes a staffing ratio of at least 40 contact tracers per 100,000 population, which in Hawaii is about 564 . The National Association of County and City Health Officials says there should be 30 tracers per 100,000 population — about 420 tracers in Hawaii.
HGEA said it’s imploring “our government leaders to put all differences aside, hire sufficient contact tracers, and promptly implement policies that will get this surge under control. The health of our entire community is at stake.”
The perceived contact tracing shortage and hiring delays have drawn criticism from U.S. Rep Tulsi Gabbard, Green, and members of the Hawaii Senate Special Committee on COVID-19.
Gabbard called for Anderson and Park to resign in April and last week issued a statement urging the “department to fully mobilize its contact tracing force.”
Green has recommended relieving Anderson and Park of their responsibility for managing the state’s contact tracing as well as quarantine and isolation response.
Gov. David Ige said in an email Monday that he is “in ongoing discussions with DOH leadership on ways to improve our testing and contact tracing systems and capacity. And we are confident that plans and resources are being put in place to meet the needs of our community.”
Ige did not elaborate on those plans, but said the recent surge in COVID-19 cases in Hawaii requires that “we continue to improve and expand our response, in addition to re-instituting restrictions on social gatherings.”
From the start, “DOH has been part of a leadership team comprised of federal, state and local leaders, and Hawaii continues to use public health guidance to make key decisions about what to do next,” Ige said.