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Hawaii News

Hawaii plans to shrink contact-tracing team next year

While health experts are predicting a third wave of infections fueled by the holidays, Hawaii’s contact tracers that track COVID-19-positive residents are set to be reduced after the new year.

Acting state epidemiologist Sarah Kemble told reporters on a Zoom call Wednesday that the state is currently overstaffed in the contact-tracing program and will downsize to match the actual needs based on Hawaii’s case rates and scale up when necessary.

“We’re in a really different place than we were back in the summer. We now have a much larger trained workforce. Hawaii is actually doing pretty well right now,” she said. “Based on current case counts we have excess capacity for contact tracing to reach every case.”

Health officials reported 78 new coronavirus infections statewide, bringing the total since the start of the pandemic to 18,044 cases. The state’s COVID-19 death toll remains at 244 with no new deaths reported. But it is still early to detect any new cases that may arise from last week’s Thanksgiving holiday and Black Friday, which attracted significant crowds to local malls despite the pandemic.

Earlier this year, the DOH was heavily criticized for failing to build a robust contact-tracing program to handle rising caseloads in the summer. It has since hired hundreds of surge staff, but many of them are currently not being used, Kemble said. The state has roughly 400 contact tracers. The Health Department did not say how many of the tracers will be cut after the new year. The DOH has 103 permanent staff, 194 contract staff, 62 National Guardsmen and 32 volunteers currently doing tracing work.

The DOH plans to refocus its resources on disease investigators who do the detective work to understand the sources of transmission in the community and let the work of first-contact tracers who notify people of exposure and how to stop further spread be done by providers and other community partners.

“If we’re reaching people day six after they start to be infectious that’s actually not going to be terribly effective. By the time we reach someone they may have already transmitted to several other people, whereas if they got the right guidance the day they went to get tested they could’ve prevented that spread,” she said. “Part of contact tracing is actually out of the control of the Department of Health.”

U.S. Sen. Brian Schatz took issue this week with the lack of contingency plans once federal CARES Act money used to fund the contact-tracing program ends on Dec. 30.

“Contact tracing is an important component of a comprehensive strategy to mitigate the spread of COVID-19. I was frustrated with the Department of Health’s initial reluctance to implement a robust contact tracing program, but I have been encouraged by the ramp-up of hiring and efforts to improve the efficiency of the program in recent months,” Schatz said in a news release. “I urge you to maintain the expanded contact tracing program beyond the end of the year and to utilize all available resources to do so.”

While contact tracing is one part of the response to prevent transmission, Kemble said that once the state surpasses 100 cases per day “the emphasis on the Health Department reaching every case is of diminishing returns.”

The program has had mixed success in reaching COVID-19-infected residents. In October, contact tracers could not reach 578 people due to missing or incorrect phone numbers and those who did not answer or return phone calls.

“There may be some fatigue. People may not be interested in isolation and quarantine and may not really want to talk to the department about that,” Kemble said. “We need to reevaluate the way we’re thinking about contact tracing. We need to push this out into the community, work with other resources like our laboratories and providers and make sure that people have … the key information that they need (on how to isolate and quarantine) even before they get sick.”

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