After scaling back its contact tracing program at the start of the year, state health officials are increasing the number of staff used to track COVID-19 cases as the highly contagious delta variant causes cases to spike to the highest levels seen since the start of the pandemic.
State health officials announced in December that they were reducing the number of contact tracers to match actual needs based on case rates. The vaccine rollout over the ensuing months helped keep COVID-19 cases low, but since the delta variant of the coronavirus took hold in July, cases have increased nearly 200% in just the past two weeks. The rising infection rate might not peak until October, according to one model created by University of Hawaii researchers.
In December there were close to 400 contact tracers. That number is now down to 299.
The state Department of Health is adding 15 extra contact tracers on Oahu, as many as six on Kauai and an unspecified number on Maui and Hawaii island. But health officials stressed that the contact tracing program may not be the most important tool at dampening the spread at this point in the pandemic, and say staff are still struggling to get residents to cooperate with the tracing, a problem that has persisted since the pandemic’s early days.
“There is room for growth. As cases go up, we recognize the importance of contact tracing,” said DOH spokesman Brooks Baehr. “We also recognize that contact tracing is just one of the tools and contact tracing alone is not going to pull us out of this.”
Baehr said contact tracers would be particularly focused on where they are most needed, such as in health care settings, schools and vulnerable and underserved populations.
Maui District Health Officer Lorrin Pang said the county had brought on two or three more contact tracers, but they quit within a couple of weeks. “They had enough verbal abuse from people who didn’t want to be called,” he said.
Pang said that given the state’s positivity rate, it may be ineffective to focus on contact tracing. “I don’t think we have the luxury of just chasing, chasing, chasing,” Pang said.
The state’s seven-day average positivity rate is currently 6.2%.
But the pressure to rein in cases is increasing as thousands of kids headed back to school this week. Just 46.9% of kids between 12 and 17 are vaccinated, according to state data, while children younger than 12 still aren’t eligible for the vaccine. Health officials have repeatedly stressed the importance of all adults getting vaccinated to curtail the overall spread of the virus and protect the state’s children. But the pace of vaccinations continues to sputter.
“You are moving into a brave new world of delta transmission. You don’t really know the effect and severity on kids, or the hyper-transmission, or not, in the schools,” Pang said. “The best thing we can do is put our best foot forward, monitor it like hell and watch carefully and try to respond.”
Top state health officials have stood by their push to get Hawaii’s children back to in-person learning, even as the Hawaii State Teachers Association unsuccessfully lobbied for a delay in reopening until case counts went down. Last year the union criticized the state for what it described as inadequate contact tracing in schools. HSTA President Osa Tui Jr. said those concerns remain today.
“It seems that from last year to this year, the Department of Health has basically offloaded their contact tracing at the school level to the school administrators,” he said.
Tui said he worried school administrators would soon be overwhelmed with the rise in COVID-19 cases among children. About one-quarter of recent cases have been in kids.
However, state health officials said that it was best to take a collaborative approach to contact tracing in schools. The Department of Education will likely be the first to identify COVID-19 cases in schools and will notify close contacts in school settings and provide guidance for quarantining, said Baehr. Health officials would only contact people identified with a COVID-19 infection and conduct cluster investigations in schools.
“The schools are going to know before us what may be going on on a particular campus,” said Jason Dela Cruz, a public health educator with the Health Department. “They have a great relationship already with their students and families. That is why this collaborative approach is our best option to respond.”
The Department of Education is also now posting information on COVID-19 infections in schools on its website, as required under a new state law.
Kauai District Health Officer Janet Berreman said the Department of Health and Department of Education have had a good working relationship over the past several months as they worked out the school reopening strategy.
“I think we are as confident as we can be, without having tried it yet,” she said of new contact tracing policies. “So we know that there is a risk in returning to school. We also know that there is an enormous risk in children remaining outside of school.”