California allocates more money for COVID-19 contact tracing in third year of pandemic – Orange County Register

Intensive contact tracing has helped contain COVID-19 outbreaks in several Asian countries. Everyone tests positive, they quarantine, and everyone they’ve come into contact with is tracked and required – or, in some countries, forced into quarantine as well.

The United States has already spent billions of dollars on contact tracing, and California alone will spend $300 million on this in the next fiscal year. But Researchers have found that 2 out of 3 people with confirmed COVID-19 in the United States had not been reached or would not have named contacts when interviewed, and that public health authorities were unable to trace cases sufficiently to prevent this.

Now, as the pandemic enters its third year, the omicron variant is as contagious as fire through hay. The incubation period can be as short as two days. The Centers for Disease Control recommends isolation for at least five days. More people are doing home checks – cases that authorities don’t even count in their letters – and some officials are giving up and suspending contact tracing.

Officials in Oregon’s Multnomah County. “Due to that dynamic, contact tracing has become much less effective at mitigating the risk of COVID-19, especially when cases rise so high and when spending time in any space. Any indoor public space is essentially considered exposure for anyone who doesn’t like their vaccines. “

Weak financial commitment

The financial commitment to contact tracing in California appears to be waning, but still is. The governor’s proposed budget shows that $258.3 million was spent on contact tracing during the first two years of the pandemic, with another $38.9 million to be spent through the end of the fiscal year. next main.

Current and future spending is expected to be $20.6 million this fiscal year and $18.3 million next year, said Sonja Petek, a financial and policy analyst with the Office of Legislative Analysts. next financial year.

“Contact tracing remains one of our many important tools in responding to the spread of COVID-19,” said a statement from Governor Gavin Newsom’s press office. “It is also an important measure used in high-risk and crowded environments. Contact tracing assists in notifying exposed persons so that post-exposure treatment, testing, and isolation can be performed in a timely manner.”

Overall, Newsom’s budget proposes $110 million to strengthen humanitarian and public health efforts at the California-Mexico border – including immunization, testing, isolation, and quarantine services – “and expand contact tracing operations statewide to help keep Californians safe and slow the spread.”

Currently, 268 state employees have been redirected to contact tracing efforts, the governor’s press office said. But experts aren’t sure the investment will yield big returns – at least not for now.

Climb uphill

“As higher levels of COVID-19 transmission occur in a community, the importance and effectiveness of contact tracing becomes diminished and beyond the ability of health departments to conduct a comprehensive effective timely tracing when staff are overwhelmed by large numbers,” said Dr. Robert Kim-Farley, professor of epidemiology and public health sciences at the UCLA Fielding School of Public Health, by email. .

“Also, with so much asymptomatic transmission occurring, contact tracing of known cases becomes a smaller fraction of the total transmission occurring in the community. In these cases, people need to step up their precautions (e.g. vaccinations, wearing masks and testing) assuming that some of the people they come into contact with may be infected.”

Kim-Farley is not alone.

“Omicron has an average incubation period of about three days,” said Dr. John Swartzberg, clinical professor emeritus of UC Berkeley’s division of infectious diseases and immunizations, by email. “Individuals can be contagious for up to 48 hours before they get sick. So many infected people will spread the virus a day or two after being infected. This will be a temporary challenge to effective contact tracing. “

Andrew Noymer, an epidemiologist and demographer at UC Irvine, agrees.

“It is now well understood that the omicron is the most contagious COVID variant,” Noymer said by email. “I think its shorter incubation period (perhaps unrelated to transmissibility) is working synergistically to fuel the current outbreak of the omicron wave. Which brings us to the question of contact tracing.

“Public health professionals often dislike the usefulness of contact tracing, because it is a cornerstone principle in our field. But the absolute spread of the omicron, plus its shortened incubation period, both affect the margin of error for contact tracing on a case-by-case basis, and actually affect to overall. For now, doubling contact tracing is not where I would allocate additional resources. It is better to spend money on buying N-95 masks for people who are willing to wear them, who are not yet, and to provide testing for people in a safety net. ”

Richard Carpiano, a public health scientist and medical sociologist at UC Riverside, lamented the nation’s lack of investment in the critical pieces of the pandemic — especially clear communication and educate the public to combat widespread misinformation and misinformation – and passionately believe that we need to steer more of the money there.

Front

Much of the work is happening at the county level. San Bernardino County, for example, has spent $16.5 million on contact tracing through the end of 2021 and has 183 contact tracers on staff. Spokesman David Wert said that was down from the 440 tracks it had at its peak.

An increase in omicrons may compromise the effectiveness of current contact tracing, but Berkeley’s Swartzberg has hope for the future. “The money transmission will allow the government to do more robust contact tracing, and” as the number of omicron cases declines, contact tracing will become a powerful public health tool, he said. much stronger,” he said.

Dr. George Rutherford, professor of epidemiology and biostatistics at UC San Francisco, is also on the camp.

“Once we get over the gap in the next few weeks, contact tracing will be possible again,” Rutherford said by email. “I’m probably mostly focused on school.”

All told, California projects direct COVID 19 spending — testing, contact tracing, vaccine distribution and administration, hospitals, and medical surgery — totaling $3.2 billion. dollars in this fiscal year and $1.3 billion in the following fiscal year, according to Legislative analyst’s most recent analysis.

The governor’s budget the state’s total pandemic response – which includes things like buying medical supplies, housing for the homeless, food programs and assistance for small businesses – at $9.5 billion . Of that, about $235 million, or about 2.5%, was spent on community engagement.