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Orange County adds coronavirus contact tracers, trains for reaching diverse communities

Since Gov. Gavin Newsom’s statewide call in May to mobilize 20,000 contact tracers – tasked with contacting people with the coronavirus and tracing who they might have spread it to – Orange County has more than doubled the size of its own force of disease detectives.

By Thursday, July 23, the county’s Health Care Agency reported it had 185 staffers dedicated to its coronavirus response, including investigators who map the movements of virus carriers.

And by next week, Trace, a public health investigation company the county has contracted with, will add 33 of its disease detectives to the mix, with the option for more as needed, Dr. Clayton Chau, the county’s interim public health officer, announced Thursday.

In total, the Health Care Agency has 568 of its staffers trained in contact tracing, but most are still working their normal jobs to keep other public health services going, agency spokeswoman Jessica Good said.

For contact tracing networks to be effective against a rising tide of COVID-19 cases, there has to be enough investigators for Orange County’s 3.2 million residents, and people in communities that have become coronavirus hot spots are being left out of the loop, public health experts say.

In April, the National Association of County and City Health Officials estimated that 30 agents would be needed per every 100,000 residents in the United States to handle the pandemic.

Newsom’s initial request for 20,000 contact tracers statewide would have given California roughly 50 agents per 100,000 people, but the state Department of Public Health ultimately asked that counties have at least 15 traces per 100,000.

Orange County’s force of about 218 dedicated agents, including those from Trace, makes for seven contact tracers per 100,000 residents. If all 568 staffers trained in COVID-19 detective work were reassigned to the force tomorrow, the county’s ratio would rise to 19 agents per 100,000.

But Orange County doesn’t just need more contact tracers, it also needs to connect and communicate better with its lower-income and non-white communities, said Daniel Parker, assistant professor of public health at UC Irvine.

Parker is directing a contact tracing workshop this month, in partnership with the Health Care Agency, to train 500 people over the next month, including 30 health agency workers and dozens of UCI students, on how to effectively reach more of Orange County’s diverse population.

“We want to target places that are most affected by the disease first,” Parker said. Two current hot spots are lower-income and predominantly Latino neighborhoods in Santa Ana and Anaheim. “The virus doesn’t differentiate between money and ethnicity, but it is clustering in those communities.”

Workshop participants include staff from community groups, such as Latino Health Access, a Santa-Ana based nonprofit that connects lower-income and uninsured people to health services and educational programs.

Such organizations are trusted messengers, Parker said, with workers who know best how to contact and communicate with people who might be hard for other contact tracers to reach. There are also language barriers to consider.

Trace, the Maryland-based contractor, can also help bridge the communication gap, Good said.

Trace is slated to handle about 600 coronavirus cases per day, she said, and the company has staff who speak multiple languages that will give special attention Orange County’s vulnerable communities.

The company is contracted through the end of the year at a base cost of $1.3 million, said Marc Meulman, acting agency director of the Health Care Agency’s Public Health Services.

Contact tracers can help a person who needs to isolate get food and medicine during that period. The agent also chart when the patient began to show COVID-19 symptoms – fever, cough, shortness of breath – and compile a list of who they might have exposed.

The Centers for Disease Control and Prevention defines a “close contact” as anyone who was within six feet of an infected person for at least 15 minutes, from two days before they started feeling sick until they began isolating themselves.

Under federal and state guidelines, people contacted by the tracers are only told they might have been exposed to the coronavirus and advised on what to do; they are not told who might have exposed them.

The question of exactly how many contact tracers is enough is complicated, Parker said, because it depends on how many coronavirus cases are in an area and how difficult infected people and those they have been around are to reach.

For Orange County, “at our numbers of cases, we need a lot of contact tracers,” Parker said.

He likened the importance of contact tracing to fighting a forest fire: Hot spots must be given special attention or they’ll flare up and spread.

Source: Orange County Register

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