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Anchorage struggles to keep up with contact tracing and testing as cases surge

was written by Kavitha George, Alaska Public Media – Anchorage , 2020-07-03 03:02:14

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A testing facility worker screens a patient at the drive through testing site on Lake Otis Parkway on Wednesday, July 1. (Kavitha George/Alaska Public Media)

At a community update on Wednesday, Department of Health director Natasha Pineda announced Anchorage’s public health capacity is at a red light, the most urgent level on the city’s scale for measuring pandemic response capability. The city saw more than 70 new cases in less than a week, up from 51 new cases in the week prior.

As cases increase, two important components of the city’s public health resources are maxed out. The city is scrambling to expand testing facilities and train new contact tracers.

“At this moment, with 561 cases and contacts to monitor, the public health contact tracing capacity is at its max at the local level,” Pineda said.

Besides not having enough contact tracers, Pineda said contact tracers on the job are having a hard time keeping up with the number of contacts newly infected people have interacted with. At the beginning of the pandemic, tracers might have identified three to five contacts. Now she said they’re having to trace more than fifty.

“In this last week, we’ve had a lot of cases that are associated with locations where there are well over 100 people that they may have interacted with and we can’t trace or contact any of them,” she said. 

With so many more contacts to keep up with, contact tracers have had to reduce the number of follow-up calls to check in with people who may have been exposed while they quarantine. In some cases, said Tari O’Connor with the state Department of Health and Social Services, nurses may choose not to follow up at all, and instead hand over contact information about how they can reach out if they need help.

“It doesn’t mean that we won’t still maintain that for folks that we’re more concerned about,” she said. “But yes, we are scaling that back.”

Testing is another big component of trying to control the spread of the virus, and like contact tracing, resources in Anchorage are overwhelmed. Since the city expanded the requirements for getting tested, four to five hour wait times have been reported at the drive through testing site on Lake Otis. 

Thomas Hennessy, an infectious disease epidemiologist at the University of Alaska said testing had been fairly accessible through most of the pandemic, but this sharp increase in cases is putting pressure on the system.

“We have several dynamics ongoing: we have travelers, we have our state workers who are coming in using testing capacity, plus we have local residents who are doing that,” he said. “All of that has increased the testing demand.”

The Anchorage Department of Health is working on expanding testing availability, including using mobile testing to provide access for workplaces, assisted living facilities and underserved communities. That program isn’t expected to be up and running for at least a few weeks.

On average, Hennessy said, an infected person will infect two other people, which means that community spread can quickly become exponential. He said it’s important to maintain a small bubble of social interaction in order to limit that spread.

“Those large group gatherings that we were not doing in March and April and May aren’t any safer now. They’re, in fact, probably riskier because of the number of people that are infected in our communities.”

The Department of Health has identified bars, strip clubs and restaurants among the hotspots for COVID-19 transmission. 

And on Wednesday, Mayor Ethan Berkowitz emphasized the need for social distancing, avoiding large group events and wearing masks in public. 

“This is a time for us to exercise the kind of discipline that allowed us to flatten the curve initially. This is a time for us to practice the physical distancing and the hygiene that makes a difference in terms of reducing the spread of the disease. It is a time for us to wear masks.”

The city is working with state health officials to hire more nurses and contact tracers to keep up with the increasing number of COVID-19 cases. O’Connor said the state hopes to bring on additional school nurses from outside Anchorage as well as expand the small National Guard public health team currently working on contact tracing.

“We are really trying to build this capacity for contact tracing,” she said. “It’s the kind of capacity that you build and then you hope that you don’t have to use it all.”

The University of Alaska is also in the process of recruiting a large reserve of contact tracers from around the state. Their goal is to get 500 people trained — so far, 99 have completed the process, and the first groups will begin working in the field this week.

Onboarding new contact tracers is a “huge effort,” said Hennessy. Training new workers, ensuring the security of contacts’ health information and coordinating with city and health officials takes time.

“The help that we would like to see for the nurses who are currently working on that tracing is coming,” he said, “but it’s not coming in large enough numbers to support them right now.”

Nat Herz with Alaska Public Media contributed to this report.

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