Health leaders weigh in on expanded testing, contact tracing

Posted at 8:58 PM, Apr 27, 2020
and last updated 2020-04-27 23:39:28-04

CLEVELAND — Governor Mike DeWine announced Monday that the state would expand access to testing and contact tracing as its economy slowly reopens.

Some health leaders in Northeast Ohio agreed that contact tracing lowers the possibility of a spike in new cases as the economy begins to reopen.

"Contact tracing is critical to move forward," said Dr. Daniel Simon, chief clinical and scientific officer of University Hospitals and president of UH Cleveland Medical Center.

Simon cited Dr. Tom Frieden, the former director of the Centers for Disease Control and Prevention, and his concept of "Box It In."

"Test, find, isolate and quarantine, as really the basis for moving forward before we have a vaccine," Simon said.

Simon said he thinks it's "terrific" that DeWine "made a commitment for increased testing, both viral PCR testing and antibody testing, coupled with nearly 2,000 healthcare workers to be able to do this very detailed, epidemiology-based contact tracing."

University Hospitals already does contact tracing for their workers, given that health care workers are at risk for COVID-19. He said about 96 employees out of nearly 28,000 have tested positive for COVID-19.

"It’s something that we take very seriously. The safety of our healthcare workers is paramount," Simon said. "We find out who’s exposed, we make a determination of whether it’s masking and self-monitoring, whether it’s quarantining and that’s something that we do."

The Ohio Department of Health does contact tracing for the general public, Simon said, noting that contact tracing interviews take approximately 30 to 45 minutes each.

"You’re asking an individual, 'Tell me all the people in the last 48 hours that you’ve been within six feet for more than five minutes,'" Simon said. "That’s considered an intense contact with an individual that promotes infection."

He described it as "detailed, painstaking work, but very important to control the spread of COVID before we have a vaccine."

Both Simon and Donna Skoda, who is the health commissioner of Summit County Public Health, said they were looking to countries that had successfully done contact tracing to reduce a surge of new cases, such as South Korea and Singapore.

Skoda said testing and tracing are techniques and strategies that local health departments employ daily.

"Our big hangup is we don’t have a lot of tests right here in the United States right now," Skoda said.

She said she was glad the health department would be able to do more testing, which then makes workers able to do more contact tracing.

"Once you have expanded testing and you have a slow reopen, it gives you time to catch your breath, to be honest with you," Skoda said.

It also keeps the system from being overwhelmed, Skoda said, noting that a surge would be likely if the economy reopened quickly. She said she was "pleased" that the reopening would be slow.

"Still social distancing, public masking, allowing people to kind of really get used to the idea of being together again," Skoda said.

Slowing down, Skoda said, would give health departments an opportunity to train people, including existing workers, on contact tracing.

"This is a really critical time," Skoda said. "We’re doing really well in Ohio. We just need to keep it up."

Dr. Ash Sehgal, a professor of medicine at Case Western Reserve University, agreed that contact tracing was good, but he said Ohio would have trouble managing a surge in cases right now.

Sehgal said that with Ohio seeing about 300 new cases per day, if each person interacted with 10 others, more than 42,000 people would need to be traced.

"I think it's a very careful, slow and thoughtful plan that's going to minimize the risk of having a surge of infections in Ohio, but I think it would have been better to wait until a little bit later in the month until the cases were under control," Sehgal said.