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In late June, as COVID-19 cases ticked up on the Central Coast, the San Luis Obispo County Public Health Department announced it was tripling its contact tracing team to about 25 people—a move that enabled it to continue to contact trace in each and every new COVID-19 case.
"Since the pandemic began, the county Public Health Department has traced 100 percent of the confirmed cases in SLO County," a June 24 press release read. "Health officials say they are committed to continuing this level of investigation to protect the community's health."
Six months later, as cases skyrocket to new record highs, SLO County can no longer say that. While the county rarely reported more than 20 new cases per day back in June, by December, new cases often eclipsed 100, and sometimes 200, per day. Yet, while the virus spread like wildfire, SLO County did not add more manpower to its contact tracing team.
Now, health officials have to prioritize who to contact as part of case investigations.
"We have 25 people who are contact tracing. They're working very hard," SLO County Emergency Services Director Wade Horton told New Times by phone on Dec. 31. "It's difficult because of just the sheer number of cases we've got. ... It's just the sheer amount of work and contacts."
While contact tracers were too busy making calls to speak to New Times on Dec. 31, Horton explained how the recent explosion of COVID-19—as well as the arrival of vaccines—has stretched county resources thin and, for now, left contact tracers with the short end of the stick.
Horton said that he is trying to hire more contact tracers to keep pace with the virus, but their requirements for training—and the other pressures facing the COVID-19 response team—are slowing things down.
"We're trying to bring more people on board," Horton said, "but you don't just bring someone in and say, 'Here's four hours of training and you can do it.' There's a class they have to take, and it takes a while to onboard somebody. So you're trying to onboard somebody in the midst of a spike—it's challenging."
Given that 100 percent contact tracing is currently impossible, SLO County is instead prioritizing its calls to cases and contacts who are age 50 or older. Others may receive a belated phone call or a text message from Public Health—after which they are generally asked to do their own contact tracing, Horton said.
"We're going to try to get to you, but we're at the point now where we have to prioritize who we're reaching out to," he said. "We're asking folks if they test positive to self-quarantine. If they've had close contacts they know—that they've spent time with indoors, closer than 6 feet—to let them know, too, and they should go get tested."
New Times' Editor Camillia Lanham recently went through this process firsthand when she came down with COVID-19 last month. After testing positive for the virus on Dec. 18, Lanham, who's 38, finally received a call from Public Health on Dec. 29. They explained that the delay was due to this new prioritization plan.
According to guidance from the U.S. Centers for Disease Control, close contacts of newly diagnosed COVID-19 cases should be notified of their exposure within 24 hours to effectively fight the spread. Now, far from meeting that target, SLO County is at least hoping to grow its contact tracing capacity soon.
"The intent is to still get to the point where we can contact and trace as many people as possible," Horton said.
A recent change to the way that the state shares its COVID-19 data with individual counties has also challenged the effort, as SLO County has to catch up on and validate a backlog of new cases reported by the state, Horton said.
Speaking candidly about the bigger picture of COVID-19, Horton noted that the county is simply getting "slammed" by the pandemic from all angles right now. In addition to confronting record-high cases, testing, hospitalizations, and multiple deadly outbreaks at congregate living facilities, SLO County is also spearheading the vaccine rollout.
All of those fronts require staffing, time, and resources, he said. SLO County has closed its libraries to redirect librarians to the COVID-19 response. Various other county departments and officials are also assisting.
"We're stretched really thin," Horton said. "We're at that point now where we have to make those tactical decisions on how best to deploy our resources when you look at the response overall. ... There's a lot going on, a lot of moving pieces, and I don't think the public really understands all the work and effort that's happening."
When asked if he expects to get more support from the federal or state government on the virus battle, Horton didn't sound optimistic. He said that his motto right now is: "Hope for the best, plan for the worst."
In other words: assume SLO County is on its own.
"I don't see outside resources coming to San Luis Obispo. I'm not planning on it," he said. "Planning for the worst means we only have ourselves to rely on. That's what we plan for. We'll keep working hard, and we'll keep protecting our community." Δ
Assistant Editor Peter Johnson can be reached at [email protected].
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