CHARLESTON, W.Va. — The effectiveness of contact tracing as a health intervention for COVID-19 declines as case numbers rise and the physician director of the Cabell-Huntington Health Department said that is what is happening right now in Cabell County.
“As the incidence rate goes up, contact tracing — while we continue to do it and it still has an important role — it becomes less protective for people,” said Dr. Michael Kilkenny, a day after the Cabell-Huntington Health Department issued a Stay-At-Home Advisory.
That advisory was a warning to residents about what Dr. Kilkenny described as “accelerated community spread of COVID-19.”
Because of that, Dr. Kilkenny said preventative measures like frequent hand washing, regular mask wearing and consistent social distancing in public settings would not be enough to control spread.
Going forward, residents were being advised to voluntarily limit time outside of their personal homes whenever possible.
“We need to really examine where we’re going, why we’re going there, who we might encounter there, how we might infect them or they might infect us and we need to make smart judgments about that because this virus is spreading rapidly in our community and that’s affecting all of us,” he said.
At the start of the day Friday, prior to the release of updated data from the state Department of Health and Human Resources, West Virginia’s daily COVID-19 infection rate was 3.12 percent.
Cabell County was yellow, one of the lower levels for coronavirus transmission, on the County Alert System Map based on percent positivity, but orange, signifying heightened transmission, based on its infection rate.
Monroe County was also yellow as of 9 a.m. Friday.
In Monroe County, school instruction shifted to remote learning Friday, Oct. 16 and the online lessons were scheduled to continue through Friday, Oct. 23.
On Monday, Oct. 26, the goal was to return students to schools in Monroe County on staggered schedules with blended learning.
“This decision is being made in conjunction with local health officials due to the increased cases in the county and not having enough substitutes to cover classes,” school officials announced.
Involved in tracing the growing number of COVID-19 case numbers in parts of West Virginia were 350 active contact tracing staff members with DHHR.
An agency spokesperson said there were an additional 150 tracing staff members in reserve.
Earlier this year, West Virginia University’s School of Public Health offered a contact tracing and pandemic response course to volunteers.
Of the 477 volunteers, information from the School of Public Health indicated 264 had completed all of the training modules as of Oct. 9. A total of 61 finished in May, 105 in June, 93 in July and five completed training for continuing medical education.
There are eight current continuing medical education students taking the course.
It is no longer available to volunteers from the general public, but it is still an option for CME. Interested trainees were asked to contact the WVU School of Public Health.
Of those trained, 233 requested field placements and were referred to the state Department of Health and Human Resources for registration.
One of the possible assignment sites is the Mid-Ohio Valley Health Department which serves six counties: Calhoun, Pleasants, Ritchie, Roane, Wirt and Wood.
Within the department, local health officials said different employees were assigned to COVID-19 case investigation, speaking with individuals who have tested positive, while others were taking lists of close contacts of positives, defined as those within six feet for more than 15 minutes with or without a mask.
In all, 20 people total were said to be involved in both aspects.
Additionally, six members of the West Virginia National Guard were helping with follow-ups with positive contacts.
Some of the same staff and Guard members covered counties in the Northern Panhandle as well, information from the Mid-Ohio Valley Health Department indicated.
In Kanawha County, 12 to 15 people have been working as contact tracers, according to an official with the Kanawha-Charleston Health Department.
In Cabell County, health officials said there were between 12 and 15 contract tracers along with specially-trained and authorized contact tracers from partner agencies with agreements with the Cabell-Huntington Health Department.
The Cabell-Huntington Health Department also houses the regional unit for the West Virginia National Guard which provides contact tracing and other services to West Virginia’s Western Region.
Additionally, the Cabell-Huntington Health Department has access to the DHHR’s contact tracing workers which are tapped for surge capacity in Cabell County.
“We’ve been doing a good job and we’re still losing this battle,” Dr. Kilkenny said.
The hope was the Stay-At-Home Advisory would help change that.
The advisory included the following voluntary recommendations:
– people at high risk for severe COVID-19 disease should stay at home;
– family members of people at high risk should restrict outside contact as much as possible while maintaining physical and emotional family support;
– family gatherings should be reduced to necessary contact;
– all people capable of working from home should consider doing so;
– all people who can safely stay at home should do so as much as possible;
– business transactions should be as contactless and as safe as possible;
– workers should follow all government-issued guidance regarding work attendance like the West Virginia School Alert System, and all COVID-related safety measures;
– workers should comply with all COVID-related safety measures;
– consider limiting travel to necessary travel only;
– plan COVID safety into all upcoming holiday events and
– all voters should exercise their right to vote in as safe a manner as possible, consistent with their desired and available options.
“This is voluntary. When we look at what our community is capable of, as citizens, they’re fantastic. We just need to make sure they know what their risk is and what they can do and they do it,” Dr. Kilkenny said.
Individual decisions, in his view, would determine what happened next for COVID-19 cases in Cabell County and elsewhere in West Virginia.
“Once it goes red, we lose the manageability,” he said. “We don’t want to get to that point.”