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Federal windfall may not solve contact tracing problems

“We still believe this is an important part of pandemic surveillance,” said John Dunn, Tennessee state epidemiologist. “We want to maintain our ability to respond appropriately.”

States have been pushing for more resources since the pandemic began last March, but the money has never come in sufficient amounts to support the kind of programs needed to deal with the summer and fall outbreaks of the pandemic. There was also no national strategy for testing or tracing, which raised the question of whether a top-down approach by states was even possible.

“There is a discussion about whether we should just create a social norm for people to do contact tracing on their own,” said Marcus Plescia, chief medical officer of the Association of Health Officials. states and territories. “We may need to completely rethink contact tracing.”

For now, officials are focused on the immediate task at hand. Only 20% of Americans are fully immunized, 30% of Americans are hesitant to get vaccinated, and more contagious strains are proliferating across the country.

“We still believe this is an important part of pandemic surveillance,” said John Dunn, Tennessee state epidemiologist. “We want to maintain our ability to respond appropriately.”

As a candidate, Biden has pledged to hire at least 100,000 public health workers and has presented rigorous contact tracing as a key part of his plan to reduce the spread of the virus.

The need has been underscored by an increase in the number of daily cases which has risen by 20% since mid-March and by governors on both sides rushing to ease public health restrictions. With more students returning to face-to-face instruction, youth sports and other group activities, public health experts have stressed that contact tracing will be particularly crucial in tracking outbreaks in children and the unvaccinated, especially in communities of the faithful.

But health workers can only follow up if they are informed of a person’s positive test result. It is not guaranteed because faster home tests are coming to market without the results being communicated to public health authorities.

“It’s not a pregnancy test,” Lori Freeman, executive director of the National Association of County and City Health Officials. “We have to be concerned about what people do with their results and how we are going to alleviate this disease.”

Freeman and other public health officials say they also don’t know when the $ 48 billion pledged as part of the US bailout will arrive and whether there will be any restrictions on how it can be. used.

“Reality has yet to hit the streets about what these resources are going to look like at the local health department level and how much flexibility they will have to use these resources to meet their unique needs,” Freeman said.

A spokesperson for the Department of Health and Human Services said the Biden administration was also sending $ 100 million to the country’s medical reserve corps and giving local health departments a separate $ 2.25 billion specifically. for testing and tracing high-risk and underserved populations.

Several state officials have said they hope to invest some of the money in the kind of public health infrastructure that will prove useful even after the pandemic. Public funding for health services has been decimated over the past two decades and many local officials, wary of funding cliffs, are looking to improve their surveillance capacities.

Dunn, the Tennessee epidemiologist, said some of the funding could go to state labs so they are better able to sequence viruses, including variants of the coronavirus.

David Scrase, New Mexico’s health secretary, said newly trained public health workers, beyond contact tracing, could reach people who are reluctant to get vaccinated.

“The message will change,” he said. “I see him becoming more assertive, more directed.”

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