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California falls short on COVID contact tracing amid warnings of new wave, audit says

Sacramento Bee - 4/2/2021

Apr. 2—More than a year after the COVID-19 pandemic began, the state auditor says California's public health agency is doing just a so-so job on a key element of coronavirus control: finding out whether infected Californians had possibly spread the disease to someone else.

Amid warnings of another potential surge in coronavirus cases, State Auditor Elaine Howle said Thursday the California Department of Public Health has fallen short of its goals for contact tracing, in which newly-infected residents are supposed to be interviewed to determine who might have infected them.

While she gave the state agency high marks on COVID-19 testing, she said contact tracing has fallen short. In a one-month period ending Dec. 24 — when infections were surging and 834,487 new cases were reported — state and local health agencies "had successful interviews for only 40 percent of the total cases," the audit said. The goal was to interview 85%.

"Moreover, the tracing staff were able to identify an additional person to contact and notify of potential exposure in only 16 percent of the total cases," the audit said.

Gov. Gavin Newsom's administration has preached the importance of contact tracing, vowing to reassign thousands of state workers to the task. But the audit said only 2,200 state workers have been reassigned, well short of the state's goal of 10,000. All told, only 12,100 people were working as contact tracers in December, compared to the 36,000 the state said it needed.

The Sacramento Bee has previously reported that one promising piece of the contact tracing program — a smartphone app called CA Notify — has had lackluster results.

About 100,000 people have received exposure alerts from the app since it was released in December, a period in which 2 million infections have been recorded. The app is designed to send someone an alert if they've been exposed in the past 14 days to someone who's tested positive for COVID-19.

Governor: 'We're very concerned about these mutations'

The auditor's report comes as infection rates have fallen dramatically since the December spike, and ramped-up vaccinations have allowed many counties to move into less-restrictive categories and reopen parts of their economy.

But Newsom, who was vaccinated Thursday in Los Angeles, said he is worried about another wave of infections, particularly as highly infectious variants of COVID-19 emerge.

If infection numbers spike again, the governor said the state might reverse course and tighten restriction under his Blueprint for a Safer Economy.

"We're very concerned about these mutations," Newsom said. "If we see numbers increase, the blueprint, which is now 30 weeks old, allows for us to toggle back."

The audit urged the Department of Public Health to conduct a thorough reevaluation of its contact tracing program by May 15. In its written response to the audit, the department said it's already retooling the system.

The agency is working "to develop a new contact tracing staffing model based on current scientific knowledge, actual data from the first ten months of California's contact tracing response, and the State's projected COVID-19 case numbers for 2021," said Tomas Aragon, the state's public health officer, in a letter to Howle.

"This revised staffing model will also consider technology innovations that save staff time and expand local workforce capacity, including automated case and contact surveys and data portals that enable external partners such as schools and businesses to share core data for cases and exposed contacts with their local health jurisdictions."


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