Western Kentucky health departments have scaled back or completely stopped making check-in calls in recent weeks to those who test positive for COVID-19 in their communities, due to being overwhelmed by a flood of cases from the omicron variant.
In past months during the pandemic, health departments have made calls to residents who tested positive for COVID-19 – a process known as disease investigation – checking in on how positive individuals are feeling and advising them on how to isolate and prevent spread. But with the extraordinarily contagious omicron variant, health departments are having trouble compiling timely COVID-19 case data, let alone making calls to COVID-19 cases.
Chloie Rager, Marketing and Communications Director for the Christian County Health Department, said her department’s contact tracing team was downsized last year from eight employees to three, due to lack of funding. But even if the department had the extra employees, they would most likely be straining to keep up. The department announced on Jan. 14 it would be cutting back its calls to only children under 18, adults older than 65 and those infected in congregate settings.
‘It really is unfortunate that we're missing that opportunity to touch base with these people,” Rager said. “If we're getting 1,000 cases a week, we barely have enough time to even get them on the spreadsheet, much less call each of them.”
Rager said individuals who test positive and are called by contact tracers can have unique situations and specific questions, including what to do if children are testing positive in a family. She said the burden on getting information out on isolation guidelines is being moved to employers and other healthcare providers because undermanned health departments can’t keep up. Fielding those specific questions from those who test positive is an advantage that’s being lost, Rager said.
Several health department leaders in western Kentucky also noted the strain that testing labs are seeing, with departments only receiving test results several days after the fact.
“The person's quarantine period, or isolation period might even be over before we even get notified that they were even positive,” Marshall County Health Department Director Billy Pitts said.
The Marshall County Health Department announced on Jan. 20 it was stopping all COVID-19 disease investigation calls to COVID-19 cases reported to the department. Currently, the Centers for Disease Control and Prevention advises that a positive individual’s isolation period can be as short as five days if the individual is “fever-free” and wears a mask for the following five days after the isolation period.
Along with compiling COVID-19 test results, local health departments also have to juggle other duties including health education programs, a milk and water testing lab at the Marshall County Health Department and a needle exchange at the Graves County Health Department – the only one in far western Kentucky.
Graves County Health Department Director Riley Willett said her department earlier this month decided to only make disease investigation calls to those who are 65 years or older, due to the age group tending to have more questions about how to isolate and their increased vulnerability to the virus. The Calloway County Health Department made a decision in late December to only make disease investigation calls for those involved in “high risk” congregate settings, and the Purchase District Health Department is considering scaling back calls sometime this week.
The cutting back of these calls is a further reduction of the role health departments have played in tracking COVID-19. Many health departments in the region stopped making contact tracing calls last year – also calling those exposed to the virus instead of just those who test positive – to help prevent spread.
“We are getting into our third year with this,” Willett said. “If you don't know what you need to do by now, you must be living under a rock.”
Other health department leaders shared a similar sentiment as Willett, saying that they do their best to raise awareness on changing isolation and quarantine guidelines for COVID-19 through social media. Health departments in the region are still encouraging those who test positive to call their departments if they have questions, even if the departments are no longer making calls to individuals themselves.
Federal health leaders have increasingly signaled that COVID-19 may become endemic in future years, regularly circulating throughout the country such as other diseases including the flu. Health department leaders interviewed aren’t sure if they’ll reimplement calls to positive cases when the omicron surge wanes. Calloway County Health Department Director Jamie Hughes said guidance from state public health officials is still being determined on how disease investigation and contact tracing the virus will look like in the future.
“It becomes taxing on the public,” Hughes said. “In the same manner, and we're trying to make sure we keep people safe and healthy.”
Susan Dunlap, Public Affairs Executive Director for the Kentucky Cabinet for Health and Family Services, said health departments across the state are making decisions best for their communities based on their local circumstances. Dunlap said health departments are still emphasizing and raising awareness to have Kentuckians receive COVID-19 vaccines and boosters, wear effective masks and to self-isolate and inform contacts of potential exposure if one tests positive.
Dunlap also referenced a statement from leading national public health associations calling for a move away from universal disease investigation and contact tracing calls, citing the omicron variant’s lesser severity, the increasing availability of at-home tests that are not reported in state and federal data, and a shorter incubation period of the omicron variant.
