Propagation tracking: contact tracing resumes due to delta variant

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Tens of thousands of Long Islanders who have been in close contact with people newly infected with COVID-19 have received phone calls in recent weeks as part of an effort to understand how the coronavirus is spreading in the region – and how help control it.

Contact tracing is not a new concept, but it has been more important lately with the state’s COVID-19 cases increasing due to the highly contagious delta variant. Yet tracing is more difficult today than it was at the start of the pandemic, as high-risk places such as bars are open without restrictions, a medical expert has said.

WHAT THERE IS TO KNOW

As the number of COVID-19 cases has increased in In recent weeks, hundreds of workers in the state, Nassau and Suffolk have called tens of thousands of Long Islanders who have tested positive for the virus or were in close contact with those who have.

People who test positive should self-isolate. Close unvaccinated contacts of people who test positive should be quarantined. People who have been vaccinated, as well as those who have tested positive for the virus in the previous three months, do not have to quarantine themselves unless they show symptoms.

New York State says there are over 800 contact tracers focusing on Long Island. Suffolk County said more than 100 people are involved in the investigation of the cases. Statewide, as well as Suffolk and Nassau, the number of workers fluctuates with the workload.

In a crowded bar, a person who subsequently tests positive may be in close contact with several complete strangers, making it impossible to follow them up, said Dr Bruce Farber, head of infectious diseases at North Shore University Hospital and the Long Island Jewish Medical Center.

And “we don’t really know who is vaccinated and unvaccinated at a lot of these sites,” Farber said.

While some other states are so inundated with new cases that they haven’t been able to keep up, New York state and county officials said hundreds of people are working every day to reach all of them. people on Long Island tested positive and those who were in close contact with them.

The labor-intensive tracing system saves lives, Farber said.

“The whole point of contact tracing is trying to break the chain of infection,” he said. By notifying people that they have been exposed to COVID-19 and then quarantining them, “You significantly reduce the risk of secondary infection,” Farber added.

The state has hired temporary workers to help track the growing number of close contacts, who, if not vaccinated, are given quarantine orders. Long Island schools do their own contact tracing, and while it is not required by law, some companies do as well.

In a school or work setting, some of the close contacts are easy to identify. The state follows guidelines from the United States Centers for Disease Control and Prevention to define close contact as a person who has been within 6 feet of an infected person for at least 15 minutes in a 24-hour period, has had direct physical contact with that person or is a member of the same household.

Close contacts who are fully vaccinated – and those who have tested positive for the coronavirus in the previous three months – are not required to self-quarantine until they show symptoms of COVID-19, according to the rules of the state. They are required to self-isolate if they develop symptoms. Vaccinated people are advised to take a COVID-19 test three to five days after exposure, and they must wear masks when in indoor public places for two weeks or until they test negative .

No “superspreaders” events, according to Suffolk

Despite the absence of most COVID-related restrictions, Suffolk County has not had a “super-spreading mega-event” in recent months, although there have been “small groups here and there are three or four cases, “said Dr Gregson Pigott, Suffolk health commissioner.

This is largely thanks to the widespread vaccination, he said. “The vaccination rate makes a huge difference,” said Pigott, who just over a year ago, before vaccinations began, faced a coronavirus outbreak at a party in Miller Place which led 38 people to test positive.

In Nassau County, there have been several events linked to four or more infections in the past few months, Nassau Health Commissioner Dr Larry Eisenstein said in an email. But he declined to give details “because of confidentiality” or to explain why the county has the confidentiality rule.

Contact tracing predates COVID-19. For years, health services have isolated people with infectious diseases such as measles and meningitis and quarantined their close contacts.

Still, county health departments were overwhelmed with contact tracing in the first few weeks of the coronavirus pandemic, so in May 2020, the state began to focus on reaching close contacts of newly newlywed people. infected, and counties focused on interviewing those who tested positive and obtaining contact names.

“We talk with them about what they did and who they were with during their time of infection,” said Jennifer Culp, assistant to the Suffolk Health Commissioner.

There are more than 800 state contact tracing staff who are focused on Long Island, the number changes depending on the workload, the state Department of Health spokesperson said. , Erin Silk, in an email. There are nearly 3,800 contact tracing staff – all of them temporary – statewide. That’s more than at the start of summer, before the delta variant began to dominate. But that’s less than half of the roughly 8,000 contact tracers during the biggest wave of COVID-19 in January, Silk said.

Statewide, the number of coronavirus cases has risen from less than 300 on some days in June to more than 6,000 daily cases in September. As of September, more than 99% of positive test result samples analyzed in the state were of the delta variant.

On Long Island, there were an average of 808 new daily cases of COVID-19 in August and September.

Suffolk had to move county employees – some from outside the health department – from different positions to COVID-19 duties as the number increased, Culp said. “We add people as needed,” she said.

Currently, there are more than 100 full-time and part-time employees focused on investigating COVID-19 cases and related work, Culp said.

Eisenstein declined to give details of the staff, including the number of investigators Nassau has, other than to say “it varies depending on the workload.”

Those who violate isolation or quarantine orders, or refuse to provide contact, face fines of up to $ 10,000, but officials in both counties said after subpoenas or warnings of a potential fine, initially recalcitrant people complied.

Quarantine differs for schoolchildren

Long Island’s K-12 schools handle contact tracing and then provide the names of those eligible for quarantine to counties, county officials said.

“They can do it a lot faster, and we obviously want the kids to be isolated and quarantined, and we’re following the official interview,” including details on the quarantine, Culp said.

In schools, the state has an exception to its quarantine requirement: If an infected child was 3 to 6 feet from another child, the second child does not need to quarantine “if both children were carrying correctly and systematically well-fitting masks ”.

Some schools have more stringent requirements. East Suffolk BOCES submits names to health department for quarantining children 3 to 6 feet from an infected child, whether or not it appears masks were worn as it is unclear whether the masks were worn correctly all the time, COO says Julie Lutz.

Local health departments typically work with employers to identify close professional contacts, Silk said.

But some employers do internal contact tracing first.

At Melville-based H2M architects + engineers, Liz Uzzo, director of human resources, said employees should immediately call or email her if they are positive. They are asked for the names of close contacts, which a company employee then calls, to make sure they don’t come to work the next morning, Uzzo said.

“It is a process that takes time, but it is a process that must be done” because state contact tracers may not reach close contacts quickly enough, she said.

“We are catching it before the health ministry even gets involved,” Uzzo said.


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