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San Diego doesn’t yet have enough contact tracers who can track and isolate COVID-19 patients, but the state wants to help it and other counties get there.
Testing capacity is going to need to improve before San Diego can continue to reopen its economy. Next, the county will need a small army of investigators who can track and isolate COVID-19 patients and the people they may have infected to know for sure where the coronavirus is headed.
These workers are known as contact tracers and their numbers in San Diego are not yet where they need to be. The state wants to help San Diego and other counties get there.
Gov. Gavin Newsom has said at least 15 contact tracers are needed for every 100,000 people if counties want to move further into the next phase of commercial re-openings. Last month, the National Association of County and City Health Officials put the number of necessary contact tracers at 30 per 100,000.
Considering that San Diego County is home to nearly 3.4 million people, local public health officials will at least need between 500 to 1,000 contact tracers. As of Thursday, the county was employing 163 contact tracers, with an “initial goal” of hitting 450.
This week, the state launched a “training academy” with the help of universities in Los Angeles and San Francisco. The plan is to get 3,000 new contact tracers ready every week to assist public health agencies across the state as they navigate the next phase of their coronavirus response.
On Wednesday, Susan Fanelli, the chief deputy director of policy and programs at the California Department of Public Health, told a special Senate committee that the state was hoping to build out contact tracing investigations on the local level. In the process, she offered a few interesting stats that reveal the quiet but massive undertaking happening right now.
Counties across the state are expected to redirect about 2,200 of their own employees for contact tracing efforts, she said. California plans to redirect another 10,000 of its own employees.
They’ll be trained on the basics of public health and epidemiology, but also will learn how to conduct interviews that are culturally sensitive and confidential. Fanelli said contact tracers need to build quick relationships and effectively communicate to a community why someone’s health information is being collected and why it’s important.
Bates Says Confidence and Privacy Are Key
The committee, which was brought together by Senate President Pro Tem Toni Atkins, met for more than three hours on Wednesday and established various testing and tracing benchmarks for lawmakers. For instance, local public health agencies are collectively conducting 30,000 tests per day statewide. By the end of May, officials said they’d like to increase that number to between 60,000 and 80,000.
Sen. Pat Bates, who vice-chaired the committee, asked how the state was taking privacy into consideration while evaluating digital tools that might be used to scale-up contact tracing investigations. Newsom last month said he was evaluating tech companies to find an app that could connect the sick with public health authorities. But Fanelli told Bates that the state had yet to do that.
Bates also pressed officials at the hearing on the difference between testing capacity and demand, and how they might boost confidence in the testing system among the general population.
In an interview Thursday, she said she’d been hearing concerns on the local level that testing results wouldn’t be private. There are concerns as well that people, especially in rural areas, might not be able to get to testing sites.
And when it comes to an app, she said, the state needed to be certain that tech companies aren’t turning around and trying to monetize private medical data.
At the hearing Wednesday, Fanelli promised that any contracts between the state and app-makers would explicitly prohibit third-party data-sharing. Bates said Thursday there could still be legislation on the horizon requiring tech companies that partner with the state to respect medical privacy laws.
“That needs to be very clearly drawn out,” she said.
In the meantime, Bates is scaling back her legislative package slightly, as are other lawmakers because so much attention is focused on the coronavirus. One of her bills, which would prevent a toll road expansion from going through open space in San Clemente, could be shelved until next year.
But her non-COVID-19 priorities this session include coastal erosion and San Onofre. SB 465, for instance, would ensure local governments receive continued funding for emergency preparedness costs associated with the decommissioned nuclear generating station.
Pharmacists Could Boost Testing in Rural Areas
Sen. Brian Jones also took part in the hearing Wednesday and echoed concerns raised by another member of the committee — Sen. Scott Wiener of San Francisco — that people in prisons weren’t being tested before release into the general population. (A large number of cases have been reported in prisons.) Fanelli said the state doesn’t and cannot mandate that people be tested.
Jones also suggested during the hearing that it would be better for rural parts of the state, like his own, if pharmacists would be allowed to perform testing.
Pharmacies are an untapped resource to help boost testing capacity, but it would require an executive order from Newsom to make it happen. The state could also issue a waiver.
As the San Francisco Chronicle reported earlier this week, pharmacies are prohibited from COVID-19 tests in California because they’re considered “high complexity.” More than two dozen other states already allow them to perform tests.
When Assemblywoman Shirley Weber appeared at a Voice of San Diego event back in February, we asked her about her ambitious pair of bills to make schools’ Local Control Funding Formula spending more accountable and transparent.
She said she was worried the bills might die before even getting a hearing.
For one of the two measures, her premonition turned out to be right.
As Will Huntsberry reported, one of the bills, which would close a loophole that allows schools to take any unspent funds marked for vulnerable students and roll them over into the general fund for the following year – thus bypassing the rule to spend them on vulnerable students – passed an Assembly committee this week.
But its companion measure, which would require schools to spell out in clear language what they spent the special funds on, didn’t get a hearing before the committee, which means it’s done for the year.
If schools “want to keep spending supplemental funds on whatever they want, all they have to do is continue to hide behind indecipherable financial reporting,” Huntsberry wrote.