SACRAMENTO COUNTY, Calif. — Sacramento County health officials are having trouble tracing the origins of many coronavirus cases after seeing a spike in their number of cases.
Health officials within the greater Sacramento region point to private gatherings of spreading the disease. All 9 counties within the Sacramento region — Colusa, Placer, Sacramento, San Joaquin, Solano, Stanislaus, Yolo, Yuba and Sutter counties — cite family and private gatherings as a reason for higher coronavirus numbers.
As of publication, there are 7,686 confirmed coronavirus cases and 96 deaths within Sacramento County.
Sacramento County Public Health Officer Olivia Kasirye spoke to ABC10 on why the county is having trouble tracing back the origins of some coronavirus cases and why everyone has a part to play in turning the tide against the pandemic.
This interview has been edited for brevity and clarity.
ABC10: What is the update on contact tracing staff?
It is constantly changing because we are constantly adding new people to those who are being trained. So far, we have 60 people who are trained. Our staff does post the contact investigation and tracing. We are also in the process of working with one of the community-based partners to recruit more people to do the contact tracing.
ABC10: How does contact tracing work?
Oftentimes, people talk about the contact tracing but don’t recognize there are two parts of it. There is a contact investigation. That is when we get information on somebody who tests positive. We contact that person to ask them for information on where they were, where they live, the number of people in the household and also find out where they could have been exposed.
Then provide that person with information on isolation. Contact tracers take that information to contact people to let them know they’ve been exposed and what they need to do about quarantine and testing.
ABC10: What is the update on hospitalizations due to the coronavirus?
This past month has been different because of the increase in the coronavirus cases over the last three weeks or so. We’ve had over a 1,000 cases per week, so it’s definitely been a challenge to be able to get through everyone on time for several reasons.
One, we are hearing it’s difficult for people to come in to get tested. Sometimes there is a delay for several days before a person could schedule an appointment. There is also a delay because of the increase in demand for how quickly people get their results back.
By the time it gets reported to us, that increase is delayed as well. One of the things we have done is that we have asked our healthcare providers that, when they’re doing testing, they provide the people they are testing about isolation and quarantine for their contacts.
Ideally, we want to get to the contacts before the 10-day period is over. Sometimes with the delays, by the time we get to them, it’s beyond that 10-day. The healthcare providers are helping us by providing that information.
Because of the shared increase in numbers, we are prioritizing the cases to conduct contact investigations.
ABC10: How does beyond capacity impact counties?
We had to prioritize the cases we investigate. There are some people who will not be contacted by us because we didn’t get to them on time.
ABC10: Is the surge in coronavirus cases related to contact tracing?
The higher numbers are because of behavior. We still hear people attending gatherings, and now, we are hearing about the exposure that is occurring in workplaces and large households.
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We are testing more, but when you look at the percentage of positives, it is increasing. When we started this whole process, our percentage of positives was about 1%. That has gone up to 6 or 7% right now. That is an indication there is more disease in the community.
What does beyond capacity mean?
For each of our contact investigators, there is a set number of contacts they can make in a day. If the number of the cases we are getting in is beyond the total number of investigators could get to, then that is beyond the capacity that we have.
ABC10: Did you expect to hit beyond capacity?
We planned for the worst, but of course, we were expecting that as we are reopening we would be able to manage. We had a plan in place for the worst-case scenario, which we implemented by hiring regional staff, and we are still working on that.
ABC10: Is there an alternative plan now that we are in a scenario beyond the capacity for contact tracers?
We are in communication with hospitals. Each of the hospitals does have a search plan, so they can increase the number of beds available. We also work with counties and the state. They can provide alternative care sites if and when they are needed.
ABC10: Which cases are being prioritized?
The highest priorities are those that are hospitalized and where we also know that they either live in a congregated setting or a category that is higher at risk, like those who are very young and the older populations. We are also looking at some of the zip codes that have high numbers.
ABC10: Are things getting better or worse?
I like to think we will get better, we will get through this. The important message is that everyone needs to realize that we can only get through this together. Each of us needs to play our part. It is not enough for us to do contact tracing. Everyone needs to follow the advice we have given, which is that we need to use face coverings, hand sanitizing, 6-feet of social distancing and those who are sick should stay at home.
Another question we are asked is do we do multiple tests on each person? The answer is no. If a person does test positive, then we don’t test them again. Even if a person does end up going to different places, or is tested, all of those results would come back linked back to that same person. They will only be counted once.
ABC10: Are you hiring contact tracers?
We are doing that in two ways: through our hiring process to get people to call. The difficult part is the training. There is a minimum of 20 hours to go through the online state training. There is also training with the database system and in-person shadow training with someone who performs that work. We are also working with community-based agencies to hire people to work as contact tracers.
We are looking for those who could work on the phone because most of the work we do is on the phone—someone who can answer calls, answer questions, and handle health information. Oftentimes, you have to explain the coronavirus and what isolation and quarantine are.
Sometimes, it is difficult to give this kind of information to people, so be sensitive on how to share information.
ABC10: What are your projections of where the pandemic is heading?
Over the next month, our hope, especially with getting the message out, with some of the businesses who unfortunately have to close again, we are hoping to see a decrease in the cases by the end of the summer - to get back to 20 cases a day, because that is manageable. We will be able to open businesses and also look at the schools as well to make sure we have a safe environment for children to return to.
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