DOH Ramps Up Contact Tracing Numbers, Efforts on All Islands

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As cases of COVID-19 continue to rise across Hawai‘i, contact tracing is becoming increasingly important to curb the surge and avoid the reappearance of social restrictions on neighbor islands in the same way they’ve returned to O‘ahu.

State Department of Health Disease Investigation Branch Chief Dr. Emily Roberson said ramped up efforts include 30 contact tracers working to track neighbor island cases, including 10 on the Big Island. As of Wednesday, those 30 joined 96 contact tracers working in Honolulu County, along with 13 support staff, to comprise a total of 139 people working to monitor the spread of COVID-19 statewide.

Health officials said they hope to activate another 100 contact tracers in the coming days, most of whom would track the incidence of the virus on O‘ahu, where the overwhelming majority of new cases continue to be identified. However, according to national guidelines, the number of active cases in Hawai‘i, a figure that stood at more than 3,000 as of Wednesday afternoon, would require well over 500 contact tracers be brought on to meet the surge appropriately.

Gov. David Ige said Wednesday that despite falling several hundred contact tracers short of the recommended number, he believes history will shine a positive light on the work Hawai‘i and its Department of Health (DOH) has done to track coronavirus during the pandemic.

“I am confident that our efforts here in the islands, and the statistics, will show that our contact tracing efforts have been better than average and among the best in the country,” the governor said.

Governor David Ige. Courtesy photo

“Among the best” may prove a relative term in hindsight, as the majority of mainland states have struggled moderately to mightily to control the spread of COVID-19, and the United States is home to the most positive cases (roughly 5.5 million) and the most virus-related deaths (more than 170,000) in the world.

The most relevant question isn’t ‘How good is Hawai‘i at managing the virus compared to the rest of the country?‘ It is, instead, ‘Is Hawai‘i doing well enough to keep its population as safe as possible and its economy open?‘

Based on surging numbers statewide and more than 3,000 confirmed cases in August, the worst month in Hawai‘i’s fight against COVID-19 by far, the answer to the latter question is flatly “No.”

Roberson said, however, that steps are in place to change that with speed. Tasks have been realigned within DOH’s contact tracing effort, which now allows case investigators to delegate to other department employees both clerical work and care coordination, which includes jobs like securing suitable quarantine sites for those found to be infected. This should remove some of the burden from the shoulders of a consistently increasing staff of active contact tracers in Hawai‘i.

Data collection will also be streamlined and reduced to its most simplified and actionable forms, Roberson added.

Finally, certain groups will be prioritized by contact tracing staff to help prevent massive outbreaks. The four groups they will focus on include those who work in high-risk occupations, like healthcare; those who live in high-risk settings, like elderly care homes, jails, and homeless encampments; those patients who are high-risk due to personal medical history, like those over the age of 65 and those with chronic conditions; and those are sick with COVID-19 symptoms.

Hawai‘i has received around $50 million in CARES Act funding to manage and trace the virus, $3.5 million of which Health Director Bruce Anderson said Wednesday has been spent to develop a contract with the University of Hawai‘i to train contact tracing staff. To date, more than 400 people have been trained through the program, he added. The rest of the money will be distributed over a period of several months to support DOH initiatives such as increasing lab capacity and updating data management.

As for the Big Island, 10 tracers appear to be sufficient for the time being. As of Wednesday afternoon, a total of 159 cases of the virus had been identified in Hawai‘i County. Of those, 26 cases remained active, 10 or 11 of which had been identified over the previous 48 hours (reports on exact Big Island numbers during that time frame varied).

DOH Director Bruce Anderson. Courtesy photo

Anderson said he had minimal information on those cases, but added that six on Wednesday were identified in Hilo and one was noted in the southern portion of the county. Most of the new cases over the previous two days were identified in East Hawai‘i, though Anderson said the department had not linked them to existing Big Island clusters. To date, DOH is unaware of any cases tied to the return of college students to the University of Hawai‘i at Hilo campus.

Contract tracers currently working on the Big Island are comprised of two Hawai‘i District Health Office employees and eight public health nurses employed by DOH, Roberson said.

The number of contact tracers that could be activated to track Big Island cases is 60, according to statistics provided by the COVID-19 Joint Information Task Force. Of those, 37 are District Health Office employees and 23 are members of the Medical Reserve Corps.

“There are individuals on island who have completed the UH Contact Tracing course, and we are currently planning to hire (two),” the Task Force wrote in an email to Big Island Now. “Additional staffing would be dependent on funding and caseload.”

Contact tracers are working under Acting Hawai‘i District Health Officer Eric Honda out of four locations on the island, which are as follows:

• Hawai‘i District Health Office at 75 Aupuni Street, #201
• Department of Health Office at 1582 Kamehameha Avenue
• Kona Health Center at 79-1015 Haukapila Street in Kealakekua
• Department of Health Office in Keakealani Building at 79-1020 Haukapila Street in Kealakekua

Hawai‘i reported 261 new cases of COVID-19 across all islands Wednesday, including two new deaths, a tally that Anderson updated Wednesday afternoon from one new death reported in the daily DOH update that was published around noon.