San Mateo County works on more tracing

With a team of 30 county workers already assigned to comprehensively tracking and documenting the contacts of those exposed to confirmed COVID-19 cases, Rogers suggested as many as 85 more trained professionals could be needed to meet the state’s expectations.

State standards for reopening call for counties to have identified 15 tracers per 100,000 residents, which would require San Mateo County to eventually have 115 workers assigned to the task. While the existing team is adequate to manage the current workload, Rogers said reinforcements will be needed as more common testing yields additional cases.

Health experts say tracing is key in the fight against transmission. If those who have been exposed to the virus are identified, they can be instructed to quarantine. Those traced can also share their contacts, generating a web of spread which can be helpful to health officials anticipating a potential patient surge.

Officials leading the effort to reopen society have said tracing, along with hospital capacity and personal protective equipment supply, are essential components of determining the region’s readiness to loosen additional restrictions. Tracers are full-time employees who are expected to build relationships and trust with those whose contacts they are examining. Rogers said many county workers are equipped to do the work, which is conducted primarily over the phone.

Currently most of the tracers are nurses or others pulled from the county health department, said Rogers, who noted the significant expense associated with the effort.

In all, Rogers anticipated the tracing program could cost the county as much as $22.2 million. That figure accounts for the expense of redirecting county employees away from their existing duties, which would also limit productivity and efficiency. As much as $1.3 million in new costs could be necessary to hire as many as 13 new employees to work as tracers and administrators, said Rogers.

The high cost is especially significant in a health department which was coping with a structural deficit before the pandemic. To that end, Rogers said $19 million needed to be pulled from reserves to balance the budget in the existing fiscal year.

In the future, Rogers anticipated the financial burden to grow larger because the department was forced to shutter revenue generating programs, such as elective medical procedures, during the shutdown.

And while the entire monetary hit is yet to be calculated, officials have projected it to be substantial — especially considering the blow dealt by the pandemic to the state budget. Rogers noted federal emergency relief funds may be available to offset some of the county cost, but there is no guarantee if that money would be available, or when it might arrive.

For his part, Supervisor Dave Pine noted the full extent of the proposed cost could be avoided if the county’s COVID-19 case count does not require such a comprehensive response. But given the health department’s inherent fiscal challenges, he also questioned whether other county departments could take on some tracing tasks.

“Would we be better off training people who aren’t health employees, so we don’t jeopardize revenue?” asked Pine. No action was taken at the meeting, and Rogers suggested a more specific budget discussion would be held later.

One county department which might be useful in assisting with the tracing work is the Probation Department.

Chief Probation Officer John Keene said many on his staff already have the requisite investigative skills to work effectively with those exposed to the virus in the quest to determine the threat to public health.

Furthermore, some on his staff could be looking for additional assignments because workload has dropped during quarantine. To that end, Keene said the population of the juvenile detention center shrunk to 11 inmates.

The decrease from about 45 inmates at the time the pandemic arrived is consistent with the efforts of correctional departments across the state, which have tried to limit the incarcerated population to reduce the threat of virus transmission. Keene said those remaining in the detention center pose the greatest public health and safety risk.

The department’s caseload has dropped further because probation violation enforcement is not a high priority during quarantine, said Keene. Probation officers have been lenient with those who struggle to attend court-assigned correctional classes for substance abuse or domestic violence offenses during the shutdown, he said.

“We want to take a positive approach,” he said.

Keene added the reduced demand grants the department an opportunity to examine operations. And while some will join the tracing effort, Keene said he will also comprehensively look for ways to improve the county’s probation services.

“There are certainly some innovations and new approaches this situation has presented that we can learn from,” he said.

austin@smdailyjournal.com

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