Thousands of contact tracing calls later, Wisconsin struggles to meet the surging needs of local departments

As local health departments struggle to meet the demands of high daily case counts, Wisconsin’s Department of Health Services says they’ve made several thousand contact tracing calls in the past month to alleviate the pressure.

Between September 6 and October 5, data released to News 3 Now from the DHS lists 7,100 completed contact tracing interviews made in support of 57 counties around the state. The department has hired 459 contact tracers this year, but according to the latest data, 125 have left (another 100 are in training, 64 will start next week, and the department plans to hire 75 next month). For smaller counties trying to manage at times more than a hundred new daily cases with small contact tracing teams, turning to the state for help still isn’t enough to meet the demand.

In Rock County, communications specialist Jessica Turner says it can take up to a week at times for some people to get a call when tracing a high-contact case. Ten full time nurses and another eleven temporary employees are averaging 800 outreach calls a week to people testing positive or the close contacts of positive cases, according to a rough estimate from Turner.

“That increase in our numbers, in addition to the large numbers of contacts we’re seeing for each positive case, has overwhelmed our system,” she noted. Rock County has registered more than one hundred new daily cases in three out of the last five days, according to their website. They’re one of the top counties in the past two weeks needing assistance from the DHS; Dane, Marathon, Outagamie, and Winnebago are also at the top of that list, DHS communications specialist Elizabeth Goodsitt said. Since the beginning of the pandemic, Dane has consistently been one of the top counties seeking contact tracing assistance from the state.

“If we can’t reach those close contacts and have them quarantine as soon as possible, there’s that potential for them to be spreading the disease,” Turner said.

It’s difficult to truly estimate the daily or weekly call capacity of a local health department, many officials said, because so many variables are involved in a single case. A positive COVID-19 case could have just a few contacts–or dozens. A single call could take a few minutes or hours–if the person picks up at all. But the math can quickly overwhelm smaller departments with fifteen or twenty contact tracers; if their county has 100 new cases in a day and each case has ten contacts, that’s another thousand calls.

The ten-day average in Marathon County is 90 cases daily, another county in the state where cases are spiking and staff have been overtaken by the load of contact tracing calls to make. Their health department’s spokesperson Judy Burrows says that with their team, they can usually successfully handle the calls for 25 new cases daily. Unable to manage the load, they–like other departments–now use DHS’s Dr. Ryan Westergaard’s crisis standards for managing contact tracing load and have turned to the state for help.

“Even with their help we are still very far behind and people aren’t hearing from either of us in 1-2 days,” Burrows said in an email.  “Those who are elderly (and more likely to have poor outcomes) and kids (because of school and asymptomatic cases) are put to the top of our call list.”

Jefferson County Health Department director Gail Scott first asked the state for help–but stopped when she said she learned they had a 5-7 day backlog. It was at that time when the department moved to crisis standards for contact tracing, at the beginning of October. While some overwhelmed counties are still endeavoring to make calls to everyone who’s been exposed to a positive case, Scott says they’ve quit trying. Prioritizing the elderly, at risk, schools and businesses for contact tracing, the department asks others who test positive to simply notify their close contacts themselves. She says if they tried to keep up with the demand, they’d never stop hiring new contact tracers.

“In Wisconsin, we know right now–we’re in a crisis,” she noted. The county’s epidemiologist, Samroz Jakvani, says a single case investigation call–the initial interview with the person testing positive–can last several hours. Trying to track down their other contacts, several more hours of work, is a burden that the fifteen-member contact tracing team just can’t manage at this time.

“At this point, anyone leaving their household should consider themselves exposed,” he noted.

The message from health officials to the public remains the same, if not more urgent: keeping the number of close contacts low during the pandemic isn’t just crucial to save the resources of public health, it’s one of the main ways to mitigate the spread of a virus that’s now killed more than 1,500 people in Wisconsin.

For Jakvani, the reason for the surge is simple.

“We’ve found that a lot of these positive infections are resulting from a lack of adherence to those public health guidelines.”