County Board of Health Supports Suspension of COVID-19 Contact Tracing
At its meeting on Wednesday, Jan. 19, the Dubuque County Board of Health voted to support a proposal from the Dubuque County Public Health Incident Management Team to suspend contact tracing efforts for positive COVID-19 cases. In place of those efforts, the team will increase promotion of quarantine and isolation guidance as well as the Dubuque County COVID-19 “hotline” (563-556-6200) for questions and support.
Contact tracing involves determining who had exposure during a positive person’s infectious period and giving those who meet the definition of close contact, instructions for quarantine. The primary goal of contact tracing is to prevent further spread of disease.
The team’s recommendation follows recent decisions by other counties to suspend contact tracing, including Linn County and Johnson County, and is based on the increased level of community spread of COVID and the increased difficulty in reaching positive individuals. Additional reasons cited by the incident management team include:
- A delay in information sharing and reporting by state public health with local public health which prevents contact during the first 24-48 hours after diagnosis, the most critical period for spread.
- An increasing percentage of contact tracing calls to residents by Dubuque County Visiting Nurse Association (VNA) staff that go unanswered.
- New testing options like rapid at-home tests that are reducing the number of positive cases reported to public health, preventing contact tracing with these individuals.
- Schools in Dubuque County provide contact tracing to students and staff in conjunction with the IMT, are experiencing similar issues, and support the change.
The 7-day number of new positive cases in Dubuque County jumped from 234 on Dec. 15 to 1,003 on Jan. 19, a 329% increase, and the county’s percent positivity rate reached almost 28% on Jan. 11.
To better address the current state of the pandemic locally, the county incident management team recommended that, instead of contact tracing, efforts focus on increased public messaging on quarantine and isolation guidance, so the public is better informed prior to receiving a positive COVID-19 test. The proposal included publications to be distributed to local health care and test providers to share with patients when tested or given self-administered tests, as well as print advertising.
Additionally, the team recommended increased promotion of the county’s COVID-19 hotline, which is staffed by the Dubuque County VNA to answer community questions related to isolation and quarantine. This will be similar to information shared through contact tracing but residents would be responsible for reaching out with questions rather than VNA staff trying to reach residents.
In July 2021, the Iowa Department of Public Health (IDPH) stopped issuing isolation and quarantine orders for COVID-19 positive or exposed individuals and IDPH’s investigations and contact tracing efforts have focused on outbreaks and vulnerable populations. This change gave local public health the option to continue contact tracing efforts. Since this decision was announced by IDPH, the VNA has continued local contact tracing on behalf of Dubuque County with funding assistance from the Dubuque County Board of Health and Crescent Community Health Center.
The Dubuque Visiting Nurse Association has been responsible for contract tracing in Dubuque County since August 2021. To date, the VNA has reached out to nearly 8,000 positive COVID-19 cases to provide isolation and quarantine guidance, testing resources for household members, encouragement of vaccinations, and guidance for virus treatment.
The full recommendation to the board of health was part of the meeting agenda and can be viewed at www.dubuquecountyiowa.gov/546/Board-of-Health-Agendas-and-Minutes