90 percent of Wake County COVID-19 patients don't know where they got it

RALEIGH (WTVD) -- Contact tracing isn't a new strategy, but to reduce the spread of the novel coronavirus, officials are signaling they'll need a lot more help in this effort.

Wake County on Friday updated their case numbers to 571 COVID19 positive patients, up 14 since Thursday.

Chris Kippes, Director of Wake County Public Health Division, told ABC11 about 90 percent of those cases - more than 500 - are considered community transmission, when the patient had no idea from where or from whom he or she got infected.

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"The importance of ramping up our contract tracing staff is to allow us to be able to act in a more swift and quick response to reach out to those individuals who may have come into contact with someone who has the virus," Kippes said. "Getting those individuals tested to check if they have the disease, to stay put so they're not circulating in the community to have that transmission."

Contact tracing was used in the COVID19 crisis' infancy, when officials first followed reports of patients traveling to Raleigh from hot spots like Seattle and Italy. Soon, though, patients admitted to attending concerts and conventions and the tough job of already playing from behind morphed into a near impossible task of containing the disease.

"The contact tracers are like disease detectives," Kippes said. "We're doing those investigations, identifying who's at risk, providing the appropriate recommendations to minimize the impact they may have personally."

Governor Roy Cooper this week announced that testing, contact tracing, and following trends in data will be critical before North Carolina reopens parts of its economy.

So far, NC-based companies are working on improving testing capacities and the availability of antibody tests, but the state has offered few details on how it will implement some sort of contact tracing strategy.

In Wake County, Kippes says that the health department has reassigned some 50 staffers to contact tracing, but the county will need many, many more.

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Across the country, several states are building strong contact tracing teams, including in San Francisco, where city officials have recruited librarians, medical students and even staff from the city attorney's office. Massachusetts, meanwhile, has earmarked $44 million to hire 1,000 new contact tracers in a collaboration with the non-profit Partners in Health. Utah has also begun training 1,000 current state employees.

"One infected person who has many contacts can easily explode to 10 or 15 people who need to be contacted," Dr. Jeff Engel, Executive Director of the Council of State and Territorial Epidemiologists, said. "That's why we need this new workforce on ground level to do the work of calling somebody up."

Dr. Engel, the former North Carolina State Epidemiologist who led the state during the H1N1 pandemic, is part of a network of national experts urging the federal government to commit $3.6 billion in disaster relief funds to hire 100,000 contact tracers.

"So as soon as a person is identified with a positive test, they need to be somehow notified and called and then they need to talk about their contacts and their contacts need to be reached so they can be placed into quarantined."

Even with that added manpower, though, the novel coronavirus and its disease, COVID-19, has proven to be extremely contagious and spread more easily than other infections. It's also possible, perhaps even likely, that patients are susceptible to forgetting some interactions over the course of 48 hours.

That's why, Dr. Engel, says technology will play a key role like it has in Asian countries that have since reopened parts of their economies; North Dakota, as well, has created an app based on its popular Bison Tracker.

Though there are some privacy concerns, Dr. Engel is confident those can be addressed, especially with Apple and Google agreeing to a groundbreaking partnership in COVID-19 efforts.

"It's not a disease with stigma per se," Dr. Engel says of COVID-19. "We think people are going to put the greater good and do what's best for their community, but time will tell."
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