One Iowa county plans to reclaim responsibility for local contact tracing and disease investigation because its public health department has taken issue with the state’s efforts to track the coronavirus.
Black Hawk County has among the highest number of cases in the state, and experienced one of the nation’s largest coronavirus clusters in April, due to an outbreak at a Tyson meatpacking plant.
The outbreak infected more than 1,000 workers, some of whom died, spreading the virus throughout the community and overwhelming county public health workers’ contact tracing abilities.
“On a daily basis we were getting sometimes up to 150 cases. And we didn’t have capacity. Staff were working seven days a week, 12 hour shifts,” county public health director Nafissa Cisse Egbuonye said at a meeting of the Black Hawk County Supervisors on Tuesday. “You never ever want to give disease investigation and contact tracing at the state level, because we know our community.”
But at that point, Egbuonye says the county public health department had to make the “heartbreaking” decision to hand over those efforts.
“We had to give up that responsibility because we didn’t have the staffing capacity to sustain it,” she said.
Since the outbreak, the Iowa Department of Public Health has been in charge of the county’s contact tracing. But now Egbuonye says she’s not satisfied with the state’s approach.
“At the beginning, there was monitoring that was done in terms of when the person was free from quarantine and stuff like that. And that…I don’t believe that’s a part that the state is doing, just because of the amount of disease investigation they have to do,” she said. “And so we’re looking to have our health care providers do that also.”
Often overworked and understaffed, other county public health departments have handed over contact tracing to the state as well. IDPH has in turn relied on service members in the Iowa National Guard to do the work of dialing up Iowans who test positive, questioning them about who they’ve spent time with and in turn contacting and alerting those individuals.
Still, a survey released by NPR in June showed that Iowa did not have enough contact tracers on staff to contain outbreaks.
Egbuonye briefed the Black Hawk County Board of Supervisors Tuesday on a plan that the county Board of Health had already pledged support for: hiring an epidemiologist and a disease management specialist, along with 20 part-time, temporary contact tracers to track the virus locally.
In order to pay for the new hires, Egbuonye said she plans to redirect funds already allocated for other positions that have remained vacant during the pandemic, as well as funds Gov. Kim Reynolds is directing to local governments from Iowa’s allocation under the federal CARES Act.
Egbuonye says her staff on the ground in Black Hawk County will be more motivated to do the work of contact tracing, including handling outreach to patients within the county’s diverse ethnic communities.
And she says she’s eager to expand the county’s contact tracing capabilities soon; with public schools, colleges and universities preparing to return to classrooms later this month, she’s expecting a resurgence of the virus.
