Last edited Sat Mar 7, 2020, 07:19 PM - Edit history (1)
... it shouldn't be too difficult to identify a large percentage of "secondary" contacts -- at least to compile a list so they can be contacted and tested, and monitored, when capacity allows it.
A couple of obvious things:
Have a hot line for visitors -- relatives, outside physicians, whoever -- to allow them to self-identify. Automated system of leaving name, patient visited, and contact information would be a good start. Can even have automated call back to confirm receipt and planned next steps so these people don't feel like they've just sent a message into a black hole. Prioritize people who visited a patient who has tested positive or died from coronavirus.
Have staff write down patient names and names of any frequent visitors to the patient they are aware of -- people most likely to have been there during critical exposure period. Cross reference those names with names listed as emergency contacts in patient's record. (A number of staff members at the facility my mother in law was knew and greeted me by name). Cross reference those identified with people who have self identified and put on a "master list" for follow-up.
Given that asymptotic people pass on the pathogen, and given that those people will not be self-quarantining, every possible effort must be made to identify those who have been exposed. And all those people should be tested and monitored -- symptoms or not.
Now, this stuff is just off the top of my head. I have no doubt there are "official" protocols for tracing and computer applications for compiling and prioritizing contacts.
Every case identified and quarantined reduces the number of contacts. It is the only way to reduce the number of people infected overall -- reduce the R zero and exponential spread -- and this reduces the ultimate burden on hospitals.
If all the focus is on increasing capacity to deal with severe cases, giving up on containment and tracing (which it appears is happening), we just end up with a lot more, and a lot more expensive, burden on hospitals and requirements for expensive "pop up" centers.
The big chunks of money being appropriated under state of emergency declarations and by state and local governing bodies, needs to be spent on both beefing up capacity to treat, and beefing up efforts to trace and contain.
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On edit:
As far as running out of workers. Develop a top-notch sample collection training program and pass legislation that allows those certified to collect samples from people "in place" -- at their homes. Properly trained people who take all necessary precautions can safely do the collection and monitoring. The limit would be the protective equipment available. Perhaps that would limit too severely, but why not have people trained and ready to go as equipment becomes available?
Had this type of effort been started last month, a lot less people and equipment would have been needed, and health care facilities and hospitals would have a lot fewer patients and symptomatic people to deal with. If we get on the stick now, we will reduce the burden on resources next month.
What I would like to know is that if DT has "Kept America Great" why can't we recruit and organize even a fraction of the number the Chinese trained and deployed?
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