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Title : Kentucky's contact-tracing program lacks specific data sought by Beshear's critics; he says its main purpose is to prevent disease
link : Kentucky's contact-tracing program lacks specific data sought by Beshear's critics; he says its main purpose is to prevent disease

Kentucky's contact-tracing program lacks specific data sought by Beshear's critics; he says its main purpose is to prevent disease

Terrie Burgan traces contacts for the Lincoln Trail District
Health Department. (Photo by Pat McDonogh, Courier Journal)

When Gov. Andy Beshear shut down indoor dining in restaurants and bars to slow the increasing spread of the coronavirus, "criticism from Republican leaders in Frankfort was both swift and predictable," Joe Sonka of the Louisville Courier Journal notes in a story about the effort to trace past contacts of those with the virus. 

Republican legislative leaders reiterated their complaint about Beshear's lack of collaboration, but also said he had no contact-tracing data to show why the move was necessary. Some restaurant owners in Louisville have made similar complaints, Sonka reports, "saying there was no data in Kentucky to justify the prohibition in the first place." 

Beshear counters that "a litany of national research and public health experts to justify his latest orders restricting things such as indoor dining," Sonka reports. But the governor and his administration acknowledge that the program lacks the sort of detailed data the critics want to see. They point to a decentralized system of 61 local health departments as one reason.

Sonka reports in some detail that other states have been able to quickly gather and disseminate the kind of data that the Republican lawmakers and restaurant groups are looking for, like what types of locations individuals visited in the days before testing positive for the coronavirus, or where "cluster locations" are, where multiple people have tested positive after visiting. 

In Kentucky, the Louisville Metro Department for Public Health and Wellness has begun publishing this type of data, including "weekly contact tracing data detailing the types of places people reported visiting in the two days before testing positive or showing symptoms, in addition to the locations where they worked in person," Sonka reports. 

However, health officials at the Louisville agency told Sonka that it's been a laborious task because of the state's approved data management system.

"The state's system allows sortable data entry only in very broad categories of potential exposure locations, such as "events" or "other" to capture exposures besides household, work or school, said Karen Handmaker, who has run the agency's tracing program since May. Handmaker told Sonka that pulling together specific locations like bars, restaurants, churches, gyms and grocery stores "is manual. . . . It is a human endeavor as opposed to an automated."

Asked by Kentucky Health News at his Dec. 7 briefing if the challenges to get better contact tracing data is an indication that the state needs a more centralized system, Beshear didn't answer directly, but said, "I think the way that we share information, the way that we collect information, needs to be more uniform, and I think that they agree as well. It's a little harder in the original system that we had out there, but we're getting closer and closer to it."

Beshear was referring to a new tracking system into which all health departments to put data on where exposure to the virus may have occurred. The system was funded by federal coronavirus money and can be used after the pandemic for other communicable-disease tracing. 

State Department for Public Health map; click to enlarge

Beshear has said more than once that the Barren River District Health Department's contact tracers identified outbreaks at 46 different restaurants, but department spokeswoman Ashli McCarty told Sonka that she could not provide specifics on that claim. 

 "We are collecting data on the number of cases that become clusters within establishments (staff), but are unable to collect data on any community spread cases that stem from these clusters," McCarty wrote in an email. "We are not providing data to the public on any specific establishments, but are tracking clusters within establishments on a case-by-case basis.” 

Beshear objected Monday to what he called the "narrative that's being pushed on contact tracers" and said the two primary purposes of tracing is to prevent the spread of the disease from the infected person and those came into contact with after exposure. 

"What we're talking about is going backwards and getting data," Beshear said. "We're in the middle of a battle to stop this thing from spreading wider, and if that means we put more focus on stopping it from reaching and potentially killing more people than being able to say, in these 34 examples it came from X, then yes, we're doing what we have to do."

He added that he has received "calls for data in areas where every national expert tells us the same thing. So if we don't believe that it was spreading in these places, ask the White House for their data; I'm sure they could give you everything that they have been relying on." 

Beshear has cited research showing that indoor service at bars and restaurants worsens the spread of Covid-19, and that there is no reason to think what goes on in other states isn't happening in Kentucky.  Sonka notes, "A CDC study of 10 states found adults with positive test results were twice as likely to have dined in a restaurant than those testing negative, while a Stanford University simulation suggested fully opened restaurants would spread four times the numbers of additional infections as gyms."

Beshear has also cited the decrease in cases in Florida, Texas and Arizona during the second wave of the virus when those states put restrictions on restaurants, and the strong recommendations of the White House Coronavirus Task Force, which regularly calls on the state to limit bar and restaurant capacity. 

On Nov. 18, when Beshear banned in-person dining and in-person schooling, Senate President Robert Stivers said the lack of publicly available contact-tracing data to justify the restrictions was unacceptable.

Last week, Stivers said the state should "kill the contract" for the tracing program and put the remaining $40 million "back into a fund to help these businesses that are barely surviving." The program employs 1,600.

Beshear, in effect, rejected that idea Monday: "Come back to those who think that we don't need contact tracers. How alone would you feel if you got an email saying you had Covid and nobody ever called you, ever?" He said the call from a tracer "puts you in a system that says: Do you need food assistance? Do you have a doctor? Who do you call? Here are the symptoms you need to monitor?"

He added, "I know the attacks are intended to be on me, but . . . the local health departments feel those too."

Mark Carter

At the governor's Dec. 1 briefing, Mark Carter, who heads up the state's tracing program, said a significant update to the data management system for contact tracers could improve its publicly available data "in the next month or so." 

Because of the recent surge in cases, contact tracers throughout the state have been instructed to tell positive cases to reach out to their potential contacts themselves and give instructions on how to self-quarantine. 

Meanwhile, federal money for the program will dry up on Dec. 30 unless Congress appropriates more, and Beshear and Carter have made urgent pleas for it.

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