Not enough contact tracers

And other reasons it's too soon to reopen

Because of relatively strong social distancing requirements placed in Illinois, the COVID-19 outbreak in this state had been relatively mild, given the size of the population. There were 243 cases per 100,000 on May 6.

Because of the success of these efforts, there is a push by some legislators and members of the public to open up the state more rapidly than Governor Pritzker's current plan.

Here are two big reasons why we are not ready yet.

Not enough testing – President Trump boasts about all the testing being done in the U.S. But, according to a study just released by the Harvard Global Health Institute, only nine states are doing enough testing to effectively monitor the health of its population.

As of this writing, Illinois is averaging 19,942 tests per day. The Harvard study estimates we need to be doing 64,167 tests a day by May 15. Otherwise there will be just too many people roaming around with early or asymptomatic infections, spreading the virus.

One way to know if you are doing enough testing is the positive test ratio, which is the percentage of tests that come back positive. The World Health Organization recommends it should be 10% or less to assure that enough people are being tested before they have symptoms to catch infections early. The Harvard study reports a 17.1% positive test ratio for Illinois.

Not enough public health contact-tracing workers – Once you identify the infected individuals, you need enough public health workers to contact them, assure they are effectively in quarantine and then do contact tracing to assure that others they have had contact with over the last two weeks will quarantine and test.

Illinois will need about 3,810 contact tracers (30 per 100,000 residents) according to the Illinois Department of Public Health. Sangamon County public health has 15 for a county population of about 195,000.

What can happen if we open up without these two steps in place? Once COVID-19 gets into a workplace, it can spread like wildfire. As a case in point, just look at what has happened with the virus tearing through meat processing plants. Meat production has dropped by a third nationwide as a result. President Trump's order that these plants stay open is useless: Workers who are sick or dead can't keep a plant open.

If we open up too fast and have a resurgence of COVID-19 that sweeps through other parts of our economy, then the economic collapse we saw in March could look like a hiccup compared to what might happen if the virus really takes off again.

What else needs to happen besides marked increases in federal funding to the states for testing and contact tracing?

During the Democratic debates I did not support what Andrew Yang proposed regarding a freedom dividend (a payment of $12,000/year to each American), at least not in a normal economy.

But in this crisis, a system of regular direct federal payments to the citizens – not businesses, not corporations – for up to a two-year period may be the solution. That would help people to meet essential needs until we have the public health infrastructure, vaccinations and treatments to deal with the pandemic.

We as a country would have to eventually pay this debt. But our country has had deficit spending during past crises, like wars, for a period of years, only to get on strong financial footing once the crisis is past.

Many of our state and federal elected officials will only have the guts to take these strong steps if they hear from the people that they are willing to stay on a tough course until we are in a position to safely emerge from the crisis. So write to them today.

Stephen Soltys of Springfield is a retired physician who still teaches medical students on a volunteer basis.

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