Is Nevada’s jump in new COVID cases a necessary evil of reopening the economy?
“To me, any increase is unacceptable,” says Dr. Brian Labus, a member of Gov. Steve Sisolak’s Medical Advisory Team. “The goal was not to have one.”
New cases of COVID-19 in Nevada have reached new records three times in the last week, topping out Tuesday when officials reported 462 for the previous day.
“In general, if we had a slight blip and we went back to normal after a couple days, we would be OK with that,” says Labus. “An increase that has gone on for all of June is not what we wanted to see.”
Nevada is not alone. Cases are on the rise throughout the U.S., especially in the west, prompting one western governor to require masks in public. The mayor of Miami is also requiring masks be worn in public in that city. Last week the Gaming Control Board mandated that casino patrons wear face coverings while playing table games.
Last week Sisolak asked his medical team to “evaluate potential options for enhanced face covering policies” and make recommendations. He is scheduled to address the state Wednesday on the pandemic and the reopening of the economy.
On May 26, before the state entered Phase Two of the reopening, the state’s seven-day moving positivity rate dropped to a low of 2.5 percent. Since then it has catapulted to 9.8 percent reported Tuesday, just under the 10 percent ceiling recommended by the World Health Organization.
“The 10 percent number is a guideline,” says Labus. “It isn’t a trigger. It’s just another indicator that we have some things to be concerned about.”
“Low positivity rates indicate that we are testing a lot of people, including those with very mild disease. This means we are catching a high percentage of our cases and can use contact tracing to find everyone,” Labus explains. “If it is a high percent, we are seeing a lot of transmissions and know that we are missing a lot of mild cases.”
As Nevada sets records for news cases, the state has a fraction of the contact tracers it needs to control the pandemic.
The National Association of County and City Health Officials (NACCHO) recommends 30 contact tracers per 100,000 people during a pandemic.
Nevada, with a population of more than 3 million, would need more than 900 contact tracers.
Southern Nevada, home to more than 2 million, has “more than 60 people working contact investigations for the Health District,” says spokeswoman Jennifer Sizemore.
That’s enough tracers for about one-tenth of Southern Nevada’s population, according to the NACCHO recommendation.
“Based on the availability of additional funding, we are partnering with the state to hire additional contract tracers to support our efforts,” Sizemore says.
Sizemore says the amount of time each interview requires can’t be quantified.
“Each investigation is different, depending on the status of the case, the number of contacts, etc., so the time to investigate each one can vary,” she says.
Labus says he is “standing up” a team of 200 UNLV students to do the work of 100 fulltime contact tracers. Public health students will get first priority for the jobs, he says.
The Washoe County Health District has about 20 case investigators and contact tracers combined “on any given day,” according to Epidemiology Manager Heather Kerwin.
“The initial notification and interview can last anywhere from 20 minutes to 1.5 hours. Investigators usually conduct 3-5 case interviews per day,” she said.
A spokeswoman for Gov. Sisolak announced recently the state is working with Salesforce and Deloitte and that “250 contact tracers started on June 13, tripling the paid contact tracers.”
The governor’s office did not respond to inquiries about where those tracers were deployed.
“Contact information is obtained for each case (discuss initial symptoms, when they were most infectious, what they did on those days, who they interacted with for at least 15 minutes within 6 feet of each other). Follow-up with identified contacts and advocate they follow CDC health guidance,” the state’s website says.
Health officials for the state did not respond to requests for information about the backlog of investigations.