COVID-19 Spike Complicates Contact Tracing, Data Collection
The lead epidemiologist for the Montana health department says the fall spike in COVID-19 cases put a strain on efforts to trace the virus' spread, making it harder to collect that data and forcing officials to rethink how they present it to the public.
Stacey Anderson, Lead Communicable Disease Epidemiologist for the Montana Department of Public Health and Human Services, says in the spring and summer when the coronavirus wasn’t as widespread in Montana, it was relatively easy to trace most cases. But now, as the state regularly reports above or near 1,000 confirmed COVID-19 cases in a day, that’s changed.
"The biggest issue right now is that the virus is pretty much everywhere," Anderson says.
COVID-19 is spreading unchecked in communities in Montana and around the nation.
It’s hard for the state to say definitively where many people contracted the virus. According to a report that analyzed Montana COVID-19 data as of November 27, the state could track the source of around 40 percent of reported cases. Timely tracing is important because it helps public health workers warn people who might have been exposed to the virus — potentially stopping that chain of spread.
But with so many unknowns, Anderson says the state health department doesn’t have a complete picture of the way the virus is spreading. In the state’s most recent epidemiological profile of the virus spread, "We sort of boiled it down to, of the cases that we have this information from, keeping in mind that that's going to change as we get more and more data."
Anderson says the current wave of COVID-19 cases forced the state health department to table and then change how they release regular reports explaining how the virus is spreading. She says the team needed to use the time to focus on contact tracing instead. According to tracking by Johns Hopkins University and Medicine, new infections in Montana have been on a downward trend in recent weeks. But local Montana health officials caution against labeling this as a definitive positive trend.
Health Department officials in Lewis and Clark and Gallatin Counties warned last week that the recent drop in COVID-19 cases are possibly due to delays in testing data collection over the Thanksgiving holiday, rather than a slow in the spread. Lewis and Clark County Clinical Disease Administrator Eric Merchant said at a news conference that data in his department didn’t upload for a couple of days.
"That dip is not actually what I’m going to call a dip. It’s just an issue with some of the data collection."
While the source of spread for many individual COVID-19 cases is unknown, here’s what is known: the Montana Department of Health and Human Services says “congregate settings” — places like workplaces, schools, assisted living facilities and prisons where multiple people live or gather in close proximity — factor heavily in COVID-19 spread.
According to its most recent report, the state health department says that one in six confirmed and traced cases was exposed to the virus at work.
Cascade County Health Officer Trisha Gardner says that's in line with what her department has observed. Gardner says this resonates for a lot of people — seeing a coworker with the sniffles come into the office.
"The other one we've heard a lot, is people dismissing some of the symptoms as, 'it's winter, I maybe have a cold. I didn't feel that bad. Therefore, I thought it was okay to go back to work.'"
She says it’s natural in our culture to push through illness, but this is a time to be extra cautious and just stay home.
"A rule of thumb that we've been trying to tell employers is if you have two or more of those symptoms like headache, nausea, diarrhea, muscle aches, fatigue, runny nose, sore throat, that's cause to go get tested and to be staying home."
Gardner says people disregarding quarantine measures, continuing to shop in-person, or gathering with others in their homes has also been a contributor to recent spread.
Rosebud County Public Information Officer Michelle Spencer says COVID spread can look different in rural areas.
"In a small community, yeah, it probably could be the grocery store, because you stop and talk to your neighbor that you run into. Everybody knows everybody."
Spencer says while there have been reports of COVID spreading at large gatherings, it’s the day-to-day interactions where they see the most cases.
"We've had some from a funeral, or from church gatherings. In a rural community there's a lot of family that live in the area, and so grandparents babysit grandkids."
In more densely populated Missoula County, coronavirus spread occurs most often between people who live together, says Missoula City-County Health Department Incident Commander Cindy Farr. Farr says large events like weddings and funerals haven't been a major source of spread since requirements were put in place to require social distancing and other precautions.
She says her department is still learning about new ways the virus is spreading. She says they’ve recently had to start warning people not to book that vacation rental for a trip with people they don’t live with.
"A group of friends traveling together to go skiing, or a group of friends traveling together to go somewhere has been a frequent thing that we've been hearing lately."
State epidemiologist Stacey Anderson says because the virus incubation period can last up to 14 days, we might not know if Thanksgiving travel and celebrations led to an uptick in COVID transmission for some weeks. Like they did for Thanksgiving, the CDC advises, people celebrate the upcoming holidays only with the people they live with, and avoid travel.