‘Huge undertaking.’ Record pace of COVID cases overwhelms small Lexington health team
Lexington is on pace to set a one-month record for COVID-19 cases in September. The team tasked with fielding those cases consists of about a half-dozen people who were consumed with full-time jobs before COVID-19 ever got to the city.
Seven Lexington-Fayette County Health Department employees make up the epidemiologist team tasked with handling the 200-plus cases coming in every day. They have to review and investigate the cases after they’re received them from labs and health care providers to verify the patient was positive for COVID-19. Then they process the information to send off to contact tracers.
As of Monday, Lexington relied on about 100 contract workers who helped with contact tracing to make most of the calls and interview positive patients. But with so many cases coming in — like the 275 new cases from Friday that were reported Monday morning — the epidemiologists pitch in to help with contact tracing interviews, too.
“It is a huge undertaking at this time,” said Kala Adams, the infectious disease manager at the Lexington health department. “We went from having 50 cases to 100 cases; now we’re up to almost 250 cases a day.”
COVID cases, hospitalizations on record pace in Lexington
Lexington’s rolling seven-day average of new cases was 213 Monday morning, according to health department data. That was one of its highest marks this year, although cases had been even higher in recent weeks. The rolling average hit 231 in early September.
Through the first 10 days of September, Lexington reported 2,288 new cases, according to health department data. That puts the city on pace to eclipse its one-month record of 6,155 set in January.
Hospitalizations were also tracking at an all-time high, with 121 reported in the first 10 days of the month. The city’s current record is 349, set in December. The health department tracks Fayette residents only.
Deaths have trended higher, too. Lexington has reported 19 deaths from August, the most in a month since February. The number could increase because the health department investigates deaths to confirm they were caused by COVID-19 before reporting them. That causes a delay in reporting.
The average age of the first 19 deaths reported from August was 64, according to the health department. In August 2020, the average age of 13 confirmed COVID-19 deaths was 80.
Monday and Tuesday mornings are the most hectic for the infectious disease team because cases from over the weekend are being confirmed. On Tuesday mornings, the health department reports three days — Saturday, Sunday and Monday —worth of data at once.
“It is non-stop” on those days, Adams said.
The infectious disease team calls on an extra four to seven people to help enter cases into databases and verify them on Monday, effectively doubling their workforce to handle the influx.
The latest surge has included more cases among children, according to Hollie Sands, one of the epidemiologists on the team. But the percentage of kids testing positive compared to the city’s total cases hasn’t increased much since May, she said.
Return to normal leaves fewer resources for COVID
Trying to find additional sets of hands wasn’t so hard when COVID-19 cases first exploded in Lexington. Bars and restaurants were either ordered closed or closed voluntarily. Schools weren’t conducting in-person classes. Health department staffers devoted to handling different issues were pulled into the COVID-19 response team.
“Bars and restaurants were closed down, so our environmental health specialists weren’t out in the field doing inspections as much,” Adams said. “They were helping us with COVID-19. But bars and restaurants are not closed at this time, so they are out doing their other full-time job.”
In early 2020, the health department shifted its entire focus to COVID-19. That’s not possible now.
“We are now back up to the case counts we were (at) back when we had everybody focused just on COVID-19 and we have less people to do it because the health department is still running their other areas,” Adams said.
The epidemiologists handling cases don’t get to focus full-time on COVID either. They have to track and monitor other diseases, like HIV/AIDS, tuberculosis, STDs, the flu, and the West Nile Virus.
Some people aren’t getting contacted about a positive COVID-19 test or a COVID-19 exposure because of the limited resources. Other issues, like miscommunication between labs and the health department, don’t help.
Sometimes missing phone numbers or addresses prevent the health department from reaching people who tested positive.
The health department has asked residents to call local health officials if they have tested positive but haven’t been contacted by the health department. The health department’s team can be reached at (859) 288-2445. Health officials have also asked positive patients to help with contact tracing by quickly notifying people they may have been in close contact with and self-isolating.
“If you have one case, you potentially have five to 10 contacts per person, and we are (at) about 50 less staff than we were back when we were at our height,” Adams said. “We’ve had to cut back on areas and ask cases to actually do their own contact tracing.”
‘People need to get vaccinated’
Reducing the strain on the public health reporting system is as simple as following recommendations from the Centers for Disease Control and Prevention, Adams said.
“People need to get vaccinated,” she said. “We need to social distance. People need to continue to wear a mask if we’re in close proximity to other people.”
This story was originally published September 13, 2021 at 2:39 PM.