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Pa. to set coronavirus testing, contact tracing benchmarks just days before gradual reopening is set to begin

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Health Secretary Rachel Levine said the testing benchmark will be “aspirational,” and stressed that it will be one of many factors in deciding which counties or regions can safely begin to relax restrictions on May 8.
Commonwealth Media Services

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HARRISBURG — Pennsylvania officials on Friday will unveil the state’s goals for coronavirus testing and contact tracing, standards the Wolf administration has so far shied away from specifying despite insisting that a robust system is key to its plan to reopen the state.

Health Secretary Rachel Levine said the testing benchmark will be “aspirational,” and stressed that it will be one of many factors in deciding which counties or regions can safely begin to relax restrictions on May 8.

“There will be a number of statistical and public health measures that we’ll be looking at,” Levine said Tuesday, adding that the administration will also announce by Friday which areas of the state will be the first to reopen.

As states increasingly seek to end stay-at-home orders and resume economic activity in the wake of the coronavirus pandemic, public health experts say that vastly expanded testing and rigorous tracing of how people became infected is needed to prevent future outbreaks.

After announcing its plan to begin reopening Pennsylvania starting May 8, the Wolf administration said counties or regions must have “adequate” testing for new coronavirus cases in place. However, it stopped short of specifying what it defines as “adequate.”

State officials have also appeared to struggle to formulate a plan to hire more contact tracers — people who connect the dots between someone with the virus and whom else they might have infected — saying as recently as last week they were still considering their options.

Krys Johnson, assistant professor of epidemiology and biostatistics at Temple University, said she welcomed the news that the Wolf administration would be setting benchmarks.

“We need testing,” Johnson said. “We have needed testing for a long time. So if this is what makes testing happen I’m 100% behind it.”

Based on a recent Harvard estimate, Johnson said Pennsylvania would probably need to conduct 19,000 tests per day. By contrast, over the last week, Pennsylvania has averaged about 5,500 per day — less than a third of Harvard’s benchmark.

“We are woefully behind,” Johnson said.

The reluctance among Pennsylvania officials to detail testing goals underscores how difficult it has been for states to lay out a clear plan to gradually and safely resume economic activity.

The difficulty has been exacerbated by testing shortages, a lack of coordination at the federal level, and widely divergent proposals among think tanks and public health experts over how much testing the nation should be doing.

The American Enterprise Institute, for instance, has proposed that the nation should be conducting roughly 400,000 tests per day. Meanwhile, researchers at Harvard have released at least two different proposals, one of which calls for conducting as many as 20 million tests each day by late July.

Don Burke, an epidemiologist and former dean of the University of Pittsburgh’s Graduate School of Public Health, said the challenge for public health officials in setting benchmarks is that it’s still not well understood what percentage of the population shows no symptoms when they’re infected with the coronavirus.

In order to know how widely the population should be tested, that’s a key piece of information.

“We are just beginning to get a clear view of the magnitude of the spread,” Burke said.

Under Wolf’s three-tiered system for reopening Pennsylvania, counties or regions with few cases can begin moving out of the “red” phase on May 8. Levine said officials on Friday will announce the first areas that will be allowed to enter the “yellow” zone.

In that phase, many businesses would be allowed to call back employees to work, as long as they provide masks and ensure social distancing. But gyms, theaters, and schools would remain closed, and large gatherings would still be prohibited.

If cases remain low in those areas, they could then enter the green zone, which could still require certain safeguards, such as wearing masks in public.

But in all those stages, one thing remains constant: adequate testing and contact tracing.

At the moment, local health departments and the state’s public health nurses — whose ranks have been decimated by years of budget cuts — are tasked with the work-intensive job of figuring out how a person might have been infected, and who else they might have contacted.

Levine said earlier this week that the state is developing “a robust method on contact tracing,” which she will circulate by Friday.

She provided only a broad outline of the plan, which she said will be led by public health nurses and also include county and municipal health departments, private health systems, and new hires and volunteers. She did not provide numbers on staffing levels.

Johnson, of Temple University, previously told Spotlight PA the state needs at least 2,000 contact tracers. The state Health Department, responsible for 60% of the state’s population, employs just 131, though it has enlisted an additional 16 employees to assist with tracing.

New York recently announced that it will hire 1,000 to do this vital work, while Louisiana, Texas, and Kentucky are undertaking similar efforts.

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