More than a year after the COVID-19 pandemic began, the state auditor says the California Department of Public Health (CDPH) is doing just a so-so job on a key element of coronavirus control: finding out whether infected Californians might have spread the disease to someone else.
Amid warnings of another potential surge in coronavirus cases, State Auditor Elaine Howle said last week that CDPH has fallen short of its goals for contact tracing, in which newly infected residents are supposed to be interviewed to determine who might have infected them.
While she gave the state agency high marks on COVID-19 testing, she said contact tracing has fallen short. In a one-month period ending Dec. 24 — when infections were surging and 834,487 new cases were reported — state and local health agencies “had successful interviews for only 40 percent of the total cases,” the audit said. The goal was to interview 85 percent.
“Moreover, the tracing staff were able to identify an additional person to contact and notify of potential exposure in only 16 percent of the total cases,” the audit said.
Gov. Gavin Newsom’s administration has preached the importance of contact tracing, vowing to reassign thousands of state workers to the task. But the audit said only 2,200 state workers have been reassigned, well short of the state’s goal of 10,000. All told, only 12,100 people were working as contact tracers in December, compared to the 36,000 the state said it needed.
The Sacramento Bee has previously reported that one promising piece of the contact tracing program — a smartphone app called CA Notify — has had lackluster results.
About 100,000 people have received exposure alerts from the app since it was released in December, a period in which 2 million infections have been recorded. The app is designed to send someone an alert if they’ve been exposed in the past 14 days to someone who’s tested positive for COVID-19.
The audit urged CDPH to conduct a thorough re-evaluation of its contact tracing program by May 15. In its written response to the audit, the department said it’s already retooling the system.
The agency is working “to develop a new contact tracing staffing model based on current scientific knowledge, actual data from the first 10 months of California’s contact tracing response and the state’s projected COVID-19 case numbers for 2021,” said Tomas Aragon, the state’s public health officer, in a letter to Howle.
“This revised staffing model will also consider technology innovations that save staff time and expand local workforce capacity,” Aragon wrote, “including automated case and contact surveys and data portals that enable external partners such as schools and businesses to share core data for cases and exposed contacts with their local health jurisdictions.”
The report from the auditor included two paragraphs specifically dealing with the technology involved in the state’s efforts:
“Finally, Public Health was slow to procure required independent oversight for the development of a new IT system to track COVID-19 data, for which it budgeted $15 million. … Accurate and timely laboratory results are critical components of the state’s efforts to document the spread of COVID-19 and assess the effectiveness of preventive measures. However, in summer 2020, the California Health and Human Services Agency reported that two IT system issues resulted in the state undercounting new COVID-19 cases. This hastened an existing plan for Public Health to develop a new, stand-alone COVID-19 reporting system, which it completed in February 2021. However, Public Health did not retain an independent verification and validation (IV&V) consultant in time to perform key, early error identification during this urgent project’s most critical development period. This failure was in spite of requirements for IV&V in both state IT policies and in the development contract for the system,” the report says.
“Although Public Health has now entered into an IV&V contract, it did not dedicate the IT consultant to a thorough review of the COVID-19 reporting system,” the report adds. “Rather, the contract includes both work on the new COVID-19 reporting system and work on several other systems, allowing Public Health to prioritize which systems the IT consultant reviews. Consequently, we question whether the contract has provided the COVID-19 reporting system with all of the necessary safeguards. Through the development phase, Public Health did not prioritize oversight of the system. As a result, Public Health may have failed to detect potential errors, which creates a risk to future system functionality and the State’s plan for addressing the COVID-19 pandemic.”
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Techwire contributed to this report.