As Michigan COVID cases soar, infected residents won’t cooperate with tracers

Contact tracers are only able to reach around 70 percent of those who test positive for coronavirus within 48 hours of their diagnosis, Michigan Chief Medical Executive Joneigh Khaldun said, and only two-thirds agree to provide information on their contacts. (Courtesy photo)

A third of Michiganders who test positive for coronavirus refuse to tell public health officials who they’ve come in contact with, indicating widespread noncompliance with a system that epidemiologists say is crucial to slowing the pandemic.

Michigan’s chief medical executive, Dr. Joneigh Khaldun, raised concerns about the problem during a press conference Wednesday. Contact tracers are only able to reach around 70 percent of those who test positive for coronavirus within 48 hours of their diagnosis, she said, and only two-thirds agree to provide information on their contacts. 

“This case investigation and contact tracing work is so important if we’re going to be able to successfully slow the spread of the disease in our state,” she said, adding that officials don’t publicly share contact information.

Coronavirus cases have steadily increased in Michigan since mid-June, about two weeks after Gov. Gretchen Whitmer lifted her stay-at-home order that locked down much of the state. On Wednesday, the state recorded 891 new cases and 158 probable ones, the highest daily tally since May 1.

Since March, Michigan has 71,197 total cases and 6,085 deaths, the 13th highest in the nation for cases and seventh most for deaths.

Whitmer has attributed that rise to non-compliance with safety requirements, including a recent executive order requiring people to wear masks inside businesses and outdoors if they can’t maintain six feet of distance from others. 

Low cooperation with contact tracing also doesn’t help, Khaldun said. 

Contact tracing involves two steps: “Case investigation,” in which public health workers interview recently-diagnosed COVID-19 patients about whom they’ve come into contact with over the last few days, and contact tracing itself, in which officials call those contacts to warn them they may have been exposed. 

A “contact” is usually counted as someone who the COVID-positive patient has had face-to-face contact with for more than 15 minutes over the last 48 hours, said Susan Ringler-Cerniglia, spokesperson for the Washtenaw County Health Department. 

Epidemiologists say large-scale contact tracing is crucial to identify, track and control flare-ups in COVID-19. While a vaccine is still unavailable, reaching infectious people early helps limit potential community exposure.

“This will be incredibly important as we prepare for a potential second surge,” Khaldun said. 

Lynn Sutfin, spokesperson for the Michigan Department of Health and Human Services, told Bridge there are now 422 trained volunteers making contact tracing calls for 16 of the state’s 45 local public health departments. Those departments comprise about 50 percent of the state’s total cases, including Detroit and Wayne, Kalamazoo, Genesee, Ingham, Saginaw counties and others. 

Michigan also has a pool of nearly 10,000 other volunteers at the ready if tracing needs to ramp up.

However, most contact tracing and almost all initial case investigations are staffed by paid public health officials employed by local health departments. They do infectious disease sleuthing year-round and are well-acquainted with contact tracing. 

Ringler-Cerniglia of Washtenaw County, which currently does not use the state’s volunteer contact tracing corps, said using local tracers makes it easier for them to compare notes, talk about cases and make connections that help identify the sources of big breakouts like a house party in Saline this month that led to at least 43 confirmed cases and 66 exposures.

“That’s how we’re putting all these pieces together,” she said. “The difficulty with having a volunteer base coming out of another location is it can be really really difficult to connect those dots.”

Other health departments, such as one in Ingham County, are using volunteer tracers in coordination with local investigators, allowing staffers “to focus on the things they are best at and doesn’t have them overwhelmed with all the rest of it,” said Ingham County Health Officer Linda Vail. 

“You can imagine the contact tracing that went on around what ended up being 185 cases out of Harper’s,” she said, referring to a bar in East Lansing that set off a wave of cases after people packed in to drink at the popular hotspot near Michigan State University.

Michigan officials don’t know how many total contact tracers are in the state, between the volunteer corps and local public health officials. And while some leading health organizations have recommended Michigan have at least 3,000 contact tracers to effectively begin reopening the economy, Sutfin said a raw number of contact tracers “is not the appropriate metric” to measure programs’ effectiveness. 

“The state wants to make sure we have enough contact tracers in place to be able to contact all positive cases and their contacts as quickly as possible (ideally within 24 hours),” she told Bridge in an email. 

She cited an opinion piece written by Tom Frieden, former director of the Centers for Disease Control and Prevention, that argued “it’s the quality of the program that matters.”

Angela Beck, a professor at the University of Michigan and director of the Behavioral Health Workforce Research Center, agreed there’s no reliable number for how many contact tracers are needed. She said it’s not surprising the state doesn’t know the exact number given Michigan’s decentralized public health system. 

Estimates of how many tracers are needed range from 30 tracers per 100,000 people to more than 90, she said, which means it’s most important to consider “situational factors” for determining the number needed. For example, more tracers would likely be needed in densely populated communities and communal living facilities “to contain any potential spike in cases before they rise too rapidly,” Beck said.

Rock Connections, the call center company that’s part of Detroit billionaire Dan Gilbert’s business group, has a more than $1 million, six-month contract from the state to run the volunteer contact tracing effort. The company organizes training, communicates with and schedules volunteers, and supervises volunteers while they’re working, Sutfin said. 

Rock Connections’ latest invoice to the state — for work in May, the first month of the contract — shows 20 employees billed more than $66,000 in hourly work beginning mid-month with a $26,500 monthly “support fee” for overseeing the program. 

Under the contract, Rock Connections must be prepared to manage up to 6,000 volunteers, which means it is now managing around 7 percent of the volunteers specified in the contract. 

But even if more volunteers are brought on, the state doesn’t expect costs to exceed $1 million, Sutfin said, because “these are fixed supervision costs.”

The state also recently received $315 million through the CDC as a part of a federal stimulus package for COVID-19 testing and contact tracing. A portion of that is going to local health departments to hire more contact tracers as state health officials prepare for fall, when some health officials  fear a second wave of cases as students return to school.

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Comments

Anonymous
Wed, 07/15/2020 - 8:48pm

Not surprised. Everyone today is so selfish, entitled.

VeeMann
Thu, 07/16/2020 - 9:19am

Yes for sure that's the reason.
/sarcasm

Sad
Thu, 07/16/2020 - 10:39am

I agree... everyone is self absorbed and apathetic.
Good luck!
Everyone for themselves.

Kevin
Wed, 07/15/2020 - 11:04pm

Just wait until school is in session...

R.L.
Thu, 07/16/2020 - 8:52am

Wow what a surprise. People don't like being asked questions. They probably in some cases were involved in some stupid activity or party. Get a clue wear a mask.

R.L.
Thu, 07/16/2020 - 10:40am

Mr. VEE MANN has strong opinions on a lot of things. I hope you are right and I am wrong. R.L.

Protests
Thu, 07/16/2020 - 11:07am

There wasn't a spike in cases until the black lives matter protests happened and the governor opened up the rest of the state so she could justify having and attending those protests. I guess if people don't tell the tracers that they attended the protests, then magically none of the spread happened because of them.

And since the governor's office controls the tracers and the data, they can spin it ANY way they want and blame it on whatever they want.

Diane J
Thu, 07/16/2020 - 1:00pm

First mistake-the Gov. wasn't the one having or attending the protests. That was the DeVos family and their PAID attendees who are die-hard tRumpsters. Second data wouldn't go directly to the Gov. it would go through the health dept. Third,The reason for having tracers is to STOP the spread of the virus and by not cooperating it wont be stopped, and lastly the state legislature, with a Republican majority, are/were the ones screaming about opening the state up. Lastly, do yourself a favor an fact check the information you get whether it comes from your right wing sources or the left wing sources-it could save your life.

Jacqueline Koehler
Fri, 07/17/2020 - 7:29am

Wow. You mean that WASN'T Gretchen Whitmer's picture marching with BLM protesters?

Dave
Fri, 07/17/2020 - 1:29am

The Governor was photographed arm in arm with the BLM/antifa 'protesters' so she is, by participation, condoning large gatherings without social distancing, yet she blames us for the spike! I don't trust any politician, but our Governor is a special kind of hypocrite!

Diane J
Sun, 07/19/2020 - 10:01am

One photo -op with some people that were tested is not the same as a bunch of unmasked, untested people running around for the DeVos family to protest wearing masks AND it was about a week or 2 after they went home to the UP and northern mitten that the virus
.showed up there-so yeah I blame irresponsible people who refuse to wear a mask.

John Gorentz
Thu, 07/16/2020 - 11:28am

Wearing masks is a good idea, but I wonder how our governor expects to be taken seriously when she first attacked one group of social justice protestors in Lansing and then turned around and joined another group of social justice protestors in the same city. A lot of people don't wear masks where they should. Whenever I see that people don' t take covid-19 as seriously as they should, I blame our governor. (Not that she is the only one to blame, of course.)

middle of the mit
Thu, 07/16/2020 - 3:40pm

John,

Maybe, the Governor was talking about not wearing masks while protesting? I think that is what she meant. I certainly don't remember her saying that the protesting was a bad thing, except for the guns in the capital.

And why blame the Governor for peoples personal choices. The people who chose not to wear masks get their info from sources telling them they don't work. They make that choice themselves despite the evidence.

central
Fri, 07/17/2020 - 7:49am

in a pandemic , no body wins, not going to happen , can't happen . the Goverment tries to make decisions that balance loss in all areas , of people , economy and services . they are all going to take a hit , its walking the edge of the blade . Politics has nothing to do with it . If the Democrats were always right or wrong , you'd see it by how their states were fairing . If the Republicans were always right it would show in their states . ( example. Texas , Florida , etc. ) The fact that the numbers of news cases lag 1 to 2 weeks from whats happening requires the government take best guess actions . Right now attempting to break / stunt the transmission chain is ALL they have. If the public gets on board , the virus goes away . with no where /no way to spread it dies out . its very simple . Don't give it any fresh meat . So, the advice from 1918 is Mask up ,Spread Out , and stay clean

CharlieD
Sat, 07/18/2020 - 5:58pm

This is not a pandemic. I work at a LARGE office. NO ONE at our office knows anyone who has died from coronavirus. Furthermore, NO ONE at our office knows ANYONE who knows someone who has died from coronavirus.

Someday, when we have a real pandemic, no one will take it seriously becuase of this BS "crying wolf" that is happening now.

Maybe that is the plan.

rosemary freitas
Thu, 07/30/2020 - 3:13pm

I know 3 people who have died. All in different social circles and situations. 1- hospital maintenance worker in Detroit. 2- elderly father of my neighbor and 3- elderly grandmother of my neighbor. Don't subscribe to BS. This is real and those who say it is not because they don't know anyone are subscribing to something otherworldly.

Mrs A.
Sat, 07/18/2020 - 6:18pm

You guys really, really seem to hate that a WOMAN is governor. There is no other reason.

Diane J
Thu, 07/16/2020 - 12:51pm

Anyone who refuses to cooperate with tracers are basically trying to spread the virus. It seems to me that the action is so against the health of the US community that they should be held liable for any infections that can be traced to them.

Thomas
Fri, 07/17/2020 - 3:31pm

There should be a law against failing to responding to a contract tracer. Reason being: The sooner this virus gets contained, the sooner our economy can get back up and running. The idiots who fail to cooperate are the ones who are deliberately spreading it.

CRB
Mon, 07/27/2020 - 5:46pm

How would you know if the contact tracer is legit and not a scammer trying to get information for future scam. Display of who call comes from may not be correct. If you get a call saying it is from your credit card do you really give them personal information or do you instead call the number on your credit card to verify the information is really needed and know you are talking to the correct person. If any contact tracer is found to release information on the people that are in the system they have access to what happens to them? Do they get a warning and allowed to do it again, does nothing happen, or can the penalties be stronger?

Protester are doxxing law enforcement can bad actor contact tracer be forced to dox themselves or be doxxed in a public forum for the twice as long as COVID-19 is a problem? Honestly there should be a number and/or website to go to to give contact information that one gets with the COVID results in there locality (state), even if you are negative it should clearly say where to go if in the future the result is positive. The problem of con artists and information leaked for personal gain is a real problem, telling people to trust someone because they say a magic word or phrase that is widely shared on public forums is silly.

GeeK
Thu, 07/16/2020 - 1:46pm

I wonder if the reluctance to provide contacts comes from embarrassment/shame. Suppose person X was a positive C19 testee and X tells the contact tracer that they were in contact with person Z. The contact tracer calls person Z and says you were in contact with person X and they tested positive for C19 and so you might have it. Perhaps positive testee X is worried person Z will be mad at them for exposing them to Covid. Or perhaps X is just plain embarrassed to let Z know and could let mutual friends know and is worried what those people will think. Do contact tracers let contacts know the identity of the infected person they were exposed to?

Waterland 4
Fri, 07/17/2020 - 12:27am

I've read several articles about ppl not cooperating with contact tracing and none of them discuss the reasons why ppl aren't cooperating. I'd really like to see some info on that. I just heard on NPR today that the increase in cases is largely in the 20-30 age range. Do they think they're going to get into trouble by giving info? Not all the cases can be crazy trump base ppl who don't believe in science, care only about themselves and are always spewing constitutional rights junk or conspiracy theories. If I got the virus I'd feel horrible about who I could have infected before I knew I had it. It'd be my moral duty to do my best to make sure that everyone I had contact with would be notified. But even before covoid I've met plenty of ppl who go around in public everywhere when they have pneumonia or bronchitis or the flu and they don't think twice about how many ppl they're infecting while they're hacking all over. They give no thought to how serious any illness could be to some ppl. When I'm sick I make sure to stay away from ppl.I don't shake hands and stay home as much as possible. But I guess I just have a conscience and empathy.

CharlieD
Sat, 07/18/2020 - 6:03pm

Cases in 0-60 age range are irrelevant as those groups are at literal zero risk from the virus. Maybe that's why they don't care to cooperate?

Joe
Thu, 07/16/2020 - 3:23pm

Wonder how many of the 891 are actual new cases and not retest of already positive cases. CDC website states new positives do not equal new cases since the same person can be tested more than once. It's time for real data and not political data.

Marlena
Fri, 07/17/2020 - 9:03am

Exactly. It's not clear from Khaldun or MDHHS site whether: a) positives are repeats on the same person, or b) additional people are testing positive. My contacts who work in Michigan's health systems who are involved with the test administration and data recording have said that multiple tests on the same person are being counted as separate new cases, not one case with several positive results. If that's how Khaldun/MDHHS are counting these, then there's definitely number inflation going on.

Todd
Thu, 07/16/2020 - 5:48pm

Well maybe had Whitmer's administration not lied about normal protocols being bypassed when a no-bid contract for coronavirus contact tracing was awarded by the state to Great Lakes Community Engagement, which is operated by a well-known Democratic consultant Michael Kolehouse -- who has previously written that President Trump should "get Coronavirus ASAP" and that someone should "do the country a favor and cough on that man," more of us would have trusted them. It was shady from the start and still is and Whitmer continued to lie even after being caught. Tying confidential health information to a political data gathering operation is SHADY but I'm sure many don't even know about it since the main stream media wasn't eager to pursue it. If a tracer from this administration comes to my home, calls me, or has any contact with me, the door will be slammed in their face and/or phone hung up. PERIOD.

G.
Fri, 07/17/2020 - 11:48am

And when you hang up, please remember that you could be spreading it already, and that your loved ones could get it from you. My grandma realized she got Covid from a caregiver who was asymptomatic, because contact tracing works. Thank God it only ended up putting her in the hospital on oxygen for one night before she was able to start getting better.
If you want to look at another piece of this puzzle, please consider that without excellent contact tracing, schools will not be able to keep their doors open. People who don't comply are not only potentially spreading a virus that can kill people, but are endangering the education of every kid in the state.

JBT
Sun, 07/19/2020 - 7:54pm

It never fails to surprise me how many people are so uninformed of the facts and willing to make claims without evidence, as you do in your post. Your claim about Whitmer "lying" about the people gathering information needs some facts behind it (which will be hard to find because it isn't all true). The real issue, though, is contact tracing (and has nothing to do with your first point), which is necessary to stop the spread of this virus. Someone who lacks the intelligence to realize that is going to harm other people.

Frankly, I think there should be consequences for not cooperating with the efforts to pin down where the virus is operating. It seems clear to me that some people in this state care nothing at all about other people, only themselves.

Becky Watts
Thu, 07/16/2020 - 11:32pm

You are taking away my constitutional rights to do and go where I please that's not up to you to decide if I want to go somewhere I'm going to go you're not going to tell me you've got everybody's mad at you Gretchen and all they're going to do is recall you I don't care who you're calling for Soros Barack Nancy whoever but I'll tell you one thing you're a one-term governor lady

pierredeboe
Sat, 07/18/2020 - 10:58am

Your willful ignorance and contempt for expertise by believing this is a political issue speaks to your lack of common sense. CDC has no political agenda no matter what FOX NOISE, BRIETBART and current presidential administration feed you. This is proven by COVID 19, as it does not discriminate between party loyalty. Your mind is cemented in politics. Poor choice.

Jacqueline Koehler
Fri, 07/17/2020 - 7:25am

Instead of "two weeks afterthe governor lifted her stay-at-home order", I think you mean "two weeks after thousands of people, including the governor decided to protest without masks or social distancing."

Pat Cornish-Hall
Fri, 07/17/2020 - 2:08pm

Contact Tracing is not very effective when it sometimes takes up to two wks or longer to get test results. Our system is broken and Covid will be around a lot longer causing Unnecessary loss of life, unless we can fix it.

Kate
Fri, 07/17/2020 - 4:53pm

Are you aware that some patients don't get their covid test results for over 10 days? Improve testing and results!

Anonymous
Sat, 07/18/2020 - 1:09pm

The cause is pretty simple. Everything you hear is based on lies. Presumptive positive cases may or may not be actual cases. But that's fine, every case added means the overall death rate is lower. Also, we need to start tracing influenza like we have been coronavirus, until we get a 100% effective vaccine for influenza. After all, around 200 children died of influenza last year. I'd argue that the number is actually underreported because of a lack of testing.

A.R.Eynon
Sat, 07/18/2020 - 3:25pm

Gee I wonder what could be the issue?
How about we start with the credibility or lack thereof of each and every one of the Republicans and Democrats in office. From "Agent Orange won't hurt our troops" right on up to "Flint River water is completely safe to drink." Now it's "Trust us, thousands of volunteers will keep your personal medical information that we input into our big 'ol corporate computers private." Fool me once shame on you; fool me twice shame on me.
Then we can look at Gov Whitmer's authoritarian over reach and how she "burned her powder." "Do this, don't do that" flipping back and forth all on the whim of public health officials who do not understand one thing about our system of government and the Bill of Rights. Whitmer "I don't care about the legalities" needs to go and the faster the better if any semblance of what makes being an American special the world over is to remain.
Both Trump and Gov Whitmer violated their oaths and your civil rights when they turned their decision making authority over to public health officials. I don't recall voting for public health officials or epidemiologists, or voting to replace an entire basket of civil rights and social issues with the "only Covid matters" mantra. Why is it that every word that comes out of one of their mouths is treated as scientific truth? They demand peer-reviewed evidence until its convenient for them to look the other way when they are pulling guesses from their behinds. Then these same officials are surprised that some 60% of kids have missed out on vaccines and, oh no!, who could have foreseen this outcome?
I have zero interest in following the advice of any of these edjits.

CharlieD
Sat, 07/18/2020 - 5:56pm

What a bunch of propoganda. Numerous studies including comprehensive CDC studies showed that mask usage by general population is NOT effective in preventing infection nor transmission of viruses like this... Yet here we are.
Contract tracers are useless when this virus has been circulating in the USA since last august. Remember the principle of six degrees of separation - You are six degrees of separation from contact with every person in this country. It has already spread to every county of every state and has been spreading for nearly a year now. So stop freaking out. Only a tiny fraction of our population is at any risk at all from this virus and those are the people who should be isolated. Everyone else should carry on like normal.

Mrs A.
Sat, 07/18/2020 - 6:16pm

How is it those who deny facts to the contract tracers don't GET that they are putting family, friends, and colleagues in danger???? I mean, that is EXACTLY what contact tracing is about, warning the people you were close to about self-isolation and seeking testing . When I read stories like this that remind me how ignorant and aggrieved a significant portion of Michigan's population is, I feel embarrassed for our entire state. If only we had national leadership providing a coherent message, but no, the imposter in the White House evidently wants to burn it all down behind him when he is voted out in a landslide this November.

Notasheep
Sat, 07/18/2020 - 9:17pm

After the elections covid 19 will be gone like a fart in the wind....

Saline Resident
Sun, 07/19/2020 - 2:26pm

I live in Saline, ground zero for the infamous "house party." I have to say, my original inclination would be to cooperate with contact tracing, should it ever be necessary. However, this house party has been noted in papers around the state and nation. I have seen more online posts from my neighbors demanding that the names of ALL who attended be "posted online for Public Shaming" (and that's a direct quote). It also makes me wonder how the media is getting this information and what lengths the Health Dept would go to protect my privacy. Given how MY local community has treated each other - and that's with contact tracing - I don't think I would cooperate. I would be too terrified the mob would come for me or my family next.