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'Well beyond our capacity' | Franklin County changing contact tracing due to overwhelming number of cases

The county will begin prioritizing certain cases and may ask infected people to self-notify their close contacts

FRANKLIN COUNTY, Mo. — The Franklin County Health Department is making changes to its contact tracing protocols due to new cases that are "well beyond our capacity to reach out to every case and every contact."

In a press release, the department announced the change to a three-tiered plan based on the number of new cases in the last seven days. The plan is based on CDC and Missouri Department of Health and Senior Services guidance for departments overwhelmed by case rates.

As of Wednesday, the county is in the first tier, which DHSS guidance calls "Extreme Risk". The first tier is for an overwhelmed county that is reporting a seven-day case rate of 351 cases or more per 100,000 residents. Franklin County, which has about 104,000 residents, reported 398 new cases in the last seven days.

In the first tier, the county health department will prioritize cases reported in the last six days, especially those cases in vulnerable populations, congregate living settings or associated with outbreaks. 

The department may also instruct people who test positive to self-notify close contacts and tell those contacts to quarantine.

The tiers in the plan are as follows:

Category 1: Extreme Risk: 7-day case rate of 351 cases or more per 100k population

  • Investigate cases prioritizing those reported within the past 6 days, especially those in vulnerable populations, cases associated with congregate settings, cases associated with outbreaks, and other high-risk groups, as defined by the CDC, using the simple case investigation.
  • Contact tracing may be limited, and resources temporarily reassigned to case interviews depending on the number of staff and the number of resources.
  • If case interviews are prioritized, provide positive cases with instructions for self-notifying close contacts with a request for close contacts to self-quarantine according to current CDC guidelines after the last possible exposure.

Category 2: Critical Risk: 7-day case rate of 101-350 cases per 100k population

  • Investigate cases prioritizing those reported within the past 6 days, especially those in vulnerable populations, cases associated with congregate settings, and cases associated with outbreaks, and other high-risk groups as defined by the CDC. At this level of community transmission, a simple case investigation may be appropriate.
  • Prioritize contact tracing for household contacts exposed within the past 6 days and contacts outside the house who are living, working, attending, or visiting congregate settings, part of a cluster/outbreak, or settings or events with potential extensive transmission.

Category 3: Serious Risk: 7-day case rate of 10-100 cases per 100k population

  • Investigate all cases with a positive test collected in the past 14 days
  • Trace all close contacts, while prioritizing contacts of symptomatic cases, household contacts, contacts associated with outbreaks, those associated with congregate settings, and other groups at increased risk for severe illness, as defined by the CDC Category 4Low to moderate risk: 7-day case rate of 0-9 cases per 100k population
  • Investigate all cases with positive test collected in the past 14 days
  • Trace all close contacts exposed within the past 14 day

A mask mandate went into place in Franklin County on Nov. 20 and continues to Dec. 20.

According to the order, anyone 10 years old and above must wear a face mask any time they are in contact with other people in public indoor spaces who are not household members.

Franklin County has reported 5,108 cases and 80 deaths as of Wednesday.

Credit: KSDK

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