As the community begins to reopen, Mayor Fischer boosts the city’s COVID-19 testing and tracing capabilities
Mayor Greg Fischer today outlined steps he is taking to significantly boost the city’s COVID-19 testing and tracing capabilities, as the city and state move ahead on a gradual reopening of the economy.
Those steps include expanding COVID-19 testing, initiating a broad contact-tracing system, and increasing Louisville Metro Department of Public Health and Wellness (LMPHW) staff, including two executive consultants to oversee testing and tracing.
“We are about two months into the COVID-19 crisis, and I couldn’t be prouder of our city’s response,” Mayor Fischer said. “While we still have work to do, as evidenced by the number of cases and deaths, we have successfully flattened the curve. Our hospitals have never been overwhelmed. We’ve shown we know how to adapt and to work together, and that’s why I have tremendous confidence as we enter the next phase of our plan to gradually and safely reopen our economy.”
Local and national health experts agree that containing the spread of COVID-19 as the economy slowly reopens is dependent on a “Box It In” strategy:
- Test more widely for the virus.
- Isolate infected people and provide support services to help them recover and stay safe.
- Find everyone who’s been in close contact with someone infected with the virus.
- Quarantine those people for 14 days, providing appropriate support services during their period of quarantine.
“This is how we protect ourselves and each other,” said Dr. Sarah Moyer, LMPHW director and the city’s Chief Health Strategist. “Boxing in the virus depends on our ability to greatly expand our testing and tracing – and that’s a major undertaking.”
The first step in the city’s strategy is rapidly enhancing testing capacity, in partnership with a COVID-19 Testing Task Force. Governor Andy Beshear has established a statewide testing goal of 45,000-50,000 tests per week, which translates to approximately 8,000 tests per week in Jefferson County, or approximately 1,100 tests per day.
“We will first ensure that we can test everyone who is symptomatic – a number that may well grow as more businesses reopen,” said Bill Altman, former Chief Strategy Officer for Kindred Health and former Chair of the Board of Health, who is leading the city’s work on testing as a consultant.
The Mayor added his appreciation for cooperation and coordination among testing partners in the Task Force, “including our major hospital systems – Norton, Baptist and University of Louisville Hospital and Lab – which have provided testing within their own organizations but also out in our community."
“We also have our federally qualified health partners such as the VA, Family Health Centers, Park DuValle Community Health Center and Shawnee Christian Healthcare, whose testing labs are part of the solution,” he said, adding that Kroger, Walmart and others also stepped up to provide community testing in conjunction with the Kentucky Department for Public Health.
Altman said the Task Force will be charged with coordinating testing efforts throughout the city, adding that its work “will not be driven solely by numbers but on ensuring that we are testing high-risk groups in our community. That’s how we slow the spread of disease.” He thanked the Task Force participants for “coming together to make sure we have the capacity to test widely in our community, that testing resources are targeted to the highest risk people, and that results are shared in real time so that we can re-open the economy safely.”
A third focus of the testing group, Altman said, is implementing an ongoing community-wide program of “insight” testing, to monitor disease trends and serve as an early warning signal for outbreaks as the economy more fully opens. “We want to keep a very, very close eye on community-wide trends,” he said, adding that this program would be done in conjunction with the University of Louisville’s Co-Immunity Project.
In addition to more widespread testing, a safe reopening depends on a robust system for case investigations and contact tracing – identifying those who have tested positive for the virus, tracing those they may have exposed, and working to ensure all are appropriately quarantined or isolated, to minimize the risk of spreading it any further.
Louisville Metro Government received “an unprecedented number of responses” to a Request for Proposal (RFP) issued May 6, 2020, seeking to engage contractors who will conduct this effort, including disease investigation, contact tracing and daily patient monitoring. Metro expects to name a contractor this week.
“Contact tracing is a critical component of our strategy to reopen safely,” said Karen Handmaker, a population health expert, formerly an executive at IBM Watson Health, who is helping lead the city’s work on COVID-19 contact tracing and follow-up.
“LMPHW will partner with our selected contractor to ensure that we tighten the timeframe between people testing positive and reaching individuals they may have been in contact with to keep them safe and minimize new cases from occurring,” she added.
“LMPHW will manage our contractor partner and ensure that we tighten the timeframe between people testing positive and reaching individuals they may have been in contact with to minimize new cases from occurring,” she added.
Prior to the pandemic, the LMPHW team that handled infectious disease investigations had nine people; it has since expanded to 55, with the help of reassigned health department staff and some volunteers.
“Going forward, the number of contact tracers needed will depend on the number of positive cases coming in every day, and the number of people they’ve been in contact with the two days before becoming ill,” said Dr. Moyer. “As the economy continues to reopen, if we have a resurgence of cases, we will need more contact tracers. Likewise, we can slowly decrease the amount if the number of positive cases remains low, and people continue to stay healthy at home.”
Both the Mayor and Dr. Moyer stressed that the city's efforts on tracing will be easier if residents continue to limit social contacts and track the contacts they've made, so they're prepared if they should contract the virus.
Metro Government will launch a broad communications effort to ensure that all residents get that message – understanding that testing and tracing are key to the health and safety of themselves, their families and the community as a whole. The messaging effort will include both marketing and creation of a COVID-19 Community Engagement Team. Details on creation of the team, under the direction of the city’s Chief Equity Officer Kendall Boyd, will be announced as they are finalized.
Louisville’s contact tracing efforts are separate from the state’s plans to add 700 contract tracing positions, including nearly 500 from the private sector. Louisville is not part of the regional health department system, as it is the only city in Kentucky to receive its own CARES Act allocation to fund such efforts.
In order to manage the increased responsibilities, Mayor Fischer also announced today that he would be increasing LMPHW staff by 41, including bringing on Altman and Handmaker, and directing Ozzy Gibson to serve as Chief over the Department for Public Health, as well as Operations section chief for the COVID-19 Incident Management Team, for the duration of the COVID-19 crisis.
“I’m very pleased at the level of expertise this team brings to the challenge of keeping our residents safe and healthy even as we begin to loosen restrictions,” Mayor Fischer said. “They’re putting in place the tools necessary to reopen our economy, but just as importantly, the measures and monitors to ensure that if there is a major spike in cases, we see and react to it immediately.”
“The COVID-19 global pandemic has severely disrupted our lives,” Dr. Moyer said. “Yet, if there is one positive take-away, it’s that the virus has shown that fortifying our public health infrastructure helps us strengthen not only our health but also our economy and our very way of life.”
The new Public Health positions include epidemiologists, nurses, lab technologists, environmental health specialists, support staff, and others, with annual salaries ranging from $31,000 to $65,000. The expanded testing, as well as the expanded Health Department operations is expected to cost $7.1 million per year, which will help the city meet the needs required by HB129, which more narrowly defines public health department missions to focus on core areas of public health, including preparing for health emergencies such as an epidemic. About $5.1 million of those costs will be covered initially by funding from the federal CARES Act with the balance covered by general fund expenses. This does not include tracing costs as that contract has not yet been awarded and those costs will be determined by the number of cases.
As of Wednesday, there have been 38 new confirmed cases of COVID-19 in Louisville, bringing the total to 2,105 with 1,352 recoveries. There have been eight additional deaths since Tuesday. The confirmed Louisville total is 140.
Currently, 47 members of LMPD, Louisville Fire, Metro EMS, Metro Corrections and the Sheriff’s Office are off-duty due to COVID-19:
- 13 are off with positive tests and in self-isolation.
- 28 are off and quarantined due to exposure to someone with a positive test.
- 6 are “screened off” with symptoms and tested, or due to be tested, but have not received test results.
Positive test numbers for first responders/public safety since the incident began:
- 48 positive tests.
- 35 have fully recovered and returned to duty.
Metro Corrections inmate data for May 20:
- 614 inmates have been tested
- 8 positives.
- 43 tests are pending.
Bill Altman, former Chief Strategy Officer for Kindred Healthcare and former Chair of the Louisville Metro Board of Health, is a consultant who is leading the city’s work on COVID-19 testing. Altman is an advisor to several healthcare organizations nationally and locally, including the Louisville Healthcare CEO Council where he is leading the group’s initiative to drive innovations in aging care and policy.
Karen Handmaker, a population health expert, formerly an executive at IBM Watson Health, is helping lead the city’s work on COVID-19 contact tracing and follow-up. Handmaker is a member of the Louisville Healthcare Advisory Board’s Coordination of Care Committee, co-chair of United Community’s Financial Sustainability Committee, a mentor for healthcare entrepreneurs at Louisville’s XLerate Health and a board member of Smoketown Family Wellness Center.