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Here's Why LA Can't Keep Up With COVID Test Demand

A healthcare worker hands a patient a COVID-19 testing kit at a drive-thru testing site at The Forum. (Courtesy of the County of Los Angeles)
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The coronavirus keeps spreading in Los Angeles County, and the death toll continues to mount. Health officials are ramping up one of the most effective public health tools: contact tracing.

The county has gone from having 250 contact tracers before the pandemic to about 1,500 and it plans to add another 1,300-1,400 over the next couple of weeks, according to Dr. Jeffrey Gunzenhauser, chief medical officer for L.A. County's Department of Public Health.

These public health workers follow up with people who test positive for COVID-19 and their contacts to get them quarantined so they don't spread the infection.

But with more than 2,000 new COVID-19 cases reported daily, how can they keep up? We spoke with Dr. Gunzenhauser about contact tracing and why it can take more than a week to receive test results. (This conversation has been edited for clarity.)

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Los Angeles County is reporting more than 2,000 new COVID-19 cases every day. How do you handle that?

We do contact tracing seven days a week. As we get 2,000 cases a day, we're reaching out to call 2,000 people a day. We ask them about their contacts and either that day or the next day. We're calling all those contacts. A lot of the [contact tracers] are actually county workers that have been reassigned to help our department do this work.

There have been reports of significant delays by laboratories contracted to do the COVID-19 testing, sometimes taking up to 14 days to report their findings to both patients and the health department. How does that impact contact tracing?

As testing has expanded and there are a lot more tests going into the limited number of laboratories, they are falling behind. There are some labs where the delays are over 10 days; the average is certainly well above three days, it might be about four days now. That's a major problem. We've made a number of efforts to improve this. First of all ... we talk to them to try to understand what the problem is and how we can work together to receive those reports more quickly. For example, if they're having a problem with their information system, they can fax us the results or we will accept it as a spreadsheet or some other way.

What is the role of the state in regard to contracted labs?

The state has a licensure and certification function. So we're suggesting they could use that to only onboard [laboratories] if they're in full compliance with everything that's needed. We also can enforce this locally, our own health officer can issue orders. And if for some reason, we as the county thought that a particular lab was either performing testing that was poor quality or was failing abysmally on some of these reporting measures, we could shut them down. But we are working very closely [with laboratories]. In my view, they're doing all they can to try to improve this.

The Department of Justice has warned that scammers pretending to be coronavirus contact tracers are trying to steal personal information and money. What should Angelenos look out for?

We've not heard of contact tracing scams, but it doesn't mean they're not happening. If you get a call, and if it doesn't say [on your caller ID] L.A. County Public Health, it's not us. We will never ask for money. We will never ask for your social security number. And we'll certainly never ask about your immigration status or anything like that. We'll only ask for information related to your situation, your health, and your contacts.

The county's public health order requires people who have been exposed to quarantine for 14 days. Contact tracers help connect people to county resources if they need it, but what if they need to keep going to work?

We do realize that the 14-day quarantine period can be difficult for some people. However, there's been a number of laws passed, including here in California, that all employers are required to provide 14 days of paid time off specifically for this purpose. So we try to work with individuals who are in a work environment, explain that if we need to, [we'll] talk to their employer. But for individuals who are working, they should have a minimum of 14 days paid time off, which should help them during this period.

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What would you like people to know about contact tracing?

We do protect your confidentiality completely. We don't divulge any information about you. And for the contacts, we do everything we can to help them meet their needs, whether there are employment issues, whether it's food, whether it's housing or even access to medical services. And in light of that, we hope that everyone will answer the phone when we call them and help to prevent the spread of this disease.

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