Updated: Jun 10, 2020
Although we were off to a delayed start, in mid-May we began ramping up our testing and contact tracing efforts in Western Nevada.
The list below includes the four metrics used to evaluate reopening Washoe County in subsequent phases. By far the most critical metric is the result of our contact tracing.
Regenesis Reno is strongly recommending members of our community apply for the contact tracing positions immediately. The CDC highlights the basic principles of contact tracing here.
The health departments of Nevada and five counties are now scaling up and training a large contact tracer workforce. Pay rates start at $17.00 per hour, plus overtime. Please contact ADECCO here to apply for the contact tracer positions and alert anyone you know about this great opportunity to serve our community.
Also feel free to contact us at firstname.lastname@example.org or 775-525-1594 to learn more about how contact tracing can be a foundation for community building after the virus subsides.
Let’s review the current situation in Washoe County. Elected leaders will use a similar process in the surrounding four counties: Carson City, Douglas, Lyon, and Storey. The four metrics for Washoe County are
1. Daily New Cases -- as of May 27, the 5-day Moving Average of Daily New Cases was 26, down by 26% from the peak of 35 on April 13 – easily meeting the 14-day goal of consistently decreasing from the peak of Daily New Cases.
2. Hospitalization Capacity meets criteria – as of May 26, 33% of licensed beds and 52% of ICU beds in short-term, acute care hospitals are available. 88% of ventilators are available.
3. Tests Per Day – the 5-Day Moving Average of Tests Per Day as of May 27 was 746, more than triple the 226 at the end of April.
4. Contact Tracing – as Tests Per Day accelerate, the need for rapid contact tracing of the new positives will require massive growth of the contact tracing force by at least a factor of 5X.
Tests Per Day
As of May 27, a total of 22,871 Washoe County residents have been tested. The latest census data from July 1, 2019 totals 471,519 for the county population including all ages. So, 5% of Washoe County’s population has been tested. Although there is no Federal guidance, typical goals reported in the media range from 5% to 15%. We’ve achieved the minimum goal.
At 15%, total tests necessary is 70,728, requiring two months of additional testing at the current rate. On May 27, the most recent day, 986 were tested. If the 1,000 goal of tests per day is maintained as the average moving forward, only 27 days of additional testing would be required.
Antibody and Regular Tests Projectable to All of Washoe
For the first time, a random selection of 1,181 Washoe County households within 173 census tracks are now receiving information from the Washoe County Health District (WCHD) regarding an antibody study designed by WCHD and the University of Nevada, Reno, School of Community Health Sciences.
One adult member of the household will receive an antibody test; the remaining household members will receive regular COVID-19 tests.
This random sample is large enough to be statistically significant for the goal of projecting the total number of residents who’ve ever had the virus to the entire county population of 471,519. The sample is also large enough to project the total number of residents who currently have the virus including both those with symptoms and those without symptoms (asymptomatic). When the results are presented, this will be the first inclusion of a statistically significant value for those infected, yet asymptomatic.
As the number of tests per day dramatically increases, this percentage will provide the estimate of the total positive results expected over the course of the future transmission of COVID-19. The results are expected to be published in late June or early July. The values estimated in this new study are among the most critical for our elected leaders to manage the reopening of the county through future phases. Under the direction of the Nevada Division of Public & Behavioral Health, the remaining four counties are completing their surveys soon with a more than adequate sample size.
The recent report by the National Association of County and City Health Officials (NACCHO) recommends 30 professionals per 100,000 population indicating the following levels for Five County Metro Reno:
Washoe County’s Road to Recovery document states they need 35 FTEs of staff to fulfill the goals in the current contact tracing model, including replacing most of the staff temporarily doing the tracing. As detailed above, reaching the target of 30 professionals per 100,000 population will require 157 in Washoe and a total of 213 contact tracers in the five counties in total.
Ashleigh Faulstich, the state’s Senior Epidemiologist in charge of contact tracing for COVID-19 will ensure all five counties implement as many of the best practices as possible recommended in the National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the US, co-created by the Johns Hopkins Center for Health Security and the Association of State and Territorial Health Officials (ASTHO).
Contact tracers reach out to everyone tested positive for the virus, find out whom they might have inadvertently exposed and encourage them all to avoid infecting others. Contact tracers have to be able to talk as easily with a business executive as with a migrant worker. Crucially, they must possess the kind of emotional intelligence making people want to talk to them. The challenge is described in a May 23 article in The New York Times titled: Contact Tracing Is Harder Than It Sounds.
For the elected leaders of the five counties, it’s relatively easy to estimate the extremely serious economic effect within our community of moving the dates of subsequent phases of reopening.
However, there is a cost in lives in need of estimation to balance the economic effects. Given all the noise online and in the media, I suspect many residents do not understand the accurate biostatistics necessary to help our elected leaders at the local, county and state level to weigh the consequences of the two portions of the decision. In addition to the lives lost, dialing back restrictions if a second surge occurs will be extremely challenging.
The mission of Regenesis Reno is to inspire Western Nevada to flourish by co-creating a sustainable, equitable, and regenerative community strengthening our common roots and unlocking our full potential for a thriving future. The response to COVID-19 is the springboard for all of us to flourish.