Baltimore’s mayor and five county executives called on Maryland Gov. Larry Hogan and the Maryland Department of Health in a letter late last week to provide more specifics about the state’s contact tracing operation for COVID-19, the disease caused by the coronavirus.
Citing a need for more clarity on the pandemic’s reach before the new academic year begins, the letter, addressed to the Republican governor, seeks more collaboration between case investigators and local health departments.
It was signed by Baltimore Mayor Bernard C. “Jack” Young, Baltimore County Executive Johnny Olszewski Jr., Anne Arundel County County Executive Steuart Pittman, Howard County Executive Calvin Ball, Montgomery County Executive Marc Elrich and Frederick County Executive Jan Gardner — all Democrats.
Specifically, the six executives urged Hogan and health officials to share more data on the state’s website and with their health departments.
They’re seeking information such as the turnaround time between when a person gets tested, when their results come back positive and when a person is contacted by a tracer; how the contacts who shared the virus came in touch with one another; and what workplaces appear vulnerable to its spread.
The letter underscores the brewing tension between the governor and individual jurisdiction leaders, who have publicly criticized and even diverged in strategy from Hogan since he began easing the lockdown and reopening this spring. Hogan’s deference to local figures to make decisions about their counties’ policies mirrors that of President Donald Trump, a Republican whose administration has largely left policy decisions up to state and local governments and has not drafted a federal plan.
Maryland’s full-scale contact tracing operation launched in June, three months after the pandemic reached the state in March. That delay concerned public health experts and state lawmakers worried about the lost time. Others worry that dayslong delays in getting test results across the country render contact tracing largely ineffective.
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Contact tracing has been used by public health officials for decades, with callers looking for potential cases of HIV, sexually transmitted diseases and other infections.
When done successfully, contact tracing can stem the flow of an infectious disease by establishing a chain of transmission and identifying possible outbreaks. The data can then influence behavior and empower people to make decisions about quarantining, returning to work or even going out to eat. But it requires the cooperation of those infected.
Maryland’s contact tracing data has shown that many infected individuals attended family gatherings, house parties or outdoor events such as weddings.
”When the governor reported information from contact tracing data at a recent press conference to make points about strategies that counties should undertake, we felt strongly that the time had come for raw data to be shared with us and our health officers,” Anne Arundel’s Pittman said. “Somehow we need to coordinate coronavirus response strategies in this state and access to state data about our jurisdictions would be a start.”
James Bentley, a spokesman for Young, said the mayor signed on to the letter because the additional requested information would help better guide Baltimore’s response to COVID-19, especially around testing and contact tracing efforts. The city has recorded more than 13,000 coronavirus cases, according to Baltimore health data.
Since the state began tracking contact tracing data, more than 30,000 cases have been logged in covidLINK, the health department’s case investigation platform, according to data maintained by health officials. Of those 30,619, the state reports that 24,686 people have been successfully reached, and 15,292 have provided at least one contact for the unit to contact.
Maryland has amassed a contact list of more than 42,000 people, according to its data, and has interviewed about 25,000 of them. For the week of Aug. 2 to Aug. 8, some 4,000 infected individuals provided more than 7,000 contacts, and case investigators completed interviews with about 4,000 of them.
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But the leaders of the six jurisdictions said that those efforts could be improved.
In the letter, they cite a need for investigators to broaden the list of symptoms tracers ask contacts about to include congestion/runny nose, diarrhea, nausea/vomiting and fatigue. They want raw data files of cases and contacts to be distributed to individual counties, definitions for terms the state uses like “family gatherings,” and more clarity on the state’s testing plan, especially as it pertains to rapid tests.
The executives also asked to look at the forecasting models being used for the state to predict trends for the fall and winter.
Hogan spokesman Mike Ricci said state health officials are working on a formal response to the letter. He noted, however, that the state already submitted a testing plan to the federal government last month, which he said the local leaders “are welcome to review.”
Ricci said more information on the use of rapid antigen testing will be forthcoming “in the days and weeks ahead.”
Meanwhile, on contact tracing, Ricci said the highest-risk gatherings are family events, the highest-risk locations are workplaces, and the highest-risk occupation is health care.
“We will continue to share these trends and data points with Marylanders so they have the information they need to help us find and fight the virus,” Ricci said.
Angela Lagdameo Cabellon, the chief innovation officer and deputy chief administrative officer for Howard County, said documents showing how the state is forecasting cases in the fall and winter would be particularly helpful to have before the school year begins.
”As we go into the fall and the winter — and as schools begin instruction — we want to be already armed with the information for planning purposes to be able to communicate with health officers on trends that we’re seeing,” Cabellon said.
[ How to add your voice to our coverage of COVID-19 in Maryland ]
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Obtaining that data would allow the counties to better collaborate and partner with each other, she added.
“Oftentimes data and information is shared and applied on an aggregate level for the state, but of course it’s the county executives and the health officers who really need to look at a jurisdiction’s specific needs,” she said. ”As jurisdictions have stood up different data platforms and as epidemiologists are combing through data, it’s so important that there’s a shared understanding and access to the data and information that the state has.”
States and counties nationwide have differed in how much data they make public, which can sow confusion among local leaders and shape policy decisions that could endanger people, said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security.
Maryland health officials, though working hard, could use more resources and make their knowledge more transparent, Watson said. Some states, such as Louisiana, go so far as to list information on their websites about where outbreaks took place and the number of people affected in each setting.
If the state cannot dramatically enhance its contact tracing or data sorting operation, it must do better at getting test results back to people with the coronavirus so they can make informed decisions, she said.
“The program should continue to try to staff up,” Watson said, “but in the meantime, the governor should look at areas with increasing case numbers, and leadership should consider more social distancing or business restrictions to bring numbers down.”
Baltimore Sun reporters Pamela Wood and Wilborn P. Nobles III contributed to this article.