Montgomery County curtails contact tracing to focus on vaccination

FONDA — Montgomery County is making a significant change in its response to the COVID-19 pandemic, shifting from tracking and tracing existing infections to vaccinating against future infections.

County officials announced the change Monday, and also said they’d be ending the time-consuming effort to verify state data on numbers of the county residents infected with or killed by the virus.

“Obviously tracking and tracing is not preventing the spread of COVID,” county Public Health Director Sara Boerenko said.

Through 10 months of the pandemic, 1,516 Montgomery County residents have been confirmed infected with the virus, yielding a positive test rate of 2.8 percent, which places it below the statewide average of 4 percent.

But COVID has been surging in the county for weeks — nearly 300 new infections were confirmed just in the past seven days.

As of Monday, the county’s only hospital — St. Mary’s Healthcare — had 30 COVID-positive patients admitted for treatment. The number can change significantly from day to day.

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By the state tally, 53 county residents have died of COVID, significantly more per capita than any nearby county.

Boerenko said prevention is always better than cure, and that’s what the county will focus on.

It’s a source of frustration for Boerenko that her department hasn’t received an allocation of vaccine yet to help slow the spread within the county of 49,000 people.

St. Mary’s Health has begun vaccinating top-priority individuals — 900 as of Monday — and is doing a fine job of it, she said, but the Montgomery County Public Health Department has not received a single dose yet for lower-priority individuals.

Mass public vaccination is a task the county has planned for and is equipped to do, and has rehearsed as recently as last year, though that was for a hypothetical anthrax outbreak, not COVID.

It also uses a flu shot clinic each year as a rehearsal, administering 100 shots in short order from a portable clinic.

“We’re very good. This is what Public Health does,” Boerenko said.

During the first wave of the pandemic, state health officials set out an aggressive regime of contact tracing as the way to halt the spread of COVID. Statewide, the COVID infection rate dropped in the late spring and summer amid the tracers’ efforts and it rose in autumn despite the tracers’ efforts.

Boerenko said the state hasn’t responded to her notification that her department’s staff is needed for other duties and the state would have to pick up tracing of most Montgomery County infections.

She and her staff also will stop scrubbing through state data each day to quantify the number of infections and deaths in Montgomery County.

“The community has relied on us very heavily for real-life numbers,” she said, but producing them is time-consuming at a stage in the pandemic where all hands are needed for other work.

Early on, state data on positive tests was skewed but it is now accurate, Boerenko said. The 1,516 infections listed countywide by the state as of Monday morning is about the same as the county’s own tally, she said.

Mortality data is a harder nut to crack.

The state Department of Health lists 53 Montgomery County residents dead of COVID as of Monday morning, while the county itself lists just 24.

Boerenko doesn’t doubt there are 53, but she’s been notified of only 24.

There’s often a lag in notification when a county resident dies outside county borders.

“Sometimes it’s months and months after someone passes away that I get their death certificate,” she said.

Boerenko and County Executive Matthew Ossenfort took a moment Monday to address another issue: COVID in nursing homes.

COVID has affected the five elder living facilities locally as it has affected those elsewhere — quite severely in some cases, mildly in others.

One current rumor is that the infections number in the hundreds at Capstone Center for Rehabilitation and Nursing, Ossenfort said. It’s actually about 50.

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The death toll in the county’s five nursing facilities is harder to ascertain, Boerenko said, again because of the delay in reporting but also because nursing home residents who die in hospitals are not counted as nursing home deaths under the state’s system.

She could not provide the number of deaths at the five local facilities but said the deaths listed by the state are accurate or closer to accurate than her own. They are:

Capstone, 11 deaths
Palatine Nursing Home 0 deaths
River Ridge Living Center, 10 deaths
St. Johnsville Rehabilitation and Nursing Center, 0 confirmed and 1 probable death
Wilkinson Residential Health Care Facility, 14 deaths

The number of infections and deaths at a given business or facility often boil down to the same causes as for the county and state in general, Boerenko said:

“Folks are making poor choices in their personal lives and then going to work.”

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