Cities and counties are at various stages of reopening after shutdowns to mitigate the coronavirus spread. Alarmingly, two-thirds of states are experiencing a surge in COVID-19. Several factors must be in place for jurisdictions to open for business safely and for people to confidently patronize the services and activities they typically enjoy. The Bipartisan Policy Center notes three key tasks to suppress the coronavirus spread:
- First, elected officials must follow the data and make evidence-based decisions with respect to reopening, pausing, and reinstituting community mitigation measures.
- Second, testing and contact tracing must expand to limit chains of transmission.
- Third, the American public will need to continue to adhere to physical distancing and the use of cloth-based masks in public to protect themselves and others.
Evidence-Based Decisions on Reopening: How severe is the spread of COVID-19 in your community, and what actions should you take?
Early July a convergence of top public health research researchers released an on-line risk assessment map that local residents and officials can use to track state and/or county COVID-19 risk levels. This resource provides guidance and tools on the intensity of actions for green, yellow, orange or red risk levels.
- Green: On Track for Containment – monitor with diagnostic testing and contact tracing;
- Yellow: Community Spread – rigorous testing and tracing program advised, along with mask-wearing and physical distancing;
- Orange: Accelerated Spread – considered “dangerous,” stay-at-home orders and/or rigorous testing and tracing programs advised;
- Red: Tipping Point – stay-at-home orders necessary along with rigorous testing and contact tracing.
Diagnostic testing and contact tracing are critical regardless of risk levels.
Since March, diagnostic testing capacity has expanded across the country, although access varies by region. Health departments at the state and local levels are expanding capacity for contact tracing. An NPR analysis found that as of mid-June, only seven states and the District of Columbia have enough active contact tracers to track contacts of positive cases in their areas on a timely basis.
Test results in current surge spots of the country often exceed 25%, indicating insufficient testing to measure community spread. Each positive test calls for an investigation from a contact tracer to identify and track down potential contacts of that person and to help them safely isolate for two weeks to prevent further transmission.
The Economy and the Public’s Health
The better jurisdictions manage testing and tracing, the fewer restrictions it may need on gatherings and economic activities. Collaboration among government (at both local and state levels), community members, businesses and organizations are vital to protect the public’s health. Coordination is key to ensuring adequate testing, contact tracing, and consistent public health practices reach individuals, businesses, and communities. And elected officials must center people most impacted by COVID-19 and structural violence, and build trust with those residents.
Cities, Towns and Villages:
Local leaders have the credibility and relationships with their constituents. They can provide transparent, timely communications to businesses and residents and boost access to Black, Indigenous, LatinX, Communities of Color, and low-income people. Critical roles of city leaders include:
- Promote and provide consistency re: public health guidelines and safe practices: wear face coverings, washing hands frequently, physical distancing.
- Partner with health providers to increase capacity for widespread testing to track spread, with data disaggregated by race, ethnicity and socioeconomic status.
- Support robust contact tracing to identify, trace and safely isolate people who are infected and quarantine for those exposed to them.
- Track surge capacity in hospital and ICU beds to treat people who need hospitalization.
- Manage expectations and be prepared to enact selective measures to mitigate illnesses and deaths based on local conditions and pending patterns of spread through the summer into the fall and winter months.
Counties are on the front lines protecting communities from the coronavirus pandemic. Counties support more than 900 hospitals and operate more than 1,900 public health departments, which are the ground troops in the fight against COVID-19. During this crisis, NACo is focused on disseminating useful information to counties, and facilitating the exchange of effective strategies and approaches through federal policy resources, research and data, online toolkits, webinars and issue briefs.
CVS Health/Aetna has been on the front lines of COVID-19 Testing through their presence in nearly 10,000 communities across the country and unique mix of assets to help make health care accessible, simple and affordable. They have engaged city, county and state partners as well as other businesses in providing diagnostic testing to help meet the needs of consumers, the business community and populations disproportionately impacted by the virus. Programs have included testing with schools, employer-based “return to work”, and meeting community needs. CVS Health/Aetna is also capturing lessons learned to be shared in an upcoming webinar with NACo and NLC.
To learn more, join a collaborative webinar by Aetna, the National Association of Counties and the National League of Cities on July 15 from 2:00 to 3:00 pm ET. Click here to register.
Hear from city, county and corporate leaders about their joint efforts to mitigate COVID transmission so that jurisdictions can safely reopen and residents can participate in activities they enjoy. This webinar will also cover important considerations around vulnerable populations including people of color and hard-to-reach communities. Speakers: Dr. Oscar Alleyne, Chief of Programs and Services, NACCHO; George Dunlap, Chairman, Mecklenburg County Commissioner; Leanne D Gassaway, Vice President, State Government Affairs; Dr. Anjali Talwalkar, Principal Senior Deputy Director, DC Health.
Contact tracing is a Race, but few U.S. states say how fast they’re running, Washington Post, July 4, 2020
Containing COVID Spread Amidst Reopening and Protests, CitiesSpeak, June 16, 2020
Building COVID-19 Contact Tracing Capacity in Health Departments to Support Reopening America Society Safely – NACCHO Position Statement
About the Author
Kitty Hsu Dana is the Program Director for Health & Wellness at the NLC Institute for Youth, Education, and Families.