Georgia’s Top Public Health Official: ‘If We Have Lost The Public’s Trust, I Hope That We Gain It Back’

An official walks near a COVID-19 testing site to guide traffic on Georgia Tech's campus last month. The state's top public health official, Dr. Kathleen Toomey, has promoted her plan to hire an army of disease detectives to track down the contacts of everyone in Georgia who tests positive for COVID-19.
An official walks near a COVID-19 testing site to guide traffic on Georgia Tech's campus last month. The state's top public health official, Dr. Kathleen Toomey, has promoted her plan to hire an army of disease detectives to track down the contacts of everyone in Georgia who tests positive for COVID-19.
Credit Brynn Anderson / Associated Press

For weeks, Dr. Kathleen Toomey, the state’s top public health official, has promoted her plan to hire an army of disease detectives, called contact tracers, to track down the contacts of everyone in Georgia who tests positive for COVID-19.

This week, the commissioner of the Georgia Department of Public Health sat down with health reporter Sam Whitehead, host of “Did You Wash Your Hands?”,  to explain her agency’s progress in setting up the contact tracing program.

Toomey also addressed recent errors on her agency’s data website tracking COVID-19 data for the state.

This interview has been edited and condensed for clarity.

You have said the state wants to hire 1,000 contact tracers by mid-June. Where are you in reaching that goal?

We have really done an extraordinary job in being able to identify candidates and bring them on board very quickly. We’ve received almost 2,000 applications as of May 17. And already we have about 200 interns from universities and schools of public health on board and are getting additional applications for temporary health workers.

But at the rate we’re going and bringing people on–both the interns from the schools as well as reaching out and advertising this position that’s available, which will place individuals across the state–we will reach our goal of 1,000 contact tracers by mid-month next month, if not sooner.

Public health groups, such as the Association of State and Territorial Health Officials, say states should try to hire 30 tracers per every 100,000 residents. In Georgia, that would be upwards of 3,000 contact tracers. So, what are you planning to do in the event this workforce of 1,000 simply can’t handle the work?

We took our estimates from Johns Hopkins, I believe it said seven contact tracers for 100,000 [people]. That’s where we made our original estimate. But because we have the capacity to bring people on board quickly, we have the agility that if we do find that 1,000 isn’t sufficient, we will be able to ramp that up quickly and add to that. So, I am not worried about that. You know, we made that initial assessment–we have to have a ballpark number based on this original seven per 100,000 estimate–but we have the capacity and ability to bring more people on board.

We have also reached out to the CDC Foundation, and they have helped us enormously both with identifying an individual to help us do training of the contact tracers, because you want the tracers to be formally trained and be able to provide the same capacity throughout the state. So, we have a trainer, as well as a deployment coordinator. This is almost like a logistical military operation. You have to use logistics to deploy across the state, consistent with the population as well as the number of cases occurring. So, we have that capacity to do that. So, I’m actually very confident. We made our original estimate. We have the agility in the system, as well as the support from external groups, both university systems as well as the CDC Foundation, to be able to deploy additional staff as necessary.

In its gating criteria for states to start to open up, the White House says it is states’ responsibility to have the ability to trace contacts of positive COVID-19 cases. Do you interpret that as tracing every contact of a positive case? Is that your goal to be able to trace every contact?

Well, to be able to interview every individual who is identified as a case and, hopefully, identify close contacts very quickly. The most important thing for this to be an effective disease-prevention tool is that the intervention occurs quickly. Because if it’s too long afterwards, the contacts themselves may have become infected and infected others. So, you want to break the chain of transmission. And that’s why we wanted to have this kind of capacity, not only here in the metro area but across the state wherever there’s cases occurring.

So, I feel good about our ability to respond quickly, and I feel good about both the individuals we have onboard trained with a partnership with the Georgia Poison Center that’s answering calls, as well as the use of a new customized Google app which will help streamline some of the work that we’re doing.

I think perhaps one of the lessons from the economy is that there are individuals who are actually very anxious to take this work and have applied for these jobs. We have had many more applications than we have spaces available right now. So, with over 4,000 applications for these positions, we can easily bring on additional staff as necessary.

From my perspective, the one piece that perhaps is not particularly evident is the most important is the work in the community. The community has to understand why this is important, why this is part of disease prevention, why it’s important for you and your family to answer that phone call or that text message that you get from the app and to cooperate with us if you’ve been identified as a contact. So, a lot of the work after we bring everyone on board and get them trained and staffed out into all the districts across the state, you’re gonna see us doing a lot of work with community partners, the faith community, with other community-based organizations, with the business community.

With the staff you have now, do we today have the ability to contact and contact trace every positive case in the state?

With the staff we have today, we can contact every case. We are contacting every case. And we will continue to expand that capacity over the next few weeks. So, we will be able to do every case. Right now, the average number of contacts per case is, I think, two.

But I think one of the things to point out is–I feel like the metrics of this is so important, that we will be posting on our website our contact tracing metrics, from the startup of this ramping up effort. So, you can see exactly how many cases and contacts we’ve been able to identify, and that probably will be posted as early as Monday, Memorial Day.

There was a bit of a snafu over the weekend where some testing numbers were included on your COVID-19 tracking website that DPH later said shouldn’t have been. But that was only one of a number of issues recently– concerns about the data that DPH is putting together and disseminating. Do you still feel like there is public trust in that data?

Well, I think it’s important that the public do trust our data, because that’s the information that both they need to trust to be able to make decisions about themselves and their family, and policymakers need to look at to make decisions about how we move forward with the state, and business owners that make decisions about the potential risk for opening up their places of employment.

So, we are working hard to ensure that those data are accurate and reflect the most up-to-date information. Sometimes graphics aren’t clearly the optimal way to present data. There are other ways to present data. Data are a tool. They aren’t the end in themselves. They are a tool to help us make decisions. And we are continuing and will continue to make every effort to improve the quality of our data to ensure everyone–the public as well as policymakers–have the information they need.

The DPH data dashboard has gotten a lot of attention recently, and it’s not really been positive. Do you feel personally like people have lost faith in this data?

I don’t know if people have lost faith. I mean, you are in a better position to make that judgment. My job is to ensure that we have the most accurate up-to-date data presented in a way that’s understandable. As I said, some of the graphics may not have been the most effective to identify information. We’re working with SAS, the programming company, to help us develop graphics, and some of them may not have been the ideal for the presentation of data that was chosen.

We’re going to continue to do better. I hope that if we have lost the public’s trust–and I hope that we haven’t–I hope that we will gain it back, because it’s important that we work together because the only way we can fight this pandemic is to fight it together as a community–public health together with the entire community, working together with the public’s trust.

Who is making the call about what information the Department of Public Health is displaying on its data page? Is that being made within your agency?

Listen, I’m gonna have to run. I actually can’t answer this right now, because I’m getting called by the Governor’s office.

But I think that, as I’ve said before, there are many decisions being made about how the decision is being made to open up or not. The data are one piece of that decision.

Is that decision being made by your agency?

I mean, the decision of what goes up on the website is being made in tandem with a lot of different–with a lot of different agencies.


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