When does fighting COVID shift to coping? Kansas moves closer by ending contact tracing

Health leaders in Kansas, Missouri and other states are shifting how they view COVID-19 as the pandemic enters its third year, acknowledging the reality that the virus is here to stay.

It’s no longer an infection that can be stamped out but a disease that must be managed.

Kansas has taken two major actions this week that underscore the transformation. The Kansas Department of Health and Environment on Tuesday announced it will end contact tracing efforts by the end of the month. That comes after top health and education officials on Monday told school districts they can take a 30-day break from contact tracing as omicron courses through buildings and forces some districts to cancel class.

“As we enter the third year of this pandemic, public health has to begin to adjust the level of response to help alleviate the strain on the Public Health system,” KDHE Acting Secretary Janet Stanek said in a statement on the contact tracing changes. “The pandemic is far from over, but this step is a move toward managing COVID-19 as an endemic disease. The responsibility of protecting yourself and others belongs to all of us.”

The transformation is occurring amid the most intense surge to date, driven by omicron. Official case counts have soared far past previous peaks in recent days, with countless additional cases detected by at-home tests going undetected.

Hospitalizations have also climbed to new highs, creating a split-screen pandemic. Catching COVID-19 is an increasingly common experience, and relatively mild for most vaccinated individuals, but mostly unvaccinated patients are severely straining the health care system.

Contact tracing has always been a key tool for public health professionals, a way of limiting the spread of a disease by getting exposed individuals to quarantine before infecting others. But KDHE’s announcement acknowledged what had become obvious among health officials: it was a practice with diminishing returns. Tracing was time-intensive and staff increasingly encountered members of the public who refused to cooperate.

A memo dated Monday, signed by Stanek and Education Commissioner Randy Watson, gives schools permission to stop contact tracing for the next 30 days as a way to temporarily relieve a “pressure point” as educators work to keep schools open. Stanek said the recommendation will be re-evaluated at the end of the period.

In Johnson County, health officials have already curtailed contact tracing operations. The Blue Valley school district told families earlier this month that it is no longer providing the county health department with close contact information, and that the health department will no longer notify staff and students if they may have been exposed.

According to the memo, districts that can continue to identify close contacts should do so. But judging whether a district is capable of contact tracing appears to rest with local school officials.

“For school districts struggling to identify and notify close contacts during this Omicron surge, we propose a temporary suspension of this practice,” the memo says.

When will COVID-19 be endemic?

Even as Kansas signals it is headed toward an endemic approach to COVID-19, the state needs to get through the current surge of infections before truly making the switch, Stanek said.

“Moving forward to an endemic stage is going to have to be after the surge, there’s no real prediction on what that timeline’s going to be,” Stanek said in a brief interview. “We are hopeful that that’s where we’re heading.”

Matt Lara, a KDHE spokesman, said in an email the state will reach endemic status once case rates are predictable and “most people have built up an immunity to the virus” that can withstand new variants. In the meantime, an end to contract tracing was a necessity as health departments could no longer keep up with the rapid increase in cases.

“What we’re really hoping to do now is move into a phase where we are arming people with the knowledge that they need to make their personal decisions,” KDHE epidemiologist Farrah Ahmed said.

In Missouri, state health officials don’t appear to have called COVID-19 endemic. A spokeswoman for the Missouri Department of Health and Senior Services didn’t immediately respond to questions.

But Gov. Mike Parson’s approach has been to move the state away from an emergency footing.

Parson allowed a state of emergency to lapse at the end of December and referred to it as a “final step” that would allow Missouri to move forward. “We all now know how to best fight and prevent serious illness from this virus,” he said at the time.

In Republican-dominated states, some conservatives have been calling on health officials to describe COVID-19 as a virus that’s not going anywhere.

Missouri Senate Majority Leader Caleb Rowden, a Columbia Republican, earlier this month said case numbers are now largely irrelevant. “It is highly unlikely that you’re going to go through the next, if you haven’t already, through the next year in your life and not have COVID-19,” Rowden said.

Kansas Rep. Brenda Landwehr, a Wichita Republican who chairs the House Health and Human Services Committee, said KDHE’s announcement was logical and a sign of progress. She advocated for further loosening of public health guidelines.

“It’s kind of evolving into more of what we deal with with our flu stuff,” Landwehr said. “Hopefully we get people away from the fear.”

Clay Goddard, a former director of the Springfield-Greene County Health Department, said contact tracing is extremely time intensive to undertake. It isn’t typically performed for flu, he noted.

“With the case numbers that we’re doing with omicron and this wave, contact tracing – really, it just becomes unmanageable because of the numbers,” Goddard said.

Dennis Kriesel, executive director of the Kansas Association of Local Health Department, said the magnitude of cases in some areas had already made it impossible for health departments to keep up. The agency’s announcement in some ways reflected an acceptance of that reality, he said.

Contact tracing on paper makes a lot of sense, he said, but the volume of cases coupled with low levels of cooperation from the public meat tracing “wasn’t achieving its public health function,” he said.

Kriesel said endemic operations were the inevitable end point after early pandemic lockdowns failed to stop the spread of the virus and the U.S. was unable to vaccinate its population before more vaccine-resistant variants arrived.

“Endemic status is ultimately the end game,” Kriesel said. “It has to be because we just can’t beat it.”

The Star’s Jeanne Kuang contributed reporting