-Declaration of Independence
There is a reason why “Life” leads the list of “unalienable rights” specified in the Declaration of Independence. No reopening of the economy can proceed safely without first paying attention to survival.
Since the Trump administration has fallen down on its core responsibility to keep Americans safe, it falls to governors, mayors and city managers to step into the federal breach and assume responsibility for getting us through this catastrophe with as little damage to health and the economy as possible. Testing, which has become the poster child for the Trump government’s epic fail, is still woefully inadequate after two-plus months of lackluster attempts and a bodyguard of blatant administration lies beginning with Trump’s March 9 CDC visit when he claimed that “anyone who needs a test can get a test.” That was not true then and it’s not true now. While other countries test vast swaths of their populations, the United States cannot.
We hear a great deal of mumbo jumbo every day at Trump’s surreal press conferences about testing, mainly lies about test availability and unwarranted self-praise for the feeble number of tests being conducted. The real story about testing is that it is yet another of the many areas where the Trump administration has repeatedly demonstrated that it cannot manage the Covid-19 crisis. Again, the absence of federal competence means that it is up to state and local leaders instead. But testing is only the first step in the process of re-opening the nation and rebuilding our decimated economy. Contact tracing is the crucial next step.
Contract tracing means the ability to identify people who may have been in contact with someone who tests positive so that they can get treatment, be monitored, quarantined and kept from spreading the infection to others. The Trump administration, incredibly, has no plan for contact tracing, yet another epic fail. As with everything else concerning the virus, the buck has been passed to the states.
South Korea understood this necessity from its first alert (the same day as the U.S.) that a pandemic was imminent. The country immediately took steps to implement widespread testing and contact tracing, and the results have been impressive. Similarly, Taiwan and Germany have demonstrated competence in combatting the virus. By their quick responses, all three countries put the U.S. to shame.
States, municipalities and tribes need to act now to put effective contact tracing programs in place and not rely on the inept Trump government to perform any function essential to this process. That means hiring and training an army of contact tracers and providing them with the resources and protocols they will need to do this incredibly important job effectively. While a competent federal government would task the U.S. Office of Personnel Management (OPM) with recruitment and training of contact tracers—these two basic functions are OPM’s bread-and-butter—this won’t happen because Trump and his sycophants live in the moment. Judgment and planning are beyond them. It will be up to lower levels of government to get this right.
Successful foreign models (e.g., South Korea, Germany) for recruiting, training and managing contact tracers should be consulted and applied here. The Trump administration’s unreasoning hostility to anything foreign should not deter governors and mayors from directly contacting the knowledgeable authorities in those countries and learning from them how to conduct an effective contact tracing program. At a minimum, it should include:
- The basics of contact tracing
- Interviewing skills
- Key questions to ask
- Likely questions to answer
- Quarantine monitoring and follow-up
- Health information privacy and confidentiality
- Cultural sensitivity
- Communicating with the hearing-impaired
- Reporting requirements
- Continuous coaching and mentoring for quality improvement
There is no percentage in delaying contact tracing program implementation in hopes that the Trump administration will get its act together. It won’t. States, cities and tribes must act now or suffer the life-and-death consequences.
May 1, 2020