An Unlikely State Emerges as Nation's Premier Contact Tracer

"On a per-capita basis, North Dakota is third in the nation in testing, effectively tied with Massachusetts and trailing only Rhode Island and New York," write Ben White and Renuka Rayasam for the POLITICO Nightly: Coronavirus Special Edition of May 7, based on an email by healthcare reporter, Dan Goldberg. The Peace Garden State is one of eight states that was never fully shut down.

On May 6, North Dakota’s Republican Gov. Doug Burgum reported that 2,211 tests were processed, the highest daily total yet, write White and Rayasam. The ratio of positive cases to total tests administered, known as the test-positivity rate, on May 8 was one of the nation's lowest, 3.6%, according to the North Dakota Department of Health, a level close to that of South Korea.

A high positive rate, like the 15% for the U.S. (calculated from the COVID Tracking Project on May 8), is not a good sign. However, it is sign of progress in that is down from the 20% reported by Keith Collins of The New York Times in the April 17 source article for the post referenced below.

“If you have a very high positive rate, it means that there are probably a good number of people out there who have the disease who you haven’t tested,” said Ashish Jha, the director of the Harvard Global Health Institute in a post last month on their new report calling for tripling the amount of testing to 500,000 daily.

“You want to drive the positive rate down, because the fundamental element of keeping our economy open is making sure you’re identifying as many infected people as possible and isolating them.”

Harvard almost doubles their minimum testing quota

The Harvard Global Health Institute partnered with NPR and released an updated version of their model of projected state testing targets on May 7, "looking at how many tests we think each state should be ready to perform by May 15." 

The numbers are sobering: Overall, our need for testing has only increased over the past weeks. Fewer than a dozen states have gotten ahead of this virus.

Nationwide, our estimates show that the U.S. will need to be doing at least 900,000 tests daily by May 15.

"Harvard's testing estimate increased, says Ashish Jha, director of the Global Health Institute, because the latest modeling shows that the outbreak in the United States is worse than projected earlier," according to NPR (a 4-minute listen plus interactive graphics for individual state minimum testing requirements).

Contact tracing champion

"NPR reported [originally published on April 28]  that North Dakota -- population 762,000 -- is the only state to meet an estimated need of 30 contact tracers per 100,000 people," reported Jack Dura for The Bismarck Tribune on May 3 (source article).

North Dakota contact tracing administrator Vern Dosch said 352 people have been trained on the techniques of finding people who have been close to someone with COVID-19.

"Robust contact tracing" is one of eight priorities [pdf] of the governor's "ND Smart Restart" for rebuilding economic activity. 

The other person in charge of contact tracing is Brigadier General Robert Schulte of the North Dakota National Guard. "Schulte said each infected person in North Dakota has, on average, six contacts," reports Goldberg for POLITICO.

Tracing and testing those contacts, and keeping them from infecting others before they display symptoms, helps explain why North Dakota, which never issued a stay-at-home order, still has one of the lowest positive test rates in the nation.

Reopening North Dakota

Gov. Burgham had either shut down or restricted access to nonessential businesses including restaurants and bars, since March 20. The Washington Post's guide, "Where states are reopening after America’s shutdown," examines every state and "is tracking the extent of this reopening alongside the rate of new infections and will update this page frequently." Here's the status for North Dakota:

On April 29, the governor issued an order that suggested many of the closed businesses — including bars, restaurants and salons — could reopen beginning May 1. Movie theaters can reopen at 20 percent capacity. Gyms can reopen with additional restrictions. Campgrounds and marinas will reopen May 9.

As for the remaining two containment strategies, isolating people who test positive for COVID-19 and quarantining their contacts found by the tracers, Gov. Burgum has issued three executive orders to that effect, the most recent one [pdf] signed on April 21.

Related in Planetizen:

• States to Train Public Health Armies to Move Beyond Mitigation to Containment, April 27, 2020
• President Trump's Plan to Reopen the Economy Rests with States, April 20, 2020
• U.S. Needs to More Than Triple Testing Before States Can Open, Study Says, April 20, 2020