The new coronavirus has presented one mountain after another: Making sure we have enough hospital beds. Enough face masks. Enough tests.

Now Pennsylvania, as it prepares to begin easing the coronavirus restrictions, faces the next big mountain — contact tracing.

Contact tracing is the process of finding people who had close contact with someone who tests positive, to make sure they aren’t also carrying the infection and spreading it. Once located, close contacts will be tested and, if positive, required to quarantine for 14 days.

It’s a major part of Gov. Tom Wolf’s plan to re-open the state. In addition to criteria including having fewer than 50 cases per 100,000 people during the previous 14 days, regions will have to be ready with sufficient contact tracing.

Pennsylvania must accomplish a lot, and do it fast, for that to happen.

Contact tracing is a labor-intensive job. It’s unclear how many people will be needed. State Rep. Dan Frankel, in announcing a bill to help the state put contact tracing in place, said it’s hard to estimate how many. Massachusetts recently hired 1,000 people for the task at a cost of $44 million. California recently announced plans to hire and train 10,000 people to be tracers, and Washington State plans to have 1,500 tracers in place by the second week in May, according to the Associated Press.

As recently as last week, Wolf said Pennsylvania was essentially at the foot of the mountain, unsure how contact tracing will be accomplished, how much it will cost, and where the money will come from. Secretary of Health Dr. Rachel Levine said Monday she expects to announce a more detailed plan by the end of the week. She has said at least some contact tracing can be done by state-employed nurses based in county offices around the state. But those offices sometimes have only one nurse, sometimes responsible for two counties.

It’s estimated it will take six hours to trace the contacts of someone who had 10 close contacts, according to the Associated Press.

States all over the country are trying to ramp up for contact tracing, seen as essential to preventing coronavirus from roaring back after restrictions such as closures of non-essential businesses are eased. The plan is for people feeling a sore throat or cough or other COVID-19 symptom to quickly get themselves tested. This, along with subsequent contact tracing, is intended to isolate the people with coronavirus, so others can return to work and begin once again patronizing businesses without great fear of getting sick.

In addition family members and co-workers, the process involves tracking down anyone who was within six feet of an infected person for more than 10 minutes, according to some approaches.

Since some people don’t become severely ill until a week or more after becoming infected, testing and contact tracing can eliminate many days when a person might otherwise be spreading the infection.

Some hospital systems may be able to play a role. For example, Geisinger says it recently began contact tracing, and State College-based Mount Nittany Health System and Penn State College of Medicine plan to collaborate on contact tracing.

Matthew Ferrari, an epidemiologist and researcher at the Center for Infectious Disease Dynamics at Penn State University, says well-established models for large-scale contact tracing already exist. Such models are commonly used in Third World counties facing disease outbreaks, he says.

There’s also a rush by technology giants such as Apple and Google to create software to enable smart phones to help with contact tracing. Those, however, may have to overcome privacy-related concerns.

Contact tracing in general is expected to cause privacy-related unease for some, although the process is intended to ensure confidentiality for people who test positive. Ferrari says it’s beneficial for contact tracers to come from the local community, in order to help foster trust. He also says contact tracing can provide local jobs. While the jobs would be temporary, they could help to offset job losses stemming from the coronavirus shutdown.

Yet contact tracing involves scaling a sort of twin peak. For it to work, it requires the diagnostic test for COVID-19 to be widely and immediately available, with results returned in a day or less. Because of supply shortages, providing the necessary level of testing remains another uphill climb.

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