As Travis County's COVID-19 caseload and related hospitalizations continue to surge, Austin Public Health is grappling with its limited resources—and recently announced that it will restrict testing and contact tracing to specific cases.

"Austin Public Health, the city and the county simply don't have the resources, the personnel, to provide for everybody everything they need," Austin-Travis County Interim Health Authority Dr. Mark Escott told Travis County commissioners Tuesday.

In response, APH is shifting its pandemic strategy.

Testing

APH opened up its free testing service to all residents on June 5, following mass protests, but announced last weekend that it would scale back, only offering tests to those who are symptomatic, live in group settings like nursing homes, or are members of other vulnerable populations.

Dr. Escott said APH is also looking to transition at least some of its testing load to private companies, and asked residents with health insurance to seek out testing from their doctors rather than through APH's free service.

"We're going to have to return to duty—to investigate other disease outbreaks: HIV, STDs, foodborne illnesses," he said of APH staff. "There are a lot of other things that public health do normally that we can't really do very well right now because we're all invested in COVID-19."

Testing can be subcontracted out to private companies more easily than other public health services, Dr. Escott said.

Contact tracing

APH is also rethinking its contact tracing strategy in the face of uncontrolled community spread, focusing on those patients with the most recently conducted tests and who live in group settings.

"For the vast majority of cases we can't tell [where they originate]—and we can't tell because we have hundreds and hundreds of people a day who are testing positive," Dr. Escott said Tuesday. "And those hundreds and hundreds of people have contacted at least dozens and dozens of people."

Another concern is an antiquated reporting system among labs, which means that some test results are faxed to APH and require manual input into an electronic database. This leads to delays between when people are tested and when contact tracing can begin.

"Getting results in 7 to 10 days is relatively useless," Dr. Escott said.