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There may be a 10-day delay between when an infected person is tested and when an investigator begins tracing their contacts, Dr. Mark Escott said Tuesday.

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Reporting delays, fax machines and a reopened state have made contact tracing efforts more difficult and less effective, Austin-Travis County Interim Health Authority Dr. Mark Escott said yesterday.


"Unfortunately, still, in public health here—and across the state and the country—this is a very manual and archaic process of getting information out," Dr. Escott said, speaking to Travis County commissioners. "And we're struggling with that."

Austin Public Health receives COVID-19 test results via fax. Its team of investigators—which is growing by around 10 members a week to meet demand—then must sort through the positives and negatives, which tally more than 1,000 daily.

Some results may include the contact information for the person tested, but not all do, which means investigators then have to call the doctor's office and lab to try to gather more information.

This whole process takes time.

"Right now, it's not uncommon to have a week to 10 days between [when] a person is tested and when their case is entered into the system so they can be called," Dr. Escott said. "They're probably not infectious anymore."

While the state has required labs to report COVID-19 test results digitally, not all have made the switch.

Commissioner Brigid Shea was "shocked" and "horrified" to learn test results are being sent to APH via fax.

"It's like a third-world technology," she said. "Most young people don't even know what a fax machine is anymore."

Another challenge is that Texas has more or less reopened.

"When we look at the efficacy of contract tracing in other countries where it worked, that contact tracing happened when the places generally were shut down, when people weren't moving around," Dr. Escott said.

APH, however, is trying to contact trace at the same time as hundreds of new cases are being reported each day.

"It works in some circumstances," Dr. Escott said. "But right now, across the state of Texas, we're getting reports from jurisdictions that they simply cannot trace everybody."

As a result, Dr. Escott expects a shift in strategy in the coming weeks, but he did not mention what form that shift may take.

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