The report issued Thursday by the Legislative Office of Fiscal Transparency says the State Department of Health lacked sufficient contact tracing data to measure the spread of COVID-19, which meant municipal leaders didn't have enough information to make data-driven decisions to respond to the pandemic.
The report also criticized the agency's "outdated and overburdened technology platform" as a hindrance to the state's contact tracing efforts and overall response to the COVID-19 pandemic.
In a legislative hearing Thursday for lawmakers to hear details of the report, Oklahoma's top health official acknowledged the State Department of Health's technological difficulties, and said most states struggled to keep up with contact tracing due to the sheer number of COVID-19 cases. "The difficulty in this is the sheer number of cases," said Health Commissioner Dr. Lance Frye. "With the current systems in place in the United States, nobody was prepared to approach that in a manner that was manageable, and that they could actually get a good response from."
Contact tracing, which is designed to help identify how a virus is spreading, is a key part of any pandemic response. When conducted properly, contact tracing can reduce the spread of disease.
"Whether global or local, every entity that successfully implemented a contact tracing program did so by gathering and providing data in a way which enabled their stakeholders to make informed decisions regarding their lives and livelihood while managing through the pandemic," according to the report.
However, the report concludes that Oklahoma's contact tracers were overwhelmed by the spread of the COVID-19 virus during some of the state's most critical months. From Sept. 24 to Dec. 23, contacts monitored by the State Department of Health decreased by 65 percent while the number of positive COVID-19 cases increased by 205 percent during the same period, according to the report.
The report was critical of the State Department of Health's contact tracing efforts, and questioned why the agency didn't make more contact tracing data publicly available.
In a survey sent to 40 Oklahoma municipal leaders, nine of whom responded, 89 percent of respondents said contact tracing data from the State Department of Health would have been helpful to determine how best to respond to the pandemic.
"Better, more specific information on the spread of COVID based on contract tracing would allow us to make better decisions about how to respond locally," according to an anonymous municipal leader cited in the report.
Noting the small number of respondents, Health Commissioner Frye cast doubt on the validity of the survey. He also pointed to a slew of other COVID-19 data, including the number of new infections and hospitalizations, the state has publicly distributed for the past year.
He also noted that contact tracing is inherently difficult, and many Oklahomans were skeptical of the process.
Some COVID-positive Oklahomans were simply unwilling to share details about where they had been and who they had possibly exposed, Frye said. Similarly, some Oklahomans resisted guidance from the State Department of Health, including when they were advised to quarantine.
"Contact tracing is only as good as the information you receive from people," Frye said.
LOFT officials noted more leadership from the State Department of Health could have increased public trust in the contact tracing process.
The State Department of Health has also changed to a decentralized approach to contract tracing, which Frye said he believes will be more successful. After setting up a contact tracing hub at the old Shepherd Mall in Oklahoma City, at a cost of roughly $6.7 million, the state shuttered the project toward the end of 2020.
Now, the State Department of Health is focused on having contact tracers across the state, working in the communities in which they are familiar, Frye said.
The LOFT report suggested boosting the number of contact tracers would have improved the state's pandemic response. Oklahoma had roughly 18 tracers per 100,000 population, but a national association of health officials recommends 30 tracers per 100,000 population would be more appropriate for a pandemic of this size and scope.
The LOFT report was also critical of the state's color-coded COVID-19 alert map, saying it communicated inconsistent metrics. LOFT repeatedly asked the agency to justify changing the high-risk triggers for the alert system, but did not receive a direct answer, the report says.
A color-coded alert map from the Oklahoma State School Board Association provided more in-depth information to help local school leaders to make decisions about in-person schooling, according to the report.
The LOFT report also makes recommendations for state lawmakers and the State Department of Health.
LOFT recommended state lawmakers make available discretionary funds to investigate and control the spread of communicable diseases. The entity also recommended lawmakers ensure public trust in contact tracing efforts by prohibiting unlawful dissemination of contact tracing data, presumably through a state law.
As for the State Department of Health, LOFT recommended the agency publish and disseminate more outbreak data to help local leaders control the spread of the disease.
LOFT also recommended the agency adopt the Centers for Disease Control and Prevention's recommendations for contact tracing and work with surrounding states to develop the best practices for collecting and publishing tracing data.
The entity also recommended the State Department of Health present to the Legislature a plan to replace the Public Health Investigation and Disease Detection of Oklahoma (PHIDDO) system. The outdated system used to track various COVID-19 metrics has crashed multiple times throughout the pandemic, setting back the state's response to the virus, the report says.
The reporting system was never created to handle a pandemic, Frye said. The State Department of Health has been working for the past year to switch, but it's a time-consuming and complex process because the system is connected to so many different aspects of the state's public health infrastructure.
"I want to flip a switch and get rid of PHIDDO, but it doesn't work like that," he said. "It's a complex disease reporting and information system."
(c)2021 The Oklahoman. Distributed by Tribune Content Agency, LLC.
