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SC to dramatically ramp up testing, contact tracing to stamp out coronavirus

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DEHC sign.jpg

Signs with messages about COVID-19 from the state Department of Health and Environmental Control are displayed on light poles in the Westwood Plaza shopping center on Tuesday, May 5, 2020, in West Ashley. Grace Beahm Alford/Staff

South Carolina’s public health agency plans to test nearly a quarter million people for COVID-19 over the next two months, partnering with health care facilities and a private lab as part of a new, coordinated assault on the pandemic.

As part of that new strategy, the state Department of Health and Environmental Control will quickly test all 40,000 residents and employees of South Carolina’s nearly 200 nursing homes, where the respiratory disease can spread quickly and prey on vulnerable residents. At least 84 nursing home residents and employees have died so far from COVID-19 in the Palmetto State.

The agency also is stepping up plans to hire contact tracers. It is identifying a pool of up to 1,000 people who can be hired and trained to track down where the virus has been and where it might spread next, a crucial piece of the state’s outbreak containment strategy.

Those plans were unveiled Wednesday as South Carolina works toward relaxing restrictions on businesses and public life while suppressing a disease that has killed more than 300 South Carolinians and infected at least 6,600 more.

Those are just the residents who have been diagnosed since March amid testing reserved mostly for the "really sick." Missing from the count are people who contracted the virus but either have no symptoms at all or symptoms so mild "they may think they have allergies" but can spread it to others who aren't so lucky, Dr. Joan Duwve, director of DHEC's public health division, told The Post and Courier on Wednesday.  

The goal is to detect infections early, before the virus circulates widely, she said. 

“We think we can make a big impact in our case numbers and help protect more people from dying from the disease,” said DHEC Chief of Staff Jennifer Read.

DHEC worked for weeks to finalize the strategy with the federal Centers for Disease Control and Prevention, a process that included procuring testing supplies from the federal government that, until now, have been prioritized for harder-hit states such as New York and Louisiana.

So far, due in part to a supply shortage, fewer than 70,000 of South Carolina’s 5.1 million residents have been tested.

DHEC officials told The Post and Courier they were able to secure enough supplies to test about 2 percent of the state's population during each of the next two months. That amounts to about 220,000 people between now and the end of June. Officials said they hope to ultimately test even more as supplies become available, stressing the importance of widespread testing.

"The virus was chasing us, but now we are turning the tables and chasing the virus," Gov. Henry McMaster said at a Wednesday afternoon news conference.

They plan to initially focus their testing and contact tracing on high-risk communal settings, such as nursing homes, correctional facilities and homeless shelters.

DHEC has hired a private outfit, LabCorp, to test residents and staff of every nursing home in South Carolina before the end of May at a cost of $2.5 million.

Phase one will start Monday with 27 homes that have had COVID-19 outbreaks or are located near hotspots of the virus, and some 45 other homes volunteering to be part of next week's testing.

S.C. nursing homes have been locked down to visitors since March 13, but COVID-19 has managed to gain a foothold in the facilities anyway.

Nursing home residents and employees account for less than 1 percent of South Carolina's population, but 14 percent of the state's confirmed COVID-19 cases and 28 percent of its deaths from the respiratory disease.

"It's the staff coming and going" who are unknowingly spreading it to those most vulnerable to the disease, Duwve said.

The goal is to identify and quarantine those employees to mitigate transmission, she said. 

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The agency is working on a longer-term plan to regularly test staff to prevent future outbreaks. 

DHEC will also focus over the next two months on urban, densely populated areas, as well as poor, rural counties where residents with underlying health conditions and lack of access to health care put them at greater risk.

Rural areas in South Carolina have become hotspots for the rapidly spreading virus. Of the 10 S.C. counties with the highest infection rates, nine are rural, officials said Wednesday. 

Most are home to larger percentages of African Americans, who tend to have more pre-existing conditions that make them vulnerable to COVID-19.

African Americans make up 27 percent of the S.C. population but account for 44 percent of the state's confirmed coronavirus cases and 46 percent of its deaths from the disease.

DHEC is partnering with major hospitals like Prisma Health and the Medical University of South Carolina to set up testing sites across the state over the next two months.

That includes mobile pop-up clinics in rural areas, including portions of Dorchester and Beaufort counties, and mass testing sites in cities such as Charleston and Columbia. Anyone who wants a COVID-19 test will be able to find a testing location on DHEC's website, show up and get one for free.

Results from those tests can be turned around in a day or two and will immediately be reflected in DHEC's testing data.

The rural testing program began Monday in rural Darlington County. Nearly 500 people showed up in Society Hill, Read said.

How many days a mobile unit will stay will depend on the need, she said. 

Experts say widespread testing and contact tracing is critical to the state’s long-term response to the coronavirus, which shuttered many of the state’s businesses and left more than 400,000 people out of a job.

Doing both aggressively will give health officials a better understanding of who has the virus, who is at risk and how to stop the spread. That’s important for identifying and containing local flare-ups of the virus before they erupt into full-fledged outbreaks that could require further restrictions.

DHEC has already expanded its contact tracing staff to 230 from its normal full-time levels of 20, mostly by reassigning the agency’s existing workers.

Contact tracers work like disease detectives. They call people who just tested positive for COVID-19, interview them to learn who else they might have exposed to the virus, then call those “contacts” and notify them that they might have the disease and need to quarantine.

At least 19 other states have already announced plans for aggressive testing and contact tracing campaigns. Massachusetts and Illinois have both released plans to hire 1,000 contact tracers. Texas wants 4,000, and California wants 10,000.

A national model and other experts have suggested South Carolina could need anywhere from 1,500 to 2,000.

DHEC officials have said they currently have enough tracers to investigate every positive test. Officials say they will hire more contact tracers as needed.

More testing over the next two months is expected to identify more positive cases.

Reach Avery Wilks at 803-374-3115. Follow him on Twitter at @AveryGWilks.

Projects reporter

Avery G. Wilks is an investigative reporter based in Columbia. He was named the 2018 S.C. Journalist of the Year by the S.C. Press Association. He grew up in Chester, S.C., and is a 2015 graduate of the University of South Carolina’s Honors College.

Assistant Columbia bureau chief

Adcox returned to The Post and Courier in October 2017 after 12 years covering the Statehouse for The Associated Press. She previously covered education for The P&C. She has also worked for The AP in Albany, N.Y., and for The Herald in Rock Hill.

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