As omicron spreads, this Vt. public health expert says top-down approach to virus, and risk, should shift
Vermont schools will no longer conduct contact tracing and PCR surveillance testing for students and staff. That's according to a policy shift announced Friday by the Agency of Education.
This news comes amid reports of high case numbers and the rapid spread of the omicron variant of COVID-19. Some public health experts argue these trends mean we need to make different decisions around testing and contact tracing policies now and into the future.
VPR’s Mitch Wertlieb spoke with Dr. Benjamin Lee, an associate professor in the Department of Pediatrics at the Larner College of Medicine at the University of Vermont. Their conversation is below and has been edited for clarity.
Mitch Wertlieb: So how does this omicron variant in particular complicate practices like contact tracing?
Dr. Benjamin Lee: Well, I think the main message is that omicron is very, very transmissible, and it does appear to have a shorter incubation time.
And what that means is, you have a lot more cases and a much narrower window of time in which contact tracing might be beneficial.
So, one way that I like to think about this is that, right now, in the current situation, contact tracing is like trying to swim directly against a riptide.
Well, last Friday, as we mentioned, the Vermont Agency of Education made this decision to stop contact tracing and PCR surveillance testing by the schools. The initial reaction, as I'm sure you're aware, has been that parents and guardians are now faced with this responsibility.
And, you know, some are saying, “Why should this be our responsibility?”
Do you agree with the agency's decision here? It sounds like you do based on what you're describing with that sort of riptide metaphor.
Yeah, I think, unfortunately, the reality of the situation is that contact tracing in its current form is no longer likely to be of much additional benefit. What would probably be a far greater benefit is changing our overall strategy in terms of how we approach the virus, how we approach the risk.
Well, what do you think should be the switch in tactics then in strategy?
Well, that's a great question, and that is one where there's no, you know, obvious right answer.
I think, part of the challenge, and one of the things that we're going through, as a society, trying to understand how we can transition towards a mode where we understand the virus to be endemic.
It appears certain that this virus is now just, you know, going to be with us moving on into the future, just like influenza, or respiratory syncytial virus, any number of the other respiratory viruses that cause illness, particularly in the wintertime.
And so, in that context, I do think it makes sense to understand that sort of the days of relying on a centralized top-down response may no longer be the best approach going forward. And it I understand that there's a fair degree of apprehension associated with that, because that is a fairly large paradigm shift — and so in that sense, I do think it does make sense that we need to start incorporating more of our strategizing on a personal level rather than a top down level.
Is contact tracing still important? Is it still useful? You know, and if we're going to put this burden, if you will, this onus on parents and guardians, are they able to do it? Would they even know how?
Well, I think contact tracing can be useful in certain times and scenarios. And so, it's very context-dependent.
However, what we do know is that there are common sense strategies that we can all exercise at all times that will reduce the risk of transmission. And these were things that were true even before COVID.
So, if a child is sick, or if anybody is sick, for that matter, stay home, don't go to work, don't go to school. With hopefully increasing accessibility for rapid antigen testing, particularly for school populations, making liberal use of antigen testing, these are all things that I think we can relatively quickly and simply incorporate into our daily living.
Granted, there'll be a little bit of a transition period, you know, that's something that we can take on and just make part of our daily routine.
Won't schools though, and really, government, state officials have to make things like rapid antigen tests widely available so that people can actually do this? What I'm trying to get out here is I think that a lot of parents are thinking: “OK, I understand you're saying the schools don't have the capacity to do this. There are staffing issues as well. But we have a lot to do, too, you know, how can we do this? How are we expected to do this if we don't have the resources.”
And that's especially true for low-income families and you know, immigrant families that may not even speak the language well enough yet to navigate these waters.
Now, certainly those are challenges, and those are real, real challenges. But I guess I would try to put this back again into the context of things that we're more familiar with, like for flu.
If you know somebody's sick, you don't let them go to school, you don't let them go to work. If you knew they had a play date with somebody the day before, you would, you know, most likely most parents would probably call folks that they know they've been exposed to and say, “Hey, we just found out that that's so and so had flu, just to make you aware.”
You know, those are really the type of things that we're talking about. We're not talking about spending hours and hours of each day trying to trace every last potential exposure, because I agree that degree of effort is not reasonable to ask families, but it's very reasonable to say, test when you can, stay home when you're sick, and let folks know that you know that you've been around when an exposure like that might have occurred.
And finally, Dr. Lee, it seems to me, you're saying that the other thing is get vaccinated and use masks? Are those just common-sense things that we can all be doing to help reduce the transmission of this disease?
Absolutely, and thank you so much for bringing that up. You know, the playbook really at the end of the day hasn't changed. The best way that we can protect ourselves from severe illness is to get vaccinated and to wear masks, especially when indoors. Avoid crowded indoor places.
I think the big difference in terms of the school population is that at least you know for kids 5 and above, we've now had about almost three months of time for families who want to get their children vaccinated the opportunity to get vaccinated. And I would argue that while we're doing well in Vermont, as you know, we have the highest rate in the 5- to 11-year-old children in the country, if I'm remembering correctly, there are so many unvaccinated children.
So, for folks who are concerned about the omicron surge, please make sure you and all of your loved ones are fully vaccinated.