Missouri, however, trained a 50-person team of existing state health department employees to assist local officials and relied mainly on city and county health departments to lead the efforts.
Local jurisdictions scrambled to move from paper charts, update computer systems, obtain federal stimulus funds, reshuffle employees from other public health activities, and hire and train new contact tracers. The effort continues as cases rise and the challenges change.
“It’s not a perfect system,” Ave said. “We often say at the health department that we’re sailing the ship as we’re building it.”
In January, the St. Louis County health department had three people and a budget of $3.16 million devoted to communicable diseases and contact tracing, officials said in a recent budget meeting. Now the county has about 140 temporary hires and 180 volunteers and is spending about $15 million a month, mostly federal Coronavirus Aid, Relief, and Economic Security, or CARES, Act pandemic relief funds.
The federal relief money runs out at the end of the year, however. Next year, the county wants to have 90 new employees dedicated to COVID-19 response, which could include distributing vaccines. Officials project the cost to be almost $14.4 million, a 24% increase in the health department’s budget.
The county also has used $600,000 in federal relief funds to hire St. Louis University to provide additional “booster” training for contact tracers, improve data collection and analysis and provide a cellphone app that staff can use to more easily get information from positive cases and their contacts.