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‘It is almost impossible’: RI struggles to ID source of new COVID-19 infections

Target 12

PROVIDENCE, R.I. (WPRI) – For weeks Rhode Island leaders have said small, indoor social gatherings among friends and family are fueling the latest wave of coronavirus infections, a message that’s being reinforced in the lead-up to Thanksgiving week.  

But a snippet of contact-tracing data obtained by Target 12 shows health officials actually have limited insight into where transmission of the virus is taking place. And among the small number of Rhode Islanders who have been willing to talk with case investigators lately, the most frequently cited type of gathering they had attended was church.

“It is almost impossible to pinpoint exactly where someone contracted COVID-19, especially now, with so much virus circulating in the community,” R.I. Department of Health spokesperson Joseph Wendelken told Target 12.

Between Oct. 6 and Oct. 19, at least 151 infected people reported attending a social gathering within the previous 14 days, according to two weeks of contact-tracing data provided to Target 12. Yet those individuals represent less than 5% of the 3,147 new infections reported during that same period, underscoring how rarely the state is hearing from people who are getting sick.

Among those 151 who did respond, one of every three people said they had attended church within the last two weeks, making religious services the most common type of gathering cited. Half that many people – 31 respondents – said they had been to birthday parties, ranking those second.

At least another eight respondents said they went to funerals and at least six reported attending baby showers. Seventeen cases were designated as “other,” which wasn’t defined; several more had no designation.

The data didn’t include breakdowns for other categories, such as work, school, recreational activities, political gatherings and protests, which might offer a clearer picture into the mobility patterns of infected Rhode Islanders that appear to be driving policy decisions behind the scenes. (Target 12 has requested this information.)

But the limited information still provides a small window into what the state is seeing quantitatively when it comes to social gatherings, and it paints a somewhat different picture than the one often described by Gov. Gina Raimondo during her weekly news conferences.

“What is it?” she asked rhetorically last week as she discussed the cause of the latest surge. “Small gatherings with friends and family that occur indoors with masks off.”

Asked why the governor has focused so heavily on this message when it’s not matched by the limited contact-tracing data made available, Wendelken said health officials have determined the responses are underreported.

Rhode Islanders’ apprehension about telling state health officials that they got sick after breaking the various restrictions in place has resulted in a disproportionate underreporting of these gatherings that health experts have determined are most risky, health officials said.

Based on that advice and others from public health experts amid a second wave of the virus, the governor earlier this month implemented a 10 p.m. to 5 a.m. stay-at-home advisory and mandated businesses – including bars and restaurants – close in-person services early. She’s also asked people to celebrate Thanksgiving only with the people who live in the same homes.

“People have too many contacts,” she said on Oct. 28.

The broader restrictions — which have evoked outcry from both people who think the mandates don’t go far enough, along with those who see them as governmental overreach — came on the heels of more targeted mandates initiated throughout the fall. The efforts didn’t appear to stem the new wave of infections, with new COVID-19 cases topping 1,000 a day twice last week, according to state data.

Other states have taken more aggressive steps toward shutting down again, including Michigan, where Gov. Gretchen Whitmer ordered the closure of all dine-in restaurants, colleges and high schools and casinos for three weeks. The move earned praise from public health experts across the country, including Dr. Ashish Jha, dean of Brown University’s School of Public Health.

“Feels like [the] kind of science-based, nuanced policy intervention we need right now,” he wrote Sunday on Twitter.

Former FDA Commissioner Dr. Scott Gottlieb said Monday the virus is spreading too quickly nationwide for more targeted strategies — like contact tracing — to work effectively.

“We’re getting to a point where we’re exhausting our ability to do the case-based interventions and the tracking and tracing as a tool to try and control spread,” Gottlieb said during a CNBC interview. “That’s why you see us going to more population-level mitigation.”

In Rhode Island, casinos, public schools and colleges, workplaces and gyms remain open. Health officials and educators have battled over whether to continue in-person learning, which Raimondo insists hasn’t contributed to the virus spreading.

Religious gatherings have been absent from much of the discussion, despite how often church attendance was cited by the small group of infected Rhode Islanders who spoke to case investigators.

Raimondo, a Catholic who regularly attends Mass, has encouraged religious leaders to offer virtual services, and she’s described some problems with people gathering after church. But it hasn’t received the same level of scrutiny as get-togethers and parties among friends and families — which don’t show up in the data as often.

“Faith leaders, you are doing a good job, but we have to do a little better,” Raimondo said a month ago. “It’s what happens outside of church – ask your congregations to cut that down and wear masks.”

The limits placed on religious gatherings were a major point of contention in the spring. Churches, synagogues, mosques and other places of worship were ordered to shutter until the state could stand up better testing and contact-tracing infrastructure.

And like many things related to the pandemic, the mandates eventually became political. In May, President Trump called on governors to reopen places of worship, deeming them “essential.” Raimondo brushed off the president’s remarks, saying reopening would be premature and “reckless.”

The Roman Catholic Diocese of Providence issued a statement at the time saying it would stick by the governor’s plan to partially reopen later that month. But Bishop Thomas Tobin separately lauded the president’s comments on Twitter.

“Politics aside, referring to churches as ‘essential’ is a breakthrough,” Tobin tweeted.

Asked recently whether the state would consider new restrictions on churches, Wendelken said the case investigation data alone didn’t suggest transmission was happening in any particular place. And he reiterated that it’s become extremely difficult to know where people are getting infected.

“Those are not locations where we know that transmission happened,” Wendelken said. “I would recommend not looking at those data and trying to draw conclusions about the largest drivers of cases.”

Rhode Islanders’ unwillingness to pick up the phone and tell state health officials about how they might have contracted the virus also underscores the current limitations of the state’s contact-tracing efforts.

In the first few months of the pandemic, Raimondo and Health Director Dr. Nicole Alexander-Scott touted high response rates, saying people were relatively willing to talk with health officials.

Now that sentiment has changed dramatically, with reports of people verbally abusing health officials who call after a positive infection is identified. Others simply refuse to pick up or call back, which is proving increasingly problematic at a time when daily infections have skyrocketed from an average of 211 cases on Oct. 16 to an average of 827 cases on Nov. 16.

Raimondo last month announced a plan to hire 100 new case investigators to help out, saying the system is “strained.” But any improvement in the Health Department’s understanding of how the virus is spreading will also require more buy-in from Rhode Islanders – and state leaders acknowledge many residents are tired of following rules that have limited their ability to see loved ones for more than eight months.  

That feeling – sometimes described as COVID fatigue or pandemic fatigue – is especially concerning to some health experts, who say the colder weather and holiday season are likely to push more people indoors where the virus tends to spread easiest.

And even though the small social gatherings aren’t showing up in big ways through the state’s case investigations, the prominent Rhode Island Hospital emergency physician Dr. Megan Ranney recently tweeted a string of articles showing how weddings and family gatherings have ended with infections and death.

“DO NOT DO INDOORS THANKSGIVINGS with people who aren’t part of your immediate household,” Ranney wrote Sunday, responding to an article citing a poll that showed 38% of Americans planned to have Thanksgiving with 10 or more people.

“I’m begging you,” she added.  

Eli Sherman (esherman@wpri.com) is a Target 12 investigative reporter for WPRI 12. Follow him on Twitter and on Facebook.

Copyright 2020 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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