Before Texas can safely re-open its economy, health experts say these four things must happen

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A call center run by the University of Texas at Austin Dell Medical School gets a notification every time its nurse triage team calls a patient with the bad news that they’ve tested positive for COVID-19, the disease caused by the new coronavirus.

That’s the signal for a separate team of a few dozen medical students, graduate students and volunteers to make a second call to the patient, beginning an arduous process that experts say will be crucial for monitoring the spread of COVID-19 as society inches toward reopening: contact tracing.

The caller’s goal: to quickly obtain a list of people and places where the patient might have spread the virus. Then they must track down everyone on that list to encourage them to self-quarantine and get tested for the virus before they potentially infect a whole new group of people.

First, “we develop a bit of a rapport with the [patient],” said Darlene Bhavani, an infectious disease epidemiologist who oversees the center’s operations. How are they feeling? What resources do they need? Do they have a thermometer, and can they isolate themselves from other people in the home?

The phone call might last hours and cover weeks of the patient’s movements. Bhavani had 67 contact tracers working in partnership with Austin’s public health department as of mid-April. That may be enough for now, but she said she needs more volunteers “to prepare for an eventual increase in cases that may or may not happen as Austin opens up and people start moving around more.”

With Gov. Greg Abbott poised this week to announce a plan for easing restrictions on Texas businesses, experts are raising questions about whether the Texas public health surveillance system can ramp up its testing and contact tracing operations enough to safely inch back toward normal life.

Health experts say that even gradual steps to reopen businesses will increase the number of people who become sick from the virus. To better understand where the virus is lingering, they say the state must rapidly increase testing. To track where it is spreading, they’ve urged the government to hire more workers to track down the contacts of those who become infected.

“An exit strategy, as we call this, is sort of difficult to suppose right now,” said Rebecca Fischer, infectious disease epidemiologist at Texas A&M University School of Public Health. “The risk being that as soon as we lift restrictions, whatever that strategy is, if it’s gradual or tiered or certain sectors of the economy or population are released first, we can certainly expect to see a spike in cases.”