Contact tracing efforts for covid-19 cases at colleges and universities in the state have shifted from the University of Arkansas for Medical Sciences to the state Department of Health, ending a joint effort announced in July as having begun with $5 million in funding from federal coronavirus relief aid.
But while UAMS spokeswoman Leslie Taylor cited the lack of Coronavirus Aid, Relief, and Economic Security (CARES) Act funding in the new year, she said the institution is continuing -- at least for now -- its contact tracing center focusing on Marshallese and Latino populations.
"We are utilizing UAMS resources in Northwest Arkansas to continue the work there through the end of January with the hope that we will be able to confirm continued funding by then," Taylor said in an email.
The University of Arkansas, Fayetteville, the state's largest university, is beginning its spring semester relying on the state Department of Health to provide the contact tracing services, UA spokesman Zac Brown said.
"For now, the university is not planning on contracting with/or using other entities," Brown said in an email.
Gavin Lesnick, a state Department of Health spokesman, said UAMS stopped doing the contact tracing for colleges and universities at the end of 2020.
The work is now being done by the Little Rock-based nonprofit Arkansas Foundation for Medical Care and Falls Church, Va.-based General Dynamics Information Technology, Lesnick said. The two organizations have been providing contact tracing services to the Health Department for several months.
Lesnick has said the two organizations would step up to shoulder the outreach work currently done by the Latino and Marshallese-focused contact tracing center should UAMS stop its involvement.
The 14 bilingual contact tracers working at UAMS' "special populations" contact tracing center have been a key part of an effort to help Marshallese and Latino communities during the pandemic, UAMS officials said.
In addition to Northwest Arkansas, the center has provided contact tracing support to Randolph, Independence, Yell and Sevier counties.
"We know that from the beginning of the covid pandemic that it has burdened the Marshallese and Latinx communities more than the general population," said Pearl McElfish, vice chancellor for the UAMS Northwest campus and the author of several research articles about health disparities.
A UAMS report cited data on the percentage of new covid-19 cases within the Latino and Marshallese communities in Benton and Washington counties.
The report noted that while these communities continue to be hit with more new covid-19 cases than other populations in the two-county area, that disparity has been reduced in recent months.
McElfish said "the actual proportion of Marshallese and Latino cases has continued to go down since we have implemented the Special Populations center."
More than ethnicity or race, "it's really language spoken" that leads a covid-19 case to be routed to the UAMS special populations center, McElfish said. Those living in counties served by the center whose preferred language is Marshallese or Spanish have their cases assigned to the UAMS bilingual contact tracers, McElfish said.
The UAMS report states that the intervention effort -- which has other components, including health education and communication aimed at preventing covid-19 -- began July 22 but did not have a "full" launch until Sept. 1.
The Northwest Arkansas Council's Health Care Transformation Division started the effort -- which includes several health care and other organizations -- after a Centers for Disease Control and Prevention report on covid-19 health disparities in the region.
"The bad news is we're continuing to see covid cases in all of our community, but the good news is we've closed the gap in that disparity," McElfish said. "To be quite honest, things would be a lot worse, we would be seeing lots higher numbers in the Latinx and Marshallese communities if we had not had this special populations center."
Latinos make up 17% of the total population in Benton and Washington counties, according to the UAMS report.
The data through November showed that the Latino share of weekly new cases in Benton and Washington counties ranged from 13.5% to 30.2% since the full launch of the community intervention effort in September.
Those weekly percentages, while more often than not higher than the population percentage, dipped compared with earlier in the pandemic. From June until mid-August, the two-county Latino share of weekly new cases ranged from 41.5% to a peak of 70.3% of new cases before falling sharply, according to the report.
Data for the Marshallese showed a similar trend. Marshallese make up 2.4% of the two-county population.
Through November, the Marshallese share of weekly new cases in Benton and Washington counties ranged from 0.2% to more than 5%, but this was well below peaks seen earlier in the pandemic. From June through July, the two-county Marshallese share of weekly new cases ranged from 8.7% to a peak of 24%. It went down to about 5% in early August, but then spiked again to 20.5% later in the month.
The CDC released a report last month on covid-19 and these communities in Northwest Arkansas. The report noted that "minority groups are more likely to work where physical distancing is not possible" such as in the poultry processing industry, which has had a "high" incidence of covid-19.
The report noted that communities suffering disproportionately from covid-19 "need culturally and linguistically tailored public health education, community-based prevention activities, case management, care navigation, and service linkage."
The federal CARES Act, signed into law in March by President Donald Trump, provided aid to states to help offset costs from the pandemic during the 2020 calendar year.
While UAMS isn't handling college cases now, Taylor said, "we are optimistic that there may be new CARES Act funding available in the future that would allow UAMS to resume participation."
Arkansas State University, the state's second-largest university by enrollment, will have contact tracing done "in the same way as it was this fall," spokesman Bill Smith said.
In November, Smith said the campus had contact tracing done by UAMS and the state Department of Health but also had contact tracing done through an agreement with the New York Institute of Technology College of Osteopathic Medicine, which has a site on the Jonesboro campus.
Colleges may also help with contact tracing within their campus communities.
At Lyon College, a private liberal arts college in Batesville, "we do the initial contact tracing and instruct those affected when they will need to begin isolation or quarantine," Shawn Tackett, the college's covid-19 coordinator, said in a statement. "Most of the time this is done before the [state Department of Health]/UAMS contact tracers have even contacted the person."
Emily Gurley, an associate scientist at Johns Hopkins University Bloomberg School of Health, described contact tracing as about communicating important information.
"One of the objectives is to try to find out who they've had contact with. But another primary objective is to ask that person to isolate at home or away from others, so that they don't infect someone else," Gurley said. Close contacts of those infected are asked to quarantine.
Gurley said the most effective contact tracing takes place quickly, but even contact tracing programs that are "a bit slow still have some impact, and they're slowing transmission down."
When it comes to public health during a pandemic, "I think that contact tracing is really one of the most important tools that we have," Gurley said.
Lorena Garcia, a professor at the University of California-Davis School of Medicine, said "language barriers are known to contribute to health care disparities."
Garcia, an epidemiologist who studies health disparities, said it's also important to understand that efforts help beyond those directly getting the outreach.
"The impact is much, much broader, because these individuals also work" and come into contact with other communities, Garcia said.
To fight the pandemic, "we need to work together, that's critical," Garcia said. "Individuals and all agencies."