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Why a plan to expand contact tracing in Minnesota is getting pushback at the Legislature

Gov. Tim Walz
While DFLers in the Legislature are backing the plan put forward by Gov. Tim Walz and his Department of Health, some Republicans are questioning the need for the expansion.
Contact tracer is not a new job for the Minnesota Department of Health. When the department receives a report of someone with any of several dozen communicable diseases, case investigators follow up as a way to stem the spread.

COVID-19 is one of those diseases.

But a fledgling plan to increase the number of tracers — from a few dozen to four thousand or more — has become a flashpoint in the increasingly political debate over the state’s response to the coronavirus pandemic. 

While DFLers in the Legislature are backing the plan put forward by Gov. Tim Walz and his Department of Health, some Republicans are questioning the need for the expansion, accusing Walz of changing his initial strategy and raising concerns over privacy and the specter of government compelling people to participate.

What the House bill would do

Contact tracing is part of U.S. guidelines for safely reopening the country. Dr. Anthony Fauci, the nation’s top infectious disease expert, warned Tuesday of increased deaths and suffering should states not follow federal advice.

In a statement released before his testimony to the U.S. Senate, Fauci said states shouldn’t skip robust contact tracing and what he termed “sentinel surveillance” which is the testing of asymptomatic people in vulnerable populations. “If we skip over the checkpoints in the guidelines…then we risk the danger of multiple outbreaks throughout the country,” Fauci wrote. “This will not only result in needless suffering and death, but would actually set us back on our quest to return to normal.”

But while the expectation that increased tracing would go along with increased testing, it has also become a partisan issue, if only very recently.

In Minnesota, even if the plan to expand tracing gets hung up in the final week of the 2020 session of the Legislature, Walz may already have the legal authority both to create the program and devote money from the federal CARES Act to pay for it.

But it could remain a political issue once the session ends and election season begins.

State Rep. Tina Liebling
State Rep. Tina Liebling
That Walz can do it without legislative help is one tool legislative DFLers are using to convince Republicans to go along. A bill currently being considered at least gives the Legislature a chance to suggest how the money is spent, though the measure hadn’t convinced any GOPers as of Monday, when the House Ways and Means Committee passed the bill, House File 4579, on a straight party-line vote. 

The bill directs up to $228 million to be spent to contract with a private vendor to hire, train, and support temporary employees to contact those who test positive and follow the trail of possible infection. Also included is $30 million for an information technology system; $30 million for local health departments and community health boards to support tracing, case investigation, and follow-up efforts; $5 million for a public relations campaign called “Answer The Call”; $4 million for Minnesota’s 11 treaty tribal nations; and $3 million for a short-term expansion of the current tracing effort within the department.

“It does little good to test if we don’t follow up with public health measures to control the virus,” said Rep. Tina Liebling, a DFLer from Rochester who’s the prime sponsor of the House bill. She said it would help restore confidence in the public that they can venture out and not confront people who are infected.

Margaret Kelly
Margaret Kelly
Margaret Kelly, deputy commissioner of the Department of Health, said the plan is for a large expansion of what the department has been doing on a much-smaller scale since the first infections became known. Tracers contact those who test positive to tell them how long they need to self-isolate, to offer assistance like food delivery and medications, to let them know what to do if symptoms appear or worsen and to find out who they might have infected.

If the number of COVID tests ever reaches 20,000 to 30,000 a day — and if 25 percent of those tests are positive — the state estimates it would need up to 4,200 tracers contacting those residents. Because test results can lag, the state would also like to contract people in vulnerable populations, the elderly and those with underlying health problems, for example, as soon as they are tested to be prepared should the test come back positive.

Using a contract vendor will allow the administration to avoid hiring state employees, and the vendor could add or reduce staff as caseloads demand. The jobs would likely last a year to 18 months.

“The whole idea with aggressive case investigation and contact tracing is to intervene as quickly as possible with an individual who has been tested, to communicate with them right away to assure that they are isolating so they are not shedding the virus as they are out in the community,” Kelly said.

“What we are trying to do here is simply find a balance between protecting our most vulnerable, protecting our health care workers, opening the economy, allowing people to be social and assuring that we don’t overrun our health care system,” she told the committee.

Kelly said current law protects the health data of those contacted, and that no one in the state would be forced to be tested — nor would they be required to cooperate in case investigations, including identifying those they might have infected. 

Infectious Disease Director Kris Ehresmann
MinnPost photo by Peter Callaghan
Infectious Disease Director Kris Ehresmann
Liebling said she opposes the use of tracing apps that would use technology developed by Apple and Alphabet to identify people’s locations. A bill introduced by four GOP House members Monday would ban mandatory tracing and make it illegal for companies to require employees to use tracing apps.

During the Minnesota Department of Health’s Monday media briefing, Kris Ehresmann, the director of the department’s infectious disease, epidemiology, prevention and control division, said case investigation is “a core element of a public health response to a outbreak of an infectious disease.”

She said tracing might help identify vulnerable people or healthcare workers who were exposed to an infected person. But she said the department is starting to have problems with a lack of cooperation by residents. “We really need Minnesotans to participate in these interviews,” she said. “In order for our work to be effective, we do need people to respond when we reach out to them.”

GOP skepticism

Republicans on the Ways and Means Committee Monday objected to many aspects of the plan, from its need to its costs. Rep. Pat Garofalo, the Republican from Farmington who is the GOP lead on the budgeting committee, said he thinks the Walz Administration has changed its strategy. Rather than trying to stop as many infections as possible, Garofalo said the state should be trying to “manage the rate of infections.”

State Rep. Pat Garofalo
State Rep. Pat Garofalo
Deaths have been concentrated on “a very, very small percentage of society” and with at-risk populations, Garofalo said. “My understanding was that, in a measured and reasonable way, we want those non-protected people to be getting infected to build up immunity so they are less susceptible for spreading it in the future.” 

Rep. Peggy Scott, R-Andover, said she was concerned with state government establishing “a massive database” of private health information of residents. 

And Rep. Jerry Hertaus, R-Greenfield, said the plan would be the first time the state would quarantine healthy people. “People are going to have to accept the reality at some point in time that they have to make their own personal decisions as to whether it is worth the risk to go into a restaurant or go into a store,” Hertaus said. “Yes … everybody is afraid. Well I wonder why? All we’ve done is fed them with fear.”

DFLers responded by emphasizing the tracing plan is designed to help reopen the economy and that the impacts on otherwise healthy people are not benign nor are the long-term health effects known. “This is about facts, not fear,” said Rep. Mohamud Noor, DFL-Minneapolis. “It is about science.”

The partisan differences were also in evidence last week when the Senate’s Health Finance committee took up a similar bill. 

State Sen. Michelle Benson
State Sen. Michelle Benson
Sen. Michelle Benson, R-Ham Lake, said she was working on a plan that would be less expensive than what the House was envisioning. 

But even that drew opposition from fellow GOP members of the committee. “This idea of going lock, stock and barrel across Minnesota, I just don’t get it, I don’t think I can support it” said Sen. Scott Jensen, a Chaska Republican who is also a physician. 

He said intervening in hotspots like meat processing plants is valid. And protecting vulnerable populations should continue. But the healthcare system already reports contagious diseases.

“It’s not like we need Big Brother to do this,” Jensen said, saying he has patients who won’t get tested because they don’t want the government to have their health data. “All I see is red flags. The data show that more and more, for people under the age of 65 with no significant comorbidities, the disease is not going to be much of an issue at all.”

Jensen’s comments brought a response from the Senate’s other physician, Sen. Matt Klein, a DFLer from Mendota Heights. “It is interesting to me that some of the most-strident voices asking us to reopen our economy oppose this tool in the toolbox that would move us forward in that regard,” Klein said. 

And he disagreed that COVID-19 is a mild illness and said those who express that “are dangerous and wrong.”

photo of article author
Sen. Matt Klein
“Young people do have to worry about this,” he said, based on both medical literature and what he has experienced as an emergency room physician. COVID-19 has mysterious and not-yet-understood complications, he noted, with clotting in the heart and brain and lungs. 

“It’s true that in 85 percent of people, they seem to get through without a whole lot of fuss,” Klein said. “But 15 percent of an unvaccinated population is a really big number.”

Benson Monday said she still expects to have a tracing bill but thinks the money in the House bill is “a little rich.” For example, she questioned spending $30 million for an IT system that will be used for, at most, 18 months.

“If this is going to be a year of intense tracking, let’s get the numbers right, let’s make the personnel is only what’s essential and no permanent full-time equivalents to do something that is really a temporary need,” she said.

“The Senate Republicans are going to take a strong position that we support testing, it’s important for public health,” she said. “But also that we are going to expect the privacy rights of Minnesotans and their personal medical data be protected. Those two things need to go hand-in-hand to have a Minnesota-ready testing-tracking and tracing program.”

Comments (24)

  1. Submitted by Joel Stegner on 05/12/2020 - 12:19 pm.

    If the police are investigating a death and want to interview you, few will question it. You may or may not have useful information, but your minor inconvenience is a small price to close a case. If you were intimate with someone and they develop an STD, contact tracing helps get people get treatment before greater damage happens. That is certainly a more embarrassing situation, where literally anyone can be infected. I have to interpret those who oppose contact tracing as simply being will to sabotage an important public effort being paranoid about dark forces that only exist in their imagination.

    • Submitted by Alan Straka on 05/12/2020 - 02:20 pm.

      The problem with your analogy is that, in either of those cases, your are not forced into quarantine for two weeks for cooperating. In the first case, it only takes a few minutes of your time. In the second, you are given treatment and are free to go about your business except for engaging in risky sex. What the state wants to do is lock you (and everyone in your household) away for a set period of time even without any proof whatsoever that you were in fact infected just because someone said they had contact with you. That is not what I would call a “minor inconvenience”.

      • Submitted by Matt Haas on 05/13/2020 - 12:41 am.

        No one is being forced into quarantine. They would be asked to be tested, and if positive to quarantine. Not really hard to understand, and the only way to contain an outbreak.

  2. Submitted by Hiram Foster on 05/12/2020 - 12:22 pm.

    I am reluctant to take advice on science issues from a political party that denies the validity of the theory of evolution.

  3. Submitted by richard owens on 05/12/2020 - 12:25 pm.

    The Alphabet and Apple Apps to do contact tracing have an anonymity component and are being unfairly demonized. No identity is given out, and no identity is known until the tracing is activated.

    Your location data is not hurtful until your identity is known– it’s just data points.

    C’mon Republicans! You spread fear almost reflexibly while almost never advocating for a common sense cooperate response. The war analogy is supposed to unite us in a common purpose.

    Sometimes it seems that some Republicans simply will not attempt unite us for ANYTHING.

  4. Submitted by Laura Tabolich on 05/12/2020 - 02:30 pm.

    I have heard people say the Republican party has turned in to a death cult and thought it was hyperbole but I’m really beginning to wonder what their strategy is. What I’m hearing from them is not enough people have died from this (because sheltering in place is working) so lets just open up and get herd immunity. Let the old and the weak die, possibly forgetting that R’s skew old? If there is a spike in the death rate the economy will be destroyed for a lot longer than getting this right in the first place. I can’t wrap my mind around how short sighted and stupid these policies they are putting forward are.

    • Submitted by Mike Hindin on 05/17/2020 - 08:15 am.

      Herd immunity requires immunity. As of this date there is little data, if and how long immunity lasts. Sailors on the Roosevelt are relapsing or the tests were not sensitive enough to detect low level continued infection. Medical and epidemiology communities are guarding all of their statements with disclaimers like “from what we know now,” etc. This is a changing situation and may current judgements are going to change with more days and experience, as it should.

  5. Submitted by Bill Mantis on 05/12/2020 - 02:34 pm.

    It’s not clear to me exactly why Republicans are opposed. And even if their reasons were clearly spelled out, it would be hard to accept them at face value. I believe there is a hidden agenda here. I believe Republicans want to risk re-opening regardless of the consequences to hospitals, healthcare workers, first responders, the homeless and police officers. They seemingly want to avoid collecting any data that might slow the re-opening process.

    • Submitted by Eric Snyder on 05/12/2020 - 06:37 pm.

      It might not be so hidden after all:

      “As Trump debates who should lead his campaign, he’s also struggling to settle on a 2020 strategy. Some advisers are lobbying Trump to embrace the reopening. “They’re going to gamble on the economy and hope it works,” a former West Wing official said.”
      https://www.vanityfair.com/news/2020/05/trump-eyes-campaign-shake-up

      To me it seems pretty clear as to what’s going on. Various Republican politicians, with support from conservative opinion leaders, are urging the re-opening of the economy in the hope that it helps Trump.

      This is abominable. They’re okay with Americans losing their lives as long as Trump benefits.

    • Submitted by Matt Haas on 05/13/2020 - 12:47 am.

      They are of two minds I think 1. They still think it’s a hoax and all will well, vindicating them and “owning the libs” or 2. They realize many thousands will die, and don’t care because they assume they will be liberals they will again “own the libs”. They’re not a death cult, they’re a revenge cult, seeking satisfaction for a lifetime of percieved slights (basically every bad thing that’s happened to them whether someone else’s fault or their own) that they can use to soothe their own fragile ego. A scapegoat that explains why their life is not as wonderful as they “deserve”.

    • Submitted by Mike Hindin on 05/17/2020 - 08:19 am.

      Dr. Jensen should keep his doctor hat on instead of the MAGA hat he is wearing. He is already spreading nonsense that the trump administration’s CDC is encouraging doctors to lable more cases as Covid19 to up hospital reimbursement.

  6. Submitted by Joel Stegner on 05/12/2020 - 03:34 pm.

    Republicans are putting up opposition because this is their one hope of doing well in the electing, as Trump has fumbled the federal response to the pandemic and made many decisions that have helped wreck our economy from his trade war costing farmers sales and retailers and consumers tariffs, to giving away borrowed money to wealthy individuals and companies that did nothing productive with it. They want to turn the subject from unchecked death and economic destruction to “freedoms”. In hard times, shared sacrifice is called for. What Republicans promise is freedom from personal sacrifice.

  7. Submitted by Carl Brookins on 05/12/2020 - 03:56 pm.

    What is the matter with these people? Have they taken leave of their senses? If a person robs you of your money, don’t you want law enforcement to have every possible piece of evidence to catch and convict the robber? What if someone coughs on your spouse and gives her/him corvid-19, is that OK with you? Yes, small business people need support and yes I understand it’s tough you can’t go to your local pub for dinner or a drink. You missed the fishing open? Is the danger you might put your friends and family in worth that indulgence? get real here. This virus is a nasty killer and the experts need to be listened to!

  8. Submitted by Eric Snyder on 05/12/2020 - 07:03 pm.

    “My understanding was that, in a measured and reasonable way, we want those non-protected people to be getting infected to build up immunity so they are less susceptible for spreading it in the future.” -Republican Pat Garofalo

    If you take him as he was quoted he seems to believe that deliberately exposing people to the virus is what we should be doing. Does he really believe this? Can anyone be so misinformed? Maybe he meant something else but misspoke.

    Or, maybe it’s the case he meant what he said. In that case his implicit belief is presumably that instead of minimizing infections and deaths we should not worry too much about it. Whether deaths can be kept to a minimum or whether they’ll reach the millions is not a concern. We know there are miseducated social darwinists out there who mistakenly believe that the virus will only kill “the weak,” and that somehow this is a good thing. Is this Garofalo’s view? Does he even know what his view is?

  9. Submitted by Amy Toner on 05/13/2020 - 02:05 am.

    As we are all aware, since March 27th in Minnesota, we have been in quarantaine to avoid contact with eachother to stop the spread of Covid-19. This fact, that we have maintained greater distance effectivly for 45 days, is now the common safe ground available and yet it is the enviorment that the disease has thrived in-because of its proposed contagion factors. If evaluating its transmission through contact tracing now, can not show currently how the numbers are growing while we are in quarantaine, than tracing can not be proposed to work as a valid source to track the disease in the future, in the public, when the disease and its numbers can not be traced and limited as easily, as the last 45 days. And even as of now, it should not be considered in limiting the fatality of the disease as a whole or partly and has not proven to be used as a factor relevant or needed in reckognizing numbers rather it only considers numbers affected by the disease and provides no certain order guaranteed to safely be moving forward. If we acheive nothing but numbers for the death toll of a disease, we are already made aware is dangerous and we avoid examing the diseases behavior at hand already, the real opportunity to do this in controlled enviornment, will be lost. That is not science. Why wouldnt we have isolated and tried examination of the behavior and transmission of the disease while it has been quarantined in the labratory, so to speak. The behavior of the disease and its transmission has been given the perfect opportunity to show its pattern, by our pattern already in this 45 days. Minnesotans, like rats have been limited in a cage to travel to and from, the same places at the same time, with great numbers all under the attack of the same virus. If it is as highly contagious as contact trace evidence is predicted to support than there should be facts that support that data through the numbers infected and the trace work done already, by the health department. The numbers infected by covid 19 and the deaths from covid 19 in Minnesota during this quarantine should relate greatly to numbers that correlate with the peoples common pathway in which both the infectios disease and the people have been limited to and contained in and on during this 45 day time period. Otherwise if the quarentined path we have all traveled on in great numbers even close in contact on the same daily routes, tracing proves no correlation with the disease and numbers of death and infection through tracing statistics already claimed by the health department, it would than show a lower probability of a highly contagious and infectious disease, as it has been determined that there is a high probability of transmission through contact and that it can be found by tracing. If they can not show proof of contact tracing in our quarantaine that can be used to show the relationship of the virus specifically relating its contagious ability to our designated pathways during this 45 day isolation and yet the numbers are growing, either tracing does not work or the disease is not contagious enough to be proved, in a caged quarentine and we should move forward because with out the statistics in that scientific approach there is no relevent proof it would even work …not even for a trillion dollars.

  10. Submitted by joe smith on 05/13/2020 - 08:21 am.

    It started off as “flatten the curve”, the United States of America never used 20% of available ICU beds in any day of the virus. Now that the “we will have no room and overrun the hospitals” narrative has failed, let’s go to a 228M boondoggle of contact tracing (private companies with public money, what could go wrong) in Minnesota. It never ends, remember Neil Ferguson’s model showing 2.2M deaths in USA that was used to scare Americans into their basements. U of Washington Institute of Health modeling has been so spectacularly wrong, we should cut funding for that program. Remember Walz telling everyone this virus is an equal opportunity killer and the only thing that will save us is our basements? Facts, 81.6 of all deaths in Minnesota are from long term care facilities, children are almost immune from this disease.
    The “experts” have been so grossly wrong on this virus, why do most Minnesotans blindly follow them?

    • Submitted by Edward Blaise on 05/13/2020 - 02:44 pm.

      “The “experts” have been so grossly wrong on this virus, why do most Minnesotans blindly follow them?”

      Because if we ignore the “experts” and follow alternative opinions we will be led to Lysol injections and gargling with fish tank cleaner.

      If it’s all the same to you, Dr. Hannity and Dr. Carlson maybe be your cup of tea, not for me!

    • Submitted by Connie Sullivan on 05/13/2020 - 05:04 pm.

      Many of us would dearly like to contain this virus, stop it fro spreading. There is no treatment or cure for it, there is no preventative vaccine for it, and no one knows how any individual is going to react to infection with the virus: You might be lucky and get away with few, mild, or no symptoms. Or, you may be a healthy athlete of 38 years of age and succumb to it, your lungs flooding with an over-response by your immune system, drowning you.

      It’s an awful death, especially if it affects other organs beyond the lungs, and even those who “recover” sometimes never really do recover, and many have to spend long weeks in rehab facilities to get back use of their limbs and lungs.Covid-19 is definitely NOT a walk int he park.

      And, have you checked out what has been happening to numbers of little kids who get the corona virus? Horrendous inflammatory response, leading to great suffering if not death.

      We can only control this virus is we test almost everybody–particularly those without symptoms who think, probably wrongly, that they don’t have the disease. Then you trace the people they’ve been in contact with and you persuade them not to be carriers who infect others. You ask them for a temporary restriction of their activities for a couple of weeks. What’s so horrible?

      Republicans are proving that they really really do not want to be part of our “community.” Where we take care of each other as best we can, all the time.

      • Submitted by richard owens on 05/13/2020 - 07:48 pm.

        Thank you Ms Sullivan for saying succinctly what should be explained, repeated and somehow communicated to our neighbors and strangers alike.

    • Submitted by Eric Snyder on 05/13/2020 - 06:10 pm.

      It has nothing to do with blindly following. The fact is that the scientific approach is the best we have, and if you know anything about science (your rejection of climate science suggests your knowledge is limited) you’d know that science isn’t about the immediate identification of timeless truths, but an ongoing process of learning, modification and error reduction. That estimates and models change is *precisely* what you’d expect if we’re doing science.

  11. Submitted by Ray Schoch on 05/13/2020 - 09:44 am.

    Mr. Smith’s callousness regarding other people’s lives is “interesting,” to say the least. Hundreds have died in Minnesota. Many thousands have died across the country. Thousands died in New York City alone, and they were not all residents of nursing homes. There’s plenty of documentation (and bodies) to show that the disease can be – and has been – fatal to people much younger than me, including children, and numerous previously-unseen side effects are now being observed.

    Why do most Minnesotans blindly follow the “experts?” Because those “experts,” even when they’re wrong (they have been wrong before, and will likely be wrong again before this is all over), are at least basing their advice and opinions on reason and science, not ideology, and perhaps most of all, not on what will provide the most benefit to stock portfolios.

    Irrational, obsessed with nihilistic ideology and placing profits ahead of lives is a fair characterization of the opinions I’m reading from people who like to call themselves “conservative,” but who simply hate the idea that there might be some necessary restriction on their ability to do whatever they want, whenever they want, to whomever they please. They’re obviously totally ignorant of history, which provides numerous examples of societies that have fallen apart when sizable portions of the population have ignored restraints imposed by government. Telling someone “You have to go back to work. Yes, we know it’s not safe, but you have to go anyway because we need to get the economy going again.” and doing so without providing proper equipment and/or the equivalent of combat pay, and/or paid sick leave, simply shows the sadistic side of capitalism, whether the business is a neighborhood coffee shop or a meatpacking plant with thousands of employees.

  12. Submitted by Brian Nelson on 05/13/2020 - 01:40 pm.

    “It started off as “flatten the curve”, the United States of America never used 20% of available ICU beds in any day of the virus.”

    It is interesting, Joe, that you are not seeing the connection here.

    Also, Joe, on 4/13/20 you stated:

    “If we are to be impressed by Dr Fauci we should note he stated deaths expected in the United States is now 60,000. That is great news for everyone. The next question should be ‘why did we shut the USA down for a bad flu season’? In 2017-18 60k+ died from the flu and no closure of economy. Interesting to hear the explanation coming on the past 6-8 weeks.”

    As you know we are now at approximately 82,000+ cases. I notice that you don’t seem to complain when the models underestimate deaths.

  13. Submitted by Reino Paaso on 05/17/2020 - 11:57 am.

    This November I trust we shall shall see lawn signs in Farmington
    “Infect Garofalo “

  14. Submitted by Matt Haas on 05/14/2020 - 12:09 pm.

    No the state of Washington plans to do exactly as I’ve stated. Quit fearmongering to serve an agenda.

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