- Associated Press - Sunday, April 26, 2020

BATON ROUGE, La. (AP) - Gov. John Bel Edwards’ decision on how quickly to loosen restrictions on Louisiana businesses amid the coronavirus outbreak hinges on two central capabilities, access to widespread testing and an ability to quickly track those who encounter someone infected with the virus.

“That’s the key to reopening the economy without seeing cases surge,” the Democratic governor said.

The state’s success on those metrics is mixed, as Edwards readies to announce his plans this week to “slowly, gradually reopen parts of the economy.” He’ll release details as early as Monday on what restrictions he’ll lift in a new order replacing his statewide stay-at-home order May 1.

To safely reopen restaurants, bars, movie theaters and other workplaces, public health experts say states need broad testing capacity to identify and isolate people with the virus. They also need an army of “contact tracers” who can pinpoint people who encountered those who test positive, are at greater risk of infection and should be isolated.

Louisiana, which became one of the United States’ hot spots for virus outbreaks in March, rapidly ramped up testing and ranks among top states nationally for per-capita testing. But Louisiana’s contact tracing brigade is far short of what state officials believe they’ll need to adequately lessen the risk of new spikes in the COVID-19 disease caused by the virus - though officials say they are actively working to build up the team.

For most people, the highly contagious coronavirus causes symptoms such as high fever and a dry cough that resolve in several weeks. But some people, especially older adults and people with existing health problems, can suffer severe symptoms that can be fatal.

Louisiana has seen encouraging signs in combating COVID-19, with slowing rates of new infections and new hospitalizations, and fewer patients on ventilators. But Louisiana has a higher at-risk population, making decisions about how to relax restrictions trickier.

That’s where testing and contact tracing come in, to make sure people who have contracted the virus - or have come in close contact with someone who tested positive - can remove themselves from spaces where they could infect others. The White House’s guidance for a phased approach to reopening stresses the need for both.

Louisiana built its testing capacity with help from the federal government, a state push to expand its existing laboratory footprint, involvement from medical schools and private sector initiatives that included hospitals, other health providers and stores like Walmart.

The LSU medical school in Shreveport is using 3D printers to make testing swabs, and the LSU veterinary school in Baton Rouge is among instate labs that are producing the liquid the swabs are transported in, as the state looks to continue boosting testing capacity.

Edwards said his goal is to reach 200,000 tests per month in Louisiana, and his administration expects to at least achieve 140,000 to 150,000 tests in May. Louisiana is focusing on a “hub and spoke model,” where tests are done in all parishes and sent to labs for analysis in central, regional locations.

To help identify those exposed to people who tested positive for the virus, Louisiana’s health department estimates it needs a cadre of 700 contact tracers. The agency currently has about 75, after tripling its previous capacity for the effort.

Dr. Alex Billioux, a department assistant secretary, said the agency is looking to quickly add public health school students, recent graduates, possible volunteers and contract workers to build up the team. It takes time, however, to train for the sensitive work of speaking with people about personal data and contacts.

Louisiana also wants to increase the availability of testing for antibodies indicating a person has had the virus, suggesting possible immunity to future infections. But health officials caution the tests can be inaccurate, they shouldn’t be used in isolation to make decisions and COVID-19 research is in such early stages that it’s hard to know what results mean for immunity.

For now, Dr. Catherine O’Neal, chief medical officer at Our Lady of the Lake Regional Medical Center in Baton Rouge, told a legislative economic recovery panel that businesses will have to focus on testing the sick and keeping them away from work, rather than using antibody testing for decisions.

“The antibody tests are fraught with a lack of knowledge,” O’Neal said.

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EDITOR’S NOTE: Melinda Deslatte has covered Louisiana politics for The Associated Press since 2000. Follow her at http://twitter.com/melindadeslatte

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Follow AP coverage of the virus outbreak at https://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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