Contact tracing is critical to combat COVID-19. Here’s why it’s easier said than done
Contact tracing isn’t always as simple as it sounds.
Health experts have heralded it as a critical component in combating the spread of the coronavirus as the country remains in the throes of the pandemic with no vaccine yet available. But states have faced a myriad of obstacles in trying to ramp up tracing.
The process involves identifying and notifying those who have come in contact with a coronavirus patient, whether through phone calls, digital tools or other methods. It also includes preventing further spread by ensuring those contacts effectively quarantine, according to the Centers for Disease Control and Prevention.
It’s been used for decades as a disease-control method — from Smallpox to the 2003 SARS outbreak, McClatchy News previously reported.
But for many states, contact tracing during the coronavirus pandemic has been easier said than done.
The process requires mass expansions of staffing and “large cadres” of contact tracers, according to the CDC.
In April, the CDC awarded $631 million to 64 jurisdictions under the Coronavirus Aid, Relief, and Economic Security, or CARES, Act to help state and local health departments expand testing and contact tracing and contain the virus, according to the U.S. Department of Health and Human Services.
However, a report from the Association of State and Territorial Health Officials and the Johns Hopkins Center for Health Security found that about 100,000 contact tracers would need to be hired to successfully trace the contacts of all reported cases — costing an estimated $3.6 billion in emergency funding to states and territories.
Demand grew quickly
States and territories have existing contact tracing capacities for isolated outbreaks or individual cases of disease, but they’re not sufficient to meet the demands of the COVID-19 pandemic, the report says. The virus has several characteristics that make it uniquely difficult to trace, including the prevalence of asymptomatic spread and its ability to quickly cause large outbreaks.
Successful tracing requires “an unprecedented and rapid scale-up” of public health workers, with exact numbers varying by state and the need for tracers increasing as cases do, per the report.
But with a lack of federal resources, many states have struggled to do so, NBC News reports.
Most states had plans to ramp up contact tracing, but few had met or were expected to meet their “estimated need,” in early May, according to an analysis from NPR News.
States not prepared
A ”cohesive national plan” and communication about contact tracing from the White House have been lacking, Jeremy Konyndyk, senior policy fellow at the Center for Global Development and coordinator of the United States’ humanitarian response to the Ebola Outbreak in 2014, told NBC News.
The White House in April listed the ability to “trace contacts of COVID+ results” as state preparedness responsibilities under its reopening guidelines. The CDC has guidelines for contact tracing and says it offers assistance to state and local agencies, for which lawmakers have pushed for increased funding, per NBC.
Konyndyk told NBC the country could’ve been more prepared if government efforts to ramp up contact tracing had started earlier.
“But the federal government chose not to own the issue,” he told NBC News.
Privacy issues
A lack of resources and tracers isn’t the only problem states are facing when it comes to contact tracing.
A Washington-Post University of Maryland poll found about 3 in 5 Americans say they would not use or are unable to use an infection-alert system developed by Apple and Google, with many citing the fact they don’t have a smartphone and others expressing distrust in the companies to protect their privacy.
While a handful of states have said they’re developing their own apps to trace, those efforts haven’t gone so smoothly, Politico reports.
Public health experts agree that, regardless of the approach, getting enough people to trust virtual surveillance will be a challenge, per Politico.
Lack of trust
But the trust issue extends beyond technology.
There’s also a “long-standing distrust” of public health officials in the U.S., especially among minority communities, The Washington Post reports.
“We don’t have a great track record in the United States of trust in the public health system,” David C. Harvey, executive director of the National Coalition of STD Directors, told The Washington Post.
Even so, COVID-19 is still proving to be a difficult virus in terms of contact tracing.
“It’s not a silver bullet. It won’t reach everyone; not everybody will comply,” Susie Welty, a contact tracer whose HIV research was suspended by the pandemic, told the Washington Post. “But it’s the best we have now, the best we will have until we have a vaccine.”
This story was originally published June 15, 2020 at 6:07 PM with the headline "Contact tracing is critical to combat COVID-19. Here’s why it’s easier said than done."
