What happens when someone tests positive for a dangerously contagious disease? Contact tracing is already a daily task for public health departments and organizations nationwide. Nearly 100 infectious diseases are currently tracked. Now, Covid-19 is forcing a rapid expansion of contact tracing capabilities as agencies seek to monitor its spread.
What is contact tracing?
The Centers for Disease Control and Prevention prescribe contact tracing as a vital control strategy for limiting the spread of the virus as localities emerge from quarantine. Without tracing efforts, new infections could quickly spread before detection, leaving lockdowns as the last option to guard against reoccurring outbreaks.
According to the CDC, the core principles of contact tracing must be followed:[i]
Public health staff work with a patient to help them recall everyone with whom they have had close contact during the timeframe while they may have been infectious.
Public health staff then warn these exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible.
To protect patient privacy, contacts are only informed that they may have been exposed to a patient with the infection. They are not told the identity of the patient who may have exposed them.
Contacts are provided with education, information, and support to understand their risk, what they should do to separate themselves from others who are not exposed, monitor themselves for illness, and the possibility that they could spread the infection to others even if they themselves do not feel ill.
There are tools available to help.
Digital tools for contact tracing have emerged and can offer several benefits for agencies and organizations tasked with the responsibility, including:[ii]
Improving the efficiency and accuracy of data management and automating tasks.
Reducing the burden of data collection on public health staff by allowing electronic self-reporting by cases and contacts.
Using location data to identify community contacts unknown to the case to look at possible exposure.
Apple and Google are building tracing systems for their devices that could be deployed to hundreds of millions of people worldwide almost instantly. However, dozens of smaller tech shops have already been rolling out apps to detect potential exposure to coronavirus utilizing mobile data, location tracking, and financial transactions. Meant to be a supplementary tool for contact tracers, these apps raise some ethical questions about the data collected, how it can be used, and by whom. In response MIT has created a Covid Tracing Tracker that provides details about these tools to help users and organizations answer those questions. The CDC has provided an overview of digitally enhanced contact tracing, and some preliminary evaluation criteria for selecting the right tools. They are awarding $631 million in Covid-19 relief funds, allocated by the CARES Act, to assist states in monitoring the outbreak. You can find a breakdown of awards here.
Implementation is happening across the nation.
Even with the digital tools, the bulk of the work must still be done by humans. A study from the Association of State and Territorial Health Officials (ASTHO) estimates 100k tracers are needed nationwide to effectively track the spread of the virus as businesses begin to reopen.
Absent a nationwide coordinated approach, states are implementing their own Covid-19 contact tracing initiatives through service contracts, non-profit partnerships, university resources, and public health department expansions. Some recent examples include:
Minnesota, following a testing partnership with universities and the Mayo Clinic, plans to hire up to 4,200 temporary staff and procure a new computer system to facilitate tracing in cooperation with local health departments and tribal organizations.
Michigan has contracted with Deloitte and Rock Connections to train, facilitate, and manage the tracing operations of up to 6,000 volunteers over the next six months.
Massachusetts teams up with non-profit Partners in Health to hire more than 1,000 tracers. They also produced a public awareness video about contact tracing to encourage those contacted to respond.
California plans to employ 20,000 tracers, with the first group currently being trained by the state university system.
New York has partnered with Mike Bloomberg and Johns Hopkins Public Health Center to hire up to 17,000 tracers.
North Carolina’s Department of Health and Human Services and Area Health Education Centers have partnered with Community Care of North Carolina to create the Carolina Community Tracing Collaborative.