Contact Tracing: Making States Difficult to Determine if Efforts Are Successful

Welcome to the Sprint called Contact Tracking. This is the process of persuading potentially exposed people to reach and quarantine them as soon as possible.

According to experts, race is the key to controlling pandemics before vaccines. But most places throughout the United States do not publish how fast or well it is performing, leaving Americans in the dark about how governments mitigate risk.

The exception is the District of Columbia, which recently added metrics for tracking contacts. Its online dashboard.. A few weeks ago, the district was still overwhelmed and we couldn’t try to ask everyone who positively tested for contact. Now, after organizing hundreds of contact tracer staff, DC officials say they are making the attempt within 24 hours of a positive test report in about 98% of cases.

For several months, all US states have posted daily numbers for coronavirus testing, along with charts of new cases, hospitalizations and deaths. So far, only one in Oregon has posted similar data about contact tracking. Officials in New York say they will launch such indicators in the coming weeks.

Recently Case spike Contact tracking efforts in Texas, Arizona, Nevada, South Carolina, West Virginia, Georgia, and California are hampered. However, even in states where declines have been seen, it has been difficult to measure contact tracking success. This is because their efforts are often led by local and county health departments.

Larry Hogan, Governor of Maryland (D) Announced Launched in May, a digital platform for contact tracing that allows personnel to view detailed performance metrics. After more than a month, state provincial health spokesman Charles Gishler declined to publish the figures, “because the data are under investigation.”

In Georgia and Colorado, Health Department officials say they are developing a platform for tracking data, but the numbers are not yet available.

Center for Disease Control and Prevention Posted guidance in April It contains various recommended contact tracking metrics. In most states none are publicly reported.

“Contact tracking is a way to prevent cases from becoming clusters and clusters,” said Tom Frieden, a former CDC director currently working on the Global Health Initiative. Solve and save lives..

He said the importance of transparency was increasing as jurisdictions expanded their tracking efforts. “The more openly we share it, the faster we progress.”

Contact tracking is not new to public health agencies that have long been used to control diseases such as tuberculosis, meningitis and measles. However, the scale of the coronavirus pandemic raises new questions. Some places Try the phone app To help their efforts, they rely on the people who download the app and raise privacy concerns.

Each positive test result requires a case study. This is usually a phone call from a healthcare professional that lasts over an hour. The goal is to help remember those who have been in close contact. It’s usually within 6 feet for 15 minutes from someone. Contract tracers try to reach each.

“We had people with over 60 known contacts. They were so busy that they were very socially active,” said Alexandria Director Stephen Haering. .., Virginia, Dozens of new positive cases were averaged per day in May.

“It’s a lot of phones,” Haering said.

The city temporarily diverted staff from family planning centers, vaccination clinics, and other specialties to track contacts.

Alexandria is averaging thanks to long shutdowns and slow restarts Over 12 new positive cases per day.. Haering maintains more than 40 tracking staff, many of whom are newly hired through state contracts and try to reach people within hours of a positive test report.

“If we get it in the afternoon, we make [the call] Haying said he was prepared to add tracers if the number of cases surged. “It’s not open 24 hours, but it’s open all year round, including holidays.”

In many places the tests were more limited and the health sector lacked tracers, so they did not attempt full contact tracking or abandoned efforts during the epidemic.

Even in the nation’s capital, healthcare workers could only focus on priority cases such as nursing homes Last month’s personnel increase..

La Quandra Nesbitt, head of DC, said: Public health center.

Experts say the United States will probably need a legion of over 100,000 contact tracers to help contain the virus.

“This number may be great,” April report According to the Johns Hopkins Bloomberg School of Public Health, less than half of the people are employed in Wuhan, China, where the virus broke out.

State and local officials have since announced the employment of thousands of contact tracers across the country. But even where those large-scale surges have been seen, even those extended operations are overwhelming.

Coronaviruses are not only fast, but also stealthy, which creates another major challenge. Researchers do not know what percentage of the infection (probably 15%, 30%, or more) comes from people who have not yet experienced symptoms.

Test results usually take several days, so in many cases, the case investigator who first calls the person with the new positive case will leave late. According to the pharmacy chain CVS, customers should expect to get results in about 3 days, and sometimes longer. DC health officials say the results from the city’s testing grounds have taken the last seven days, but now it takes three to five days.

If the test results for Person A take 4 days, the contact tracer may be experiencing symptoms by the time they reach Person B. At that point, she may have decided to self-isolate, but only after spending 1-2 days spreading the virus.

“By the nature of this virus, it means that the next round of infectious events will have a very small window before infecting others. I wrote The Rules of Contagion, due out this week. Medical doctor.

To Modeling research Kucharski and his coauthors, recently published in the Journal Lancet, concluded that contact tracking alone is unlikely to contain the virus.

“Whether you detect a case very quickly, or if you follow a very wide range of traces, you may need to take some additional precautions,” Kucharsky said. ..

Still, the more the community manages contact tracking, the less restrictions are needed on gatherings and economic activities.

Health officials in North Dakota say they only see dozens of positive cases per day and that they contact them within an hour of being notified by their health care provider of the test results. Maine officials with a similar number of cases say they will begin the investigation within hours.

New Mexico contact tracers add 100 to 200 cases per day, reaching a median of 48 hours from test results, below the state goal of 36 hours. Press conference in late June..

Massachusetts officials say they have recently experienced 100-300 new cases per day and have contacted cases and contacts within 24-48 hours. Colorado set a goal to reach a patient’s close contact within 72 hours of a test result, with a similar number of tests being positive, but unable to extract metrics from the data until later this month.

One sign of the success of the contact tracking program is the inclusion of new positive cases. After the tracer identified it as a close contact with another infected person, the tracer had already spoken and persuaded the quarantine.