Massachusetts employs 1,000 “contact tracers” to fight COVID-19

Massachusetts has begun to approach, test, and quarantine or treat as needed any person in the state that may be infected with the coronavirus. The ambitious goal is to stop the devastating force of COVID-19 through a boring and powerful public health tool called Contact Trace.

Contact tracking begins with a call to the person who tested for coronavirus positivity and followed up with family members, friends, colleagues, etc. who were closer than a short distance, such as family members, friends, colleagues. encounter. Everyone on that list is interviewed about their contact and symptoms.

It is a routine, resource-intensive public health strategy that has been successfully used to stop outbreaks in the United States and around the world. measles To smallpox To tuberculosis To Ebola More.

Local public health workers throughout the United States are already using this strategy with COVID-19. Robert Redfield, Director of Centers for Disease Control and Prevention (CDC) last week Told NPR “Very aggressive” contact tracking is needed before the country begins to return to any kind of state Normal before pandemic. In Massachusetts, Governor Charlie Baker had already begun to work statewide.

“We need to do what we can do in Massachusetts ahead of this, after the surge, and after the spillover,” Baker said at a project briefing on April 3rd. It was

The state, in partnership with Boston-based Nonprofit Partners in Health, has begun hiring and training some 1,000 people who call every person who tests positive.

Many of the thousands of Massachusetts residents who receive calls are unaware that they may be infected. The caller keeps the infected person’s name private, but the organizer acknowledges that it is not difficult to determine why the call recipient is exposed to COVID-19.

In an ideal scenario, everyone who is in close contact with a positive person is tested, even if the person who receives the call has no symptoms. However, like other states, Massachusetts does not yet have the ability to do that. As of Sunday, at least 25,475 tested positive. Last week, an average of 6,499 tests were run in Massachusetts each day.

If you are in close contact with someone who is positive, you will be asked to quarantine for 14 days, even if you have been tested and are negative. This is because the incubation period for coronavirus is believed to be up to 2 weeks. Close contact here is defined as spending more than 15 minutes within 6 feet of a positive person.

Public health experts say more tests for coronavirus are needed to cover everyone identified in this project. And waiting for test results for up to five days, as some people still do, is a problem.

“The delay in getting results is still too long for contact tracking to be very effective,” he said. Sandro Galea, M.D., Dean of Public Health, Boston University.

However, Galea pointed out that the test functionality may change at any time.

“Yesterday we probably didn’t have the tools,” he said. “I still don’t know if I’ll get the tools tomorrow,” he said.

And then there is the question of how to help people who need to be quarantined instead of illness to spread the virus, or how to help people who need to be quarantined because of illness. Some people have enough homes to remain relatively isolated from other members of their family. However, many others are given choices, such as those who share a bathroom, kitchen, bedroom, or those who live with those at high risk of severe cases of COVID-19.

The Baker administration, which says it plans to spend $ 44 million on a contact tracking project, is considering setting up isolation units in dormitories and hotels. Not only quarantined individuals, but also those who are quarantined, need food delivery, and in some cases parenting, and much more to prevent them from interacting with others or spreading the virus.

“It will be a big job,” he said. Joia Mukherjee, M.D., Chief Medical Officer of Partners in Health. “We know that we will succeed to some extent and fail to some extent. We cannot find everyone, but we hope we can prevent many deaths.”

Mukhersey said that if contact tracing doesn’t “cancel” the coronavirus, it can “flatten the curve as well as shrink the curve to reduce the number of infected people.”

Mukazy, who has helped organize similar projects to combat Ebola in West Africa, called contact tracing “offensive” against the coronavirus. She claims that defense strategies alone are not enough.

“Let’s elaborate on what is” defensive ” [strategy] is. The defense is “we’ll be creaming, and we’ll just make sure we have staff at our hospital,” she said. “We’re saying,” Let’s use the tools that can reach out to that quiet fad and start censoring it. “

Some public health leaders and infectious disease doctors question the timing of this launch in Massachusetts. Galea said contact tracking is usually more effective at the onset of pre-epidemic diseases like COVID-19.

“I don’t know it’s too late, but it’s certainly late,” he said. “If we had tests and were organized to do contact tracing out of the box, we could have taken a very different path in this fashion.”

Baker said contract tracking is a “powerful tool” that states must try to further prevent infections. Mr Galea said it could help Massachusetts control a second wave of outbreaks that could occur when home orders and recommendations are lifted.

Massachusetts may be rolling out the most powerful extension of contact tracing so far, Utah (PDF), North Dakota Other states are also launching projects. CDC’s Redfield has 600 staff members at his institution, Will add more.

However, it is still unclear how much state funding the federal government can expect.

Partners in Health collaborates with 36 community health centers in Massachusetts for tracking. The health center says the deal will allow employees who have recently bounced back when selective medical care is discontinued. Partners in Health connects the tracing project to the clinic, where it is tested and can talk to nurses and doctors.

It is not easy to make or receive these calls, and cultural sensitivity is important. Task force (PDF) From Johns Hopkins University Medical Safety Center, we recently investigated what “case finding and contact tracking” might involve across the United States.

A contact tracer can be the first person to alert someone who may be infected with a coronavirus. Stacey King, director of the Chan School of Public Health at Harvard University, works with a student volunteer who works with a local health committee in Massachusetts to help track contacts. King said it was difficult to build trust by asking about symptoms, contacts, recent activities, and family health.

“Especially when people are under so much stress right now,” she said, “I think it will be one of the most difficult things we experience.”

Even if the state has not strengthened its contact tracking efforts, local public health officials may call you if you have contacted someone with confirmed coronavirus test results. If you get a call someday and you’re asked to follow your contacts, you might want to start taking notes right away. Public health officials say: Has anyone recently been within 6 feet of someone who spent more than a few minutes?

The Partners in Health project will continue through October and will end in January 2021.

This story is part of a partnership that includes: WBUR, NPR And Kaiser Health News.