What’s contact tracing? It’s key to reopening US after COVID-19 pandemic, experts say
Many public health experts agree contact tracing will be critical to reopening the U.S. after coronavirus pandemic ends.
But what does that mean, and how will it work?
The country will need to implement a “robust and comprehensive system” of contact tracing to return Americans to work, reopen schools and ease social distancing guidelines, Johns Hopkins University experts say.
Already, there are signs of a mobilization from tech advancements such as software by Apple and Google to boots-on-the-ground investigators talking with those infected. Other countries are using methods that may cause Americans concerned about their privacy to bristle.
Here’s what you need to know about contact tracing.
What is contact tracing?
It’s all about keeping in touch with people who’ve been in close contact with an infected person, according to the World Health Organization. That means helping them get care and treatment if needed and preventing more transmission of the virus.
WHO breaks contract tracing into three steps:
- Contact identification: After testing positive for the virus, a person’s contacts should be identified through asking about daily activities and the activities of others around them, including family, colleagues and health care workers.
- Contact listing: These contacts should be listed, and there should be an effort to inform them of the exposure and the importance of getting care right away if they develop symptoms. Quarantine or isolation may be required.
- Contact follow-up: There should be regular follow-up with contacts “to monitor symptoms and test for signs of infection.”
Studies show contact tracing was fundamental to stopping widespread outbreaks, including SARS in 2003, Ebola in 2014 and even the eradication of smallpox, according to research on the National Institutes of Health website.
How it works
Those who’ve done contact tracing say it can be “unglamorous” and typically requires lots of workers.
Keren Landman, an epidemiologist and journalist, wrote for NPR that she helped a contact tracing effort by the Centers for Disease Control and Prevention during a mumps outbreak in the Midwest, cold-calling residents potentially exposed to the disease with a scripted list of questions from a cubicle office in Atlanta.
“Contact tracing can feel like drudgery, but in an outbreak, it’s vital to public health,” Landman wrote. “During events like the current COVID-19 outbreak, it helps make possible early diagnosis and getting care to people who need it.
The Centers for Disease Control and Prevention is increasing the number of people who can contact trace in the U.S. to carry out a “very aggressive” plan to track coroanvirus, CDC Director Robert Redfield told NPR.
“We are going to need a substantial expansion of public health fieldworkers,” Redfield told NPR.
In an ideal world, that would mean “100,000 new contact tracers,” Anita Cicero, deputy director at the Johns Hopkins Center for Health Security, told The Verge.
Privacy vs. contact tracing
South Korea developed a plan using medical records, cell phone GPS records, credit card transactions and closed-circuit television, according to Johns Hopkins University.
Singapore created TraceTogether, an app using Bluetooth to determine when users are close. The health ministry can use the data for 21 days to identify contacts, according to the university.
Below is a Singapore government video explanation of the technology.
Taiwan links medical records, health insurance records and travel history to supplement contact tracing efforts, as well as a hotline for reporting possible cases, according to Johns Hopkins University.
“While technology-heavy methods used by Taiwan, Singapore, and South Korea may be difficult to replicate in the U.S. context because of privacy protections, New Zealand and Iceland’s approach could be achievable with a large enough contact tracing workforce,” Johns Hopkin University researchers wrote in a proposal for coronavirus contact tracing.
Contact tracing in the US
New Zealand and Iceland have used “aggressive” traditional contact tracing methods coupled with technology.
For example, NBC News reported, dozens of police detectives are among members of a special contact team to track coronavirus in Iceland. Additionally, a voluntary app traces contacts, and the data are promptly deleted when it’s no longer needed, according to Johns Hopkins University.
In New Zealand, the country shifted manual contact tracing to a national electronic platform synced with other health databases, the researchers said.
Last week, Apple and Google announced plans to create a system to allow apps from public health authorities to exchange information anonymously and alert people who come in contact with someone who tests positive for the virus, McClatchy News reported.
Experts agree the U.S. will need to massively scale up its public health workforce to replicate efforts in other countries.
Massachusetts, for example, already has plans to add 1,000 staff to for a contact tracing initiative in a partnership with nonprofit organization Partners in Health.
Nationally, former CDC Director Tom Frieden estimated the U.S. will need many, many more workers to suppress the COVID-19 outbreak, according to Stat.
“We need an army of 300,000 people,” Frieden told the health and medicine news outlet.
This story was originally published April 13, 2020 at 4:43 PM with the headline "What’s contact tracing? It’s key to reopening US after COVID-19 pandemic, experts say."