Epidemiologists call for widespread contact tracing ‘as soon as possible’ amid COVID-19 pandemic

MINNEAPOLIS - A new report from the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, is calling for immediate expansion of contact tracing in the U.S. using a more “tailored approach” amid the ongoing COVID-19 pandemic.

Contact tracing has been praised by health experts as a pillar of infection control that involves trained public health workers reaching out to people who may have been exposed to an infected person.

The report calls on public health officials to implement a data-driven approach to contact tracing, suggesting that a “one-size-fits-all” approach would be detrimental in containing the spread of COVID-19.

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“Although we know that contact tracing, including use of digital technologies, has been employed in several Asian countries to combat COVID-19, we don’t know exactly what methods were used, how many cases were involved, and what the estimated impact was in reducing transmission since other mitigation strategies were employed at the same time,” authors of the report wrote. 

The report suggests that the effectiveness and potential for contact tracing is still very limited. 

“Contact tracing for COVID-19 is predominantly being done by telephone, given the potential exposure risk. Ideally, regular ongoing follow-up with contacts should be done to monitor for symptoms. At a minimum, contacts should be asked to report any symptoms to the appropriate health department as soon as they occur.”

Some tech companies, including Apple and Google, have released apps using Bluetooth wireless technology to detect when someone who downloaded the app has been in contact with someone who has later tested positive for the novel coronavirus. 

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Many governments have already tried, mostly unsuccessfully, to roll out their own phone apps to fight the spread of the COVID-19 pandemic. Many of those apps have encountered technical problems on Apple and Android phones and haven't been widely adopted. They often use GPS to track people’s location, which Apple and Google are banning from their new tool because of privacy and accuracy concerns.

Public health agencies from Germany to the states of Alabama and South Carolina have been waiting to use the Apple-Google model, while other governments have said the tech giants' privacy restrictions will be a hindrance because public health workers will have no access to the data.

CIDRAP suggests these factors could hinder the success of contact tracing:

• There are no mechanisms in place to identify asymptomatic individuals
• There is still a lack of adequate testing in some parts of the country 
• Due to the unprecedented transmissibility of COVID-19, it is almost impossible to identify all exposed contacts
• Lack of an effective medical countermeasure to treat COVID-19
• Contact tracing is predominantly being conducted by telephone

In order to improve contact tracing, CIDRAP suggests the expansion of contact tracing programs for COVID-19 in the United States “as soon as possible.” More importantly, trust plays a key role in the success of contact tracing. 

“If [contact tracing] is not done in culturally appropriate ways, it may lead to loss of trust in the public health system or in government in general,” the report authors wrote. 

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New York City has hired 1,700 people for its contact tracing effort and needs to reach 2,500 in order to meet Gov. Andrew Cuomo’s target for entering the first phase of the state’s four-step reopening process. The contact tracers are placing people infected with the virus in hotel rooms if they need to isolate themselves away from their families as well as reaching out to the close contacts of those who test positive for COVID-19.

These tracers reached out to all of the roughly 600 people who tested positive for the virus citywide on June 1, the first day of the program, and succeeded in reaching more than half of them, officials said Tuesday.

“On Day 1 of the program, seeking to reach several hundred people and have what could be an hour conversation with each of them was a tall order,” Dr. Ted Long, the head of the city’s contact tracing program, said at a briefing. Long said the fact that the contact tracers actually got through to more than half of the new cases “shows that the system we’re setting up is working.”

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Asked if the past week’s protests over the death of George Floyd might spark a new wave of infections, Long encouraged anyone who was at a protest to get tested for the coronavirus at one of the more than 150 free testing sites around the city. Floyd, who was black, died after a white police officer pressed a knee into his neck for several minutes.

“It starts with the testing piece, which is why we’re extending the invitation we are to anybody that’s been out there at the protests, come in for a free test, it’s close to where you live,” Long said. “We’d love to have you.”

The Associated Press contributed to this story. This story was reported in Los Angeles.