New York – Contact tracing is supposed to be one of the key weapons in the fight against the coronavirus pandemic, and for months authorities in the United States have touted the need for an “army” of tracers to allow the economy to reopen safely.
But the project to recruit and hire such tracers — who will have a daunting job ahead of them — has only just begun.
Director for the Centers for Disease Control and Prevention (CDC) Robert Redfield has emphasized the importance of tracing — in which public health officials get in touch with every person who has had contact with someone who has tested positive for the virus, and ask them to isolate themselves.
“It’s a critical part to stop the chains of transmission (of the virus) and prevent the occurrence of sustained community transmission,” he told a congressional committee Tuesday.
Experts estimate that the U.S. as a whole — which has seen more than 84,000 COVID-19 deaths, by far the most of any country — will need at least 100,000 contact tracers.
And that estimate still assumes there would be what experts call complementary use of geolocation applications, which could help automatically track users movements and flag if they come in contact with anyone who has tested positive.
Most U.S. states, which will handle their own contact tracing, have just started the process of building such forces.
Since mid-April the governor of New York — the hardest-hit state — has talked about hiring between 6,000 and 17,000 tracing agents.
But it is just this week that renowned Johns Hopkins University medical school — in partnership with New York state — has launched a free online course that potential tracers would have to complete.
With so many people out of work due to the virus, there are already thousands of candidates.
But New York’s tracing program is not set to begin before early June, when officials say they will have trained 1,000 agents.
Harvard public health professor Andrew Chan explained the struggle of establishing a tracing program: there must be enough agents, but also enough tests for everyone who may have been exposed and the facilities to quarantine those who might not be able to stay at home.
“All of these things have to be in place before you actually get the operation started,” he said.
Plans for contact tracing have hit a similar snag as to what the U.S. has faced in testing, which has still not reached sufficient levels in the country.
“You really do need government to be able to step up and take on this responsibility on behalf of the people,” Chan said. “And because that has not happened at the federal level, it’s been left up to the individual states to work out the details.”
That “patchwork” approach has created “chaos and confusion,” he said.
Even in Chan’s state of Massachusetts, which has been a pioneer in organizing contact tracing, the program is still not fully up and running.
Even when the contact tracing “armies” do become operational, their task can seem overwhelming.
“It’s not a very short and simple conversation,” Chan said of contact tracers’ experiences in Massachusetts. “It requires a lot of discussion to alleviate the anxiety of being tested positive, and (to) go about the details of what it means.”
And in many places it is Hispanic and black communities, some already facing hardship, that are proving most susceptible to virus spread.
Many of the people who the contact tracers talk to do not speak English or risk losing their jobs if they are asked to quarantine.
Julian Drix, who has been a tracer in the small neighboring state of Rhode Island since March, says that many who are “traced” are undocumented immigrants who are wary of authorities, and that there are not enough bilingual tracers.
“It can make it harder to gather information and trust,” he said, explaining that many tracers work 10 or 12 hours per day, six or seven days a week. “It is possible, but it takes more time and more work.”
“We won’t ask people what their immigration status is,” Drix said. “We don’t want to instill fear in people.”
Chan calls the work a “monumental undertaking.”
“In some ways it’s so daunting that it can certainly be an impediment to even getting it started.”
And many states could face funding troubles as their tax revenues take a hit from the slowing economy.
But whatever the obstacles, the efforts must push ahead, said the chief medical officer of the Association of State and Territorial Health Officials Marcus Plescia.
“This is the only option,” he said of contact tracing.
“If we don’t put contact tracing (in place) in a big way, the virus is going to come back even worse,” he said.
For the programs to work, Plescia said, people across the country will have to come to see tracing and quarantine as an obligation, despite the inconveniences.
“This has to kind of become the social norm, that people expect and expect of each other,” he said.
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