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As more and more states prepare to reopen segments of their economies in light of the Covid-19 pandemic, public health experts hail contact tracing and testing as vitally important. Tracing, combined with testing, will allow for isolation of Covid-positive patients, with or without symptoms. According to Dr. Ashish Jha, a physician and professor at the T.H. Chan School of Public Health, “If we don’t have extensive contact tracing in every community in America, it’s going to be really hard not to see this virus when we open back up.”
In New York City, Major Bill de Blasio has likewise indicated that widespread testing and tracing of those who have been in contact with infected individuals will be central to lifting restrictions and reopening the city for business.
What is Contact Tracing?
What is contact tracing and how does it work? In short, contact tracing is identifying those with whom an infected individual has come into contact. As simple as this may sound, developing contact tracing programs is a logistical challenge. Up to this point, most so-called ‘contact tracing’ has been word-of-mouth, with infected individuals reaching out to friends, family, and coworkers with whom they have been in close proximity. This strategy has its limitations, however, in that it relies upon memory and accurate reporting to be effective. In the current environment of social distancing, an individual may not want to admit to having been part of a large gathering. Or, a person may have not known or remember all of the people with whom he or she has been in contact.
In order to facilitate a more robust tracing system, technological solutions are in the works. Both Apple and Google are developing apps that users can download onto iphones or android phones. The app will send a beacon via Bluetooth, connecting with others also using the apps. This will build a network of contacts. If someone with whom a person has been in contact is later diagnosed with Covid-19, that person will receive an alert. While this system promises to provide a comprehensive body of data to monitor spread and trends, privacy concerns and willingness of the public to buy in will determine its effectiveness.
Meanwhile, Salesforce has teamed up with the city of New York to create a contact tracing network that the city hopes will be up and running by the end of May. Major de Blasio stated, “It will allow us to track every case, analyze the data constantly, keep the right information on each and every case, [and] manage the whole process efficiently.”
States Prepare for Contact Tracing
Contact tracing programs have proved effective in places such as South Korea, while North Dakota and South Dakota are already using tracing apps to monitor the viral spread. New York City hopes that, by the end of June, it will have hired 2,500 “foot soldiers” as part of its “test and trace corps” in order to fully implement its tracing program. The state is also working to develop its own smartphone apps to help monitor the spread.
As of May 7, 44 states around the nation, plus the District of Columbia, had indicated plans for contact tracing programs. These states indicate a combined need for 66,000 individuals, to include epidemiologists, nurses, and trained citizens, to form a contact tracing workforce. In Minnesota alone, the state anticipates the need for 4,200 individuals, for as long as 18 months, to make up its network of contact tracers. This would put the state health department at two and half times its current staffing level.
Increased Testing Still Required
Experts stress that states must also increase rates of testing alongside contact tracing. One research group, Harvard’s Global Health Institute, says that the U.S. should be doing more than 900,000 tests per days. According to the group, only 9 states are testing at the necessary level, with many others quite far from this target.
Minnesota Department of Health Deputy Commissioner Margaret Kelly has indicated that, while already in the works, contact tracing is phase two of the battle against coronavirus, but phase one – testing – must still increase as part of the overall strategy. In South Carolina, the Department of Health and Environmental Control (DHEC) plans to nearly double its current test rate during May and June. According to DHEC agency director Rick Toomey, “It’s going to be a challenge. As we accelerate South Carolina and as we return to the new normal, however that is going to be defined, we and our partners will be expanding the testing.’’
Not only are state governors and health departments highlighting the need for further testing, business owners themselves are weighing in on the safest way to reopen their businesses. From small mom and pop establishments to larger hotel conglomerates to behemoths such as Microsoft and Amazon, businesses have begun to plan for and implement employee test programs. According to Amazon CEO Jeff Bezos, “Regular testing on a global scale, across all industries, would both help keep people safe and help get the economy back up and running.”
Conclusion
To reach these tracing and testing goals, local, state, and federal governments face obstacles such as funding and availability. Tracing programs will be expensive, and Covid test kits have not yet been available on the levels needed to meet such aggressive testing goals. Availability does continue to improve, as new tests are developed and new players enter the field, such as Blueflame Medical, which offers Covid-19 test kits alongside its PPE supplies. Still, the need for significant, coordinated effort looms as states pave the way for reopening with test and trace programs.
