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Is contact tracing getting enough attention in U.S. coronavirus response? The answer may…not surprise you. @jenkatesdc and I have a new post about this. https://www.kff.org/coronavirus-policy-watch/is-contact-tracing-getting-enough-attention-in-u-s-coronavirus-response/">https://www.kff.org/coronavir...
There is a clear consensus among public health experts that contact tracing will need to be part of the solution contact tracing is going to be an important piece of the puzzle for eventually allowing people to congregate in public and go back to work again.
For countries that been successful in turning the tide of the virus, contact tracing has been a part of that success, from China, South Korea, Singapore, and Germany.
In the US, local health departments are responsible for contact tracing, and have been stretched thin, and weakened by budget cuts for years. Undertaking contact tracing, even when coronavirus case numbers are falling, will still be a monumental effort. https://www.reuters.com/article/us-health-coronavirus-usa-tracing/its-just-impossible-tracing-contacts-takes-backseat-as-virus-spreads-idUSKBN21I324">https://www.reuters.com/article/u...
For example, If we have a 10% positivity rate on 750,000 tests a week (target benchmarks from experts), that’s 75,000 cases contacts might need to be traced a week. This was the same scale faced in Wuhan, where contact tracing teams traced tens of thousands of contacts daily.
A truly massive, nationally-coordinated scale-up would be required for this level of effort.
To complicate further, the characteristics of Covid-19 make contact tracing even more difficult, due to asymptomatic and pre-symptomatic infections. A recent study suggests a standard approach to contact tracing will likely face limitations due to this https://science.sciencemag.org/content/early/2020/03/30/science.abb6936">https://science.sciencemag.org/content/e...
As the authors of that study say, standard methods can be supplemented with more automated, technology-based approaches using mobile phones and apps – pushing notifications or having lots of people have an app on their phone that alerts them.
Recognizing this, some private and academic groups have begun to create just these kinds of resources and push for digital participatory, crowd-sourced contact tracing. NextTrace, Covid Watch, Trace Together and Safe Paths are examples. https://www.statnews.com/2020/04/02/coronavirus-spreads-too-fast-for-contact-tracing-digital-tools-could-help/">https://www.statnews.com/2020/04/0...
Clearly, these efforts face privacy challenges especially when trying to bring them to scale. https://www.wsj.com/articles/to-track-virus-governments-weigh-surveillance-tools-that-push-privacy-limits-11584479841">https://www.wsj.com/articles/...
In the end, really only the federal government could truly bring order and achieve a national, coordinated effort on the scale (and expense) necessary. At the very least to coordinate and set national standards.
So, there is a need for a massive scale up of traditional contact tracing and much more work to do technological approaches, but we’ve heard almost nothing from the government side on this.
Even though the CDC Director has said he expects to pursue aggressive early case definition, isolation, contact tracing in the coming months, there little evidence of a genuine federal effort to build up capacities. https://www.npr.org/sections/health-shots/2020/03/31/824155179/cdc-director-on-models-for-the-months-to-come-this-virus-is-going-to-be-with-us">https://www.npr.org/sections/...
