New Jersey shows US the way on contact tracing

CONTACT TRACING IS ONE OF FEW TOOLS AUTHORITIES HAVE IN THE ABSENCE OF A VACCINE

The Uber driver had lost his sense of smell and taste but otherwise felt fine. He kept driving passengers in this small, industrial city until last week, when he took a test for Covid-19.

By Friday, Jean Mugulusi of the Paterson Health Department was on the phone with him, breaking the news that he had tested positive and asking for a list of his recent passengers. He gave her eight phone numbers.

“You came into contact with somebody who tested positive for Covid-19, so I need you to self-isolate,” Mugulusi told one of those passengers, a young man who worked in a factory.

Contact tracing exercise

Mugulusi was doing contact tracing, a once obscure public health measure that has suddenly taken centre stage in the fight against the coronavirus.

States and cities around the country have begun with varying degrees of success to ramp up efforts to put contact tracing in place on a large scale. Last week, Governor Philip Murphy of New Jersey said that his state would hire up to several thousand contact tracers to assist the 800 now working for local and county health departments.

In New York, Governor Andrew Cuomo announced that the state will build an army of up to 17,000 contact tracers. A political tangle between agencies has complicated efforts to expand tracing in New York City, the epicentre of the pandemic in the United States, but Mayor Bill de Blasio said Sunday that he hoped to have 1,000 tracers in place by June.

Twenty miles to the west of New York City, Paterson, a poor, largely nonwhite city of about 150,000, has been tracing the virus at a level that could be the envy of larger cities. The team has been able to successfully investigate and trace about 90 per cent of the more than 5,900 positive Covid-19 cases in Paterson, said the city’s top health officer, Dr Paul Persaud.

As of Saturday, 306 Paterson residents have died, giving the city a Covid-19 death rate of 5.1 per cent among those who have tested positive for the disease, compared to 7 per cent statewide.

Perry N. Halkitis, dean of the Rutgers School of Public Health, said that it was impossible to know how much contact tracing has helped control the spread of the virus. But contact tracing, he noted, “is one of the few tools that we actually have in the absence of a vaccine.”

When the first cases began to appear in Paterson in midMarch, the Board of Health added two dozen employees who had been trained in communicable disease investigation last year to join their regular team of two disease detectives.

Strike force

Since then, the full team, which the board calls its ‘Covid-19 strike force’, has grown to nearly 50 of the 60 board employees. Joining a dozen public health nurses are clerical staff, translators and health inspectors. The board’s accountant, Bob Ardis, tallies total cases and deaths and asks police to drop by homes where Covid-19 positive cases don’t pick up the phone.

“We are almost like an extra arm of the Board of Health here,” said Lt. Detective Louis

Spagnola, the group’s police liaison.

The contact-tracing team mostly works from their homes, making calls and entering their interview results into the state’s communicable disease reporting system. Once a week, they come to the city’s small public health headquarters to confer about the crush of cases.

During last week’s meeting, Andre Sayegh, the city’s mayor, handed out a sheet showing a line curve that tracked the city’s progress: From a high of about 260 daily positives on April 15, the city is now at about 50 to 70 cases per day, a level not seen since March.

“This is a testament to what you have been doing,” the mayor, who had Covid-19 himself, told the team. “You kept me and many others alive.”

This is a testament to what you [Paterson contact tracing team] have been doing. You kept me and many others alive.”

Andre Sayegh | Mayor, Paterson, N.J.