San Diego Union-Tribune (Sunday)
CONTACT TRACING EBBS IN PARTS OF U.S., BUT NYC STAYS COMMITTED
Officials say effort can still provide valuable data
Coronavirus contact tracing programs across the U.S. scaled back their ambitions as cases surged in winter, but New York City has leaned into its $600 million tracing initiative.
The city hired more tracers during the holiday season surge and in early March hit its goal of reaching at least 90 percent of people who test positive, a mark it hadn’t reached since around Thanksgiving. Last week, the number hit 96 percent.
Overwhelmed tracing programs elsewhere confronted the wave by switching to automated calls, limiting the types of cases they trace or telling infected people simply to reach out to their contacts themselves.
But New York remains committed, saying tracing helped curb the city’s second surge and is all the more necessary now as vaccination campaigns race to outpace the spread of worrisome viral variants.
“This is the danger zone, where we can’t let our guard down,” contact tracing chief Dr. Ted Long says.
Still, considerable challenges remain. Less than half of people who test positive name anyone they might have exposed to the virus. Some stop answering a blizzard of follow-ups meant to ensure they’re staying isolated.
There’s some debate among public health experts over whether local governments should cut back on contact tracing and focus more on vaccination.
After enduring the country’s deadliest coronavirus surge last spring, New York City set up what appears to be the biggest contact tracing effort in any U.S. city, now counting about 4,000 tracers and a $582 million budget for this fiscal year and next. Another $184 million is budgeted for services such as voluntary hotel stays for people who can’t isolate at home.
Tracing infected people was easier in mid-august, when the city had about 200 new cases daily. It became a monumental effort by midjanuary, when new cases topped 6,000 per day.
Since then, the daily caseload has fallen by about half. Still, the city’s five boroughs have infection rates in the top 2 percent of counties nationwide. Long argues the city’s tracing program helped limit the surge to considerably fewer new deaths per person than in the U.S. as a whole.
Tracer Jessica Morris said “it was very intense for twoand-a-half straight months” during the wave.
Slammed with calls to make and callbacks to answer, tracers strove to compress their conversations without skipping important information.
Though responses vary, Morris said she’s “usually able to get through to some degree — maybe not fullblown contact sharing, but at least a willingness to stay home.”
Some infected people report they were already quarantining so didn’t have any contacts. Others simply don’t name names, saying they personally called their contacts and felt they didn’t need the city’s involvement.
The city’s tracing efforts can be intense.
Emmaia Gelman, a graduate student in New York City, said contact tracers called her about 70 times after she tested positive. Each day brought calls, texts or both to monitor her and her two children, who tested negative. Gelman briefly stopped answering the calls.
Faced with their own surges, some other state and local governments decided to dial back their tracing efforts.
In Philadelphia, tracers were stretched so thin that they tried to reach just half of new cases as of early February — and fewer lately as most staffers temporarily switched to helping with vaccination call centers and distribution, Public Health Department spokesman Matt Rankin said.
Philadelphia-based epidemiologist Carolyn Cannuscio saw contact tracing hit its limits as she helped lead Penn Medicine’s program. The holiday season surge forced tracers to focus on cases seen as high spreading risks, though tracers have since resumed trying to reach all its patients who test positive.
Still, she said tracing remains valuable and could help answer such questions as whether vaccinated people can transmit the virus.
“We shouldn’t just give up and think, ‘Now is not the time for contact tracing,’” she said.