Former CDC chief: Protests increase need for contact tracing
Protests against police brutality have increased fears of a second coronavirus wave in Connecticut, even as the state accelerates its reopening after three months of lockdown.
There have been protests against brutality in every state, including many throughout Connecticut.
Simultaneously, nearly every state has placed restrictions on the size of gatherings, in the hopes of halting person-to-person transmission of the coronavirus.
Are those protests a source of disease transmission? And, with Connecticut among other states beginning to reopen their economies concurrently with those protests, will public health officials be able to tell?
“It depends how good the contact tracing is, how good the investigations are of the new cases,” Dr. Tom Frieden said during an interview with Hearst Connecticut Media. “If you find a bunch of cases a week from now, among people who participate in protests, then those likely were the source.”
Frieden was director of the Centers for Disease Control for eight years, appointed by then-President Barack Obama. After leaving the office in 2017, he became president and CEO of Resolve to Save Lives, an initiative intended to prevent epidemics.
He has been very vocal since then about the need for a four-step, “box it in” strategy for fighting the coronavirus: Test, trace, isolate and quarantine.
Protests, Frieden said, are not particularly good arenas for viral transmission.
“First off, the risk of spread from outdoor contact is much, much lower than the risk of spread from indoor contact. One scientific review suggests that it's 19 times lower risk. And the risk is even lower if people are wearing a mask,” he said. “To protest outside with lots of other people wearing a mask, is pretty low risk.”
That being said, “there are a lot of impacts of the current situation on our ability to control COVID,” according to Frieden. “Obviously, if people are taken to indoor spaces like correctional facilities, that's an area where there's often explosive spread of COVID.”
Tear gas, too, as has been used against protesters in several locations around the country recently, presents a problem.
“If people get tear gassed and they cough and take off their mask, that becomes higher risk,” Frieden said. “And you do want to be careful because you still want to not touch your face.”
On Tuesday, almost 1,300 medical and public health officials signed an open letter urging governments, among other recommendations, to avoid the use of “tear gas, smoke, or other respiratory irritants, which could increase risk for COVID- 19 by making the respiratory tract more susceptible to infection, exacerbating existing inflammation, and inducing coughing.”
Connecticut has launched a contact tracing initiative called ContaCT, in which towns and cities trace any contact coronavirus patients have had since infection, and then sharing that information with a central database.
“Of course there’s definitely a concern regarding possible transmission,” said Max Reiss, a spokesman for Gov. Ned Lamont. “I think within the next two weeks you would actually be able to have a bearing on if one of these events was a spot.”
Reiss said Friday that 24 of the state’s 65 health districts had signed up to be part of the program. Since May 20, 449 cases have had contacts followed, and there were 607 registered users as of Friday.
“This is a thing state government has never done before and we’ve already activated the system in a third of our health departments,” Reiss said. “We’re still ramping this up but so far we’re very pleased with this software rollout.”
Lamont has said that protesters should get themselves tested for COVID-19.
“I would go to one of the drivethru testing facilities and get yourself tested if you’ve been in one of these protests,” Lamont said at a Wednesday press briefing. “I’ve been intrigued and interested and happy to see that most of the people there are wearing masks.”
New York Gov. Andrew Cuomo took it one step further on Thursday.
“If you were at one of those protests, I would, out of an abundance of caution, assume that you are infected,” Cuomo said. “One person, one person can infect hundreds if you were at a protest.”
Frieden, though, said the greatest threat of COVID-19 resulting from the protests would be from violence, and a lack of trust in government. People need to feel comfortable enough with governments to get themselves tested, and to share their recent contacts for tracing purposes.
“If there is destruction of property, and I was just seeing an article that testing centers have been damaged, that's a big problem for COVID response. Basically, violence is inimical to public health,” he said. “I also wouldn't like to see the pandemic response being used as a reason to tell people not to protest. People make judgments, and I think our role as scientists and in public health is to give people the information they need to make those judgments in an informed way.”