This One Effort to Contain COVID Is "Broken," Experts Say
Contact tracing should be a useful tool, but it faces way too many problems to be effective.
Throughout the pandemic, experts on infectious diseases have been championing a multi-faceted approach to curbing coronavirus. Testing, contact tracing, closures, and personal responsibility are all a part of stopping the spread, in addition to studying the disease and developing treatments and vaccines. But a recent New York Times article reveals why one particular piece of this country's response to COVID has been so ineffective. The U.S. contact tracing program is failing to bring coronavirus cases down, many experts told the publication.
"I think it's easy to say contact tracing is broken," Carolyn Cannuscio, associate professor at the University of Pennsylvania, told The Times. "It is broken because so many parts of our prevention system are broken."
As the publication points out, tracing the close contacts of individuals who have been infected is a disease containment strategy that's been around for centuries, well before smartphone apps and internet connections. (A version of it was even used back in the 16th century to control the bubonic plague, according to an academic paper published on The Conversation.) The Centers for Disease and Prevention (CDC) officially defines a close contact as someone who is closer than 6 feet to a person with coronavirus for 15 minutes or more (though they recently clarified to note that a sneeze or a cough that happens in a five-minute interaction could, of course, also make you susceptible).
Yet, contact tracing hasn't had much of an impact on reducing the spread of the coronavirus in the U.S. That's because of several issues, including inadequate training, public resistance, testing lags, the sheer number of cases, and certain aspects of the virus itself.
In its most effective form, contract tracing enables the close contacts of an infected person to take steps to reduce their exposure to others, limiting the amount of people who they may infect, in case they've also contracted the disease. But in some parts of the country, the amount of positive tests results are simply overwhelming the state's contract tracing teams. NBC5 in Texas, for example, released a report earlier this week citing research from George Washington University that estimates that the state would need 10 times their current amount of contact tracers to keep up with their case load.
And testing challenges aren't doing contact tracers any favors. (Many lab providers have seen the wait for results climb to a week or more.) "It's a race against time," Maryland's Deputy Secretary for Public Health Fran Phillips, RN, told The Times. "And if we have lost days and days of infectious period because we didn't get a lab result back, that really diminishes our ability to do contact tracing."
In addition, COVID is a particularly difficult disease to pin down via contract tracing as it doesn't always make itself immediately known. Many patients may have several days go by between exposure and symptom onset, and about 40 percent of cases are asymptomatic entirely. Add to that a reluctance amongst part of the population to cooperate with tracers—as well as tracers working with incorrect or incomplete contact information—and there are many, many COVID-19 cases all over the country going untraced.
For this reason, some experts recommend scaling back contact tracing and putting those resources into other methods of containment, which may have more potential to drive cases down right now. Former Texas health commissioner David Lakey told The Times, "Contact tracing is the wrong tool for the wrong job at the wrong time," and former head of the Centers for Disease Control and Prevention (CDC) Tom Frieden said, "At some point when your cases are very high, you have to dial back your testing and contact tracing. We may be in that situation in some parts of the country today." And for more places where COVID-19 is taking over, check out The COVID Outbreak Is "Moving Up" Into These States, White House Says.