Contact tracing is critical to getting COVID-19 under control, and the U.S. is failing at it

Contact tracing is critical to getting COVID-19 under control, and the U.S. is failing at it

The Association of State and Territorial Health Officials and the Johns Hopkins Center for Health Security estimates that state and local health departments need $3.6 billion to effectively conduct contact tracing of the coronavirus to reduce transmission. They’ve received $631 million so far from Congress. Contact tracing is the process of finding out all the people an infected person might have exposed to the virus while carrying the disease. It takes a lot of work, and most states aren’t ready for it.

Instead, they’re reopening with neither adequate testing nor contract tracing in place. “We flattened the curve. Then, by the time we ended, the contact tracers weren’t up and running yet,” Will Humble, former director of Arizona’s health department, told The Washington Post. Cases in Arizona are  surging there, with more than 4,440 cases in the past three days. Humble told the Post that the state should have tied reopening regions of the state to the hiring of adequate contact-tracing staff, but “We didn’t do that here,” he said. “Now we have to ramp up a contact-tracing workforce that isn’t going to get to everything, probably.” While Arizona is the nation’s current coronavirus hotspot, it’s not the only state that is ill-prepared to stem the virus’ spread with this simple—though time- and labor-intensive—epidemiological tool.

Texas and South Carolina are two states also seeing a sharp increase in cases, and neither have enough staff available to meet the need for contact tracing. But that’s not the only problem. In Louisiana, the state did ramp up for contact tracing, but hasn’t been able to get people—the contacts that might be infected—to answer their phones. In the last two weeks of May, they spoke with fewer than half of the people they were trying to reach.

“We don’t have a great track record in the United States of trust in the public health system,” said David C. Harvey, executive director of the National Coalition of STD Directors. There’s also profound mistrust in the government for many communities, particularly Latino, and for good reason. Venus Ginés, founder of the Latino community health organization Dia de la Mujer Latina in Houston, says of the community: “They’re scared. […] There’s always that fear if I say something, and this person is undocumented and the government finds out about it, then that person could be deported. […] We don’t know if this information is going to get hacked or how it is going to be utilized.”

In some of these states, they’ll also be facing out-and-out hostility and threats, the kind of backlash that’s leading many public health officials to leave their jobs. All of this is a challenge for officials trying get infection rates down.

That’s all hard to combat, but it’s necessary. It’s necessary for stopping rampant infections. It’s necessary for health officials and scientists trying to get a better picture of how the virus spreads—or just as important, doesn’t spread—in certain settings. There needs to be a much greater investment by the government in both testing and contact tracing if the states are ever going to get a handle on this

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