The high transmissibility of the omicron variant is leading experts to rethink the use of one of public health’s most powerful weapons: contact tracing.
Major public health organizations including the Association of State and Territorial Health Officials and the National Association of County and City Health Officials announced this week that it is time to transition away from universal case investigation and contact tracing in favor of “a more strategic approach.”
“Over the past few weeks, we have really seen it shifting,” said Adriane Casalotti, chief of government and public affairs at NACCHO, who said with such high levels of spread, many health officials can better use their time on community education and vaccination efforts, including first shots for 5-to-11-year-olds and ensuring adults get boosters. “With this pandemic, there is plenty of work to be done,” she said.
The groups’ announcement emphasized the ongoing importance of contact tracing to control other communicable diseases, such as measles, tuberculosis, hepatitis A, HIV, syphilis and gonorrhea.
Contact tracing — or attempting to identify and reach out to anyone who has been in contact with someone diagnosed with an infectious-disease — is often viewed as public health’s most effective method for tracking transmission and helping people protect themselves. It has been used to bring outbreaks of Ebola under control and allowed smallpox to be cornered before being eradicated by a vaccine.
The CDC’s website includes a brief animated video, urging those infected with the virus to “answer the call” from public health officials.
But the value of contact tracing has from the start of this pandemic been questioned by some health experts. The coronavirus spread so quickly and stealthily, often before people realized they had contracted it, that the labor-intensive process threatened to overwhelm local and state health departments.
“I thought there were too many asymptomatic infections,” said Alfred Sommer, former dean of the Johns Hopkins Bloomberg School of Public Health, who helped lead the fight against smallpox. “Early on, when people weren’t wearing masks in the grocery store or at other gatherings, they often had no idea who they were in contact with.”
Now the even more transmissible omicron variant, along with the wide availability of effective vaccines and a better understanding of the epidemiology of the virus, has led to a need for change, the public health groups said: Investigations should focus on high-risk settings, such as those serving vulnerable populations, often in institutions such as shelters, correctional facilities and nursing homes.