Contact tracing locates those who are sick, using case-by-case detective work, discovering whom they may have exposed, and isolating the ill so others can return to schools, offices and factories. It has worked elsewhere, such as in South Korea.
President Trump has negligently dumped much of the burden for the coronavirus response onto the states. An overarching federal response to the pandemic would have been better, but at this point, the states have the ball. Contact tracing has long been in the toolbox of state public health departments. Impressive efforts are underway to stand up contact tracing teams, but as Frances Stead Sellers and Ben Guarino report in The Post, the nation is fragmented and the results a patchwork. Overall, the United States is moving too slowly. A National Public Radio survey shows that the workforce in contact tracing nationwide has tripled in the past six weeks, from 11,142 workers to 37,110, but still well short of the estimated 100,000 or more tracers that some experts say is the minimum needed nationwide. According to NPR, given current case counts, only seven states and the District of Columbia are prepared to contain outbreaks.
Tracing and containment becomes harder when infections spike, as has occurred in Arizona. According to the multidisciplinary team at Covid Act Now, Arizona has only 100 contact tracers, but with an average of 1,740 new daily cases, needs 8,700 staff to trace all new cases in 48 hours, before too many other people are infected. By contrast, New York has 9,600 contact tracers; with an average of 695 new daily cases, the state is in position to trace all new infections in 48 hours. When combined with widely available testing, it means the virus there may be contained without lockdowns.
The high proportion of asymptomatic and presymptomatic cases in the pandemic makes contact tracing more difficult. So does the natural suspicion of people who are contacted. Just getting a proper caller ID could help contact tracers reach people who are overwhelmed with spam phone calls. Then tracers must coax people to cooperate, overcoming a reluctance to inform on others, especially friends and family, who might then have to self-quarantine as a result. While part of the federal money set aside for testing in the federal stimulus packages can go to contact tracing, states confront their own budget woes. State public health officials estimated in late April they needed about $4.8 billion to stand up 100,000 workers for contact tracing.
Reopening is popular, but doing it without sufficient contact tracing and testing is foolish. We can and must be smarter.