NEW YORK (AP) – Coronavirus contact tracking programs in the US have scaled back ambitions as winter cases soared, but New York City has leaned on its $ 600 million investigation initiative.
The city hired more tracers during the holiday season, and in early March reached its goal of reaching at least 90% of people who test positive, a figure not reached since around Thanksgiving. Last week, the number reached 96%.
Overwhelmed investigation programs elsewhere have faced the wave of switching to automated calls, the kinds of cases they track down, or telling infected people to just contact their contacts themselves.
But New York remains committed, saying tracing has helped curb the city’s second wave and is all the more necessary now that vaccination campaigns outsmart the spread of worrying viral variants.
“This is the danger zone, where we cannot let our guard down,” said chief of contact Dr. Ted Long.
Still, significant challenges remain. Less than half of people who test positive name someone who may have been exposed to the virus. Some stop answering a blizzard of follow-ups meant to keep them isolated.
There is some debate among public health experts about whether local governments should cut back on contact tracking and focus more on vaccination.
After enduring the country’s deadliest coronavirus blast last spring, New York City has launched what appears to be the largest contact-tracking effort in any U.S. city, now with approximately 4,000 tracers and a budget of $ 582 million for this fiscal year and next financial year. Another $ 184 million has been budgeted for services such as voluntary hotel stays for people who cannot isolate at home.
Tracking down infected people was easier in mid-August, when the city got about 200 new cases every day. It became a huge effort in mid-January when there were more than 6,000 cases a day.
Since then, the daily caseload has decreased by about half. Still, the city’s five boroughs have infection rates in the top 2% of rural counties. Long argues that the city’s tracking program has helped limit the rise to significantly fewer new deaths per person than in the US as a whole.
Tracer Jessica Morris said during the wave, “It was very intense for two and a half months in a row.”
Full of calls to make and return calls to answer, tracers tried to compress their calls without skipping important information. “I have mastered the art of ice breaking very efficiently,” she said.
While responses vary, Morris said she “can usually get through to some degree – maybe not sharing full contact, but at least a willingness to stay home” and respond to monitoring.
Some infected people report that they were already quarantined and thus had no contacts. Others simply don’t mention names, saying they personally called their contacts and felt they didn’t need the involvement of the city.
The city’s investigation efforts can be intense.
Emmaia Gelman, a graduate student in New York City, said contact tracers called her about 70 times after she tested positive. Every day brought phone calls, text messages, or both to her and her two children, who tested negative.
Gelman paused to answer the calls. She also withheld some of the names of people she had been in contact with before her symptoms came to light, partly because of the immigration status of the people.
“You’re always on the lookout for listing people’s names,” said Gelman, who said she notified all her contacts before a tracer called her.
Long said the city now plans to have one person answer for a family.
“But I will stand by our persistence,” he said. “One of the features of our program that I am proud of is that we are a group of people who do not give up.”
Faced with their own peaks, some other state and local governments decided to reverse their investigative efforts.
In Philadelphia, the tracers had been stretched so thin that they were trying to reach only half of the new cases as of early February – and less recently as most staffers have temporarily switched to help with vaccination call centers and distribution, said spokesman Matt Rankin. public health.
According to health department spokesperson Alyse Kittner, Chicago began automating calls in December and instructing recipients to notify their own contacts. Automation allows the city to reach more than 90% of newly diagnosed people, she said.
New York City has not had to take such steps, Long said.
Still, some other public health experts have reservations about tracking down contacts in the US.
A new study of 300 people who had antibodies to the virus found that 60% had no idea they were infected, making tracers unlikely to know. The study, which has not yet been reviewed by other scientists, also found that less than 18% had been asked about their contacts.
“Contact tracking is not a tactic that will work well, given the speed and scale and stealth with which this virus is spreading,” said lead author Denis Nash, a professor of epidemiology at the City University of New York. He argues that resources may be better spent on tackling vaccination differences, among other strategies.
Philadelphia-based epidemiologist Carolyn Cannuscio saw that contact tracking reached its limits when she helped lead Penn Medicine’s program. The holiday season spike forced the tracers to focus on cases considered high risk of spread, although tracers have since been trying to reach all patients who test positive.
Still, she said tracing remains valuable and could help answer questions like whether vaccinated people can transmit the virus.
“We shouldn’t just give up and think, ‘Now is not the time to track down contacts,’” she said.