Overwhelmed by omicron, contact tracing is forced to adapt: ​​Gunshots


The speed with which the American variant spread in the United States exceeded programs dedicated to contact tracing. Some public health services are reducing their activities.


UNIDENTIFIED REPORTER: The Virginia Department of Health is no longer using contact tracing in regards to positive cases of COVID-19.

ASA HUTCHINSON: Thanks to omicron, we are not able to do contact tracing.

TOM WILLIS: The Department of Health is ending its COVID-19 contact tracing in Duval County schools.

FLORIDO: Some headlines have gone so far as to state that contact tracing is dead, it’s over. NPR’s Selena Simmons-Duffin has been tracking contact tracing efforts since the pandemic began. She says, not so fast.

Hello, Selena.


FLORIDO: So was the number of cases in the omicron wave just too big to track?

SIMMONS-DUFFIN: Yes. I mean, that’s definitely a big part of it. The other thing is that speed is really important, right? Contact tracing works to slow the spread when people with COVID-19 know they should stay home and their close contacts know they should also self-quarantine in case they are sick as well.

But this variant has spread so quickly that by the time you get the result from the lab and the contact tracing staff make that call, close contacts may already have COVID. They may have already released it. It is simply too late to break the chain of transmission.

And at the same time, it’s not March 2020. Now there are vaccines and treatments. Contact tracing isn’t the only tool here, which is why you see so many health services changing the way they work.

FLORIDO: So what does it look like? What are the health services doing? Are they literally shutting things down now?

SIMMONS-DUFFIN: Yes. I mean, some are, especially the health departments that have hired contractors to make these calls. I’ve heard of contracts ending early; that’s it.

But I would say most pivot. Maybe they don’t call everyone. They just call people over 60, for example, or people who are in settings like daycares, nursing homes, or prisons where outbreaks are a big concern.

How health services communicate this change is also very important. One health department director I spoke with is Jodie Pond. She’s in Teton County, Wyo., and they’ve still been able to call everyone who tested positive in the county up until omicron.

JODIE POND: The numbers were just staggering. So we, you know, decided how we would prioritize cases. And, you know, our phone lines kept ringing because people were saying, I haven’t heard from you.

SIMMONS-DUFFIN: They ended up going on local news and putting out an alert that you might not get a call from us. We cannot reach everyone at this time. Because if people have been waiting for a call for days and it never comes, that could play into public health being broken, you can’t trust it.

And that’s why there’s great pressure now to explain to the public that these changes in contact tracing are happening, that they’re intentional. And several major public health groups recently issued a press release endorsing the shift from universal contact tracing to this more targeted approach.

FLORIDO: Are there any ways the contact tracing process is improving at this point?

SIMMONS-DUFFIN: Oh, sure. There are lessons learned here. There are some pragmatic changes, as many people can call their own close contacts. It’s easier and faster. Also, your friends can screen the health service call, but they can answer yours.

And there have been innovations since the scrappy beginnings of contact tracing. Marcia Pearlowitz heads the Maryland Department of Health’s contact tracing unit. And when someone tests positive at home or in a lab test, they immediately receive a link to an online survey that asks for demographic information, whether they have symptoms, when these have- they started?

MARCIA PEARLOWITZ: And it allows us, after they’ve completed the investigation, to provide them with personalized isolation information.

SIMMONS-DUFFIN: So it’s convenient for the person with COVID, isn’t it? Because they get a date, like self-isolating until Wednesday, instead of a long list of general guidelines. And then for the health department, they get data on where outbreaks are happening, and that helps them figure out who’s most at risk. Then those people get an old-fashioned follow-up phone call.

FLORIDO: So it sounds like maybe you’re saying that, you know, the reports of death from contact tracing might be a bit exaggerated, a bit premature.

SIMMONS-DUFFIN: Basically, yes. I mean, everyone I’ve talked to in health services, policy centers, universities, they’re all saying it doesn’t make sense to abandon this process. He still has a role. It can still save lives.

Crystal Watson, principal investigator at the Johns Hopkins Center for Health Security, made a good point to me. She said she thinks people are eager to close the book on contact tracing because it would signal that COVID is just a regular seasonal virus. But she says, we’re not there yet.

FLORIDO: This is Selena Simmons-Duffin, NPR’s health policy correspondent. Thank you, Selena.


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