The surge in new COVID-19 case numbers in the Sunbelt and the West is so alarming that New Jersey, New York, and Connecticut now require visitors from “hot spot” states to self-quarantine. As the Philadelphia region reopens, the long-promised expansion of contact tracing — an essential tool to control person-to-person transmission — is just getting started. And as is true with testing, the amount of contact tracing underway is nowhere near what’s necessary to control the spread of the coronavirus.
Contact tracing is labor-intensive, especially if it is to be culturally sensitive. Workers reach out to everyone who has been in proximity to a person testing positive for the coronavirus and advises them to self-quarantine. The tracing should happen within 24 hours of exposure; otherwise, those exposed stand a greater chance of exposing more people. Contact tracing also works best when caseloads are growing more slowly. If the Pennsylvania, New Jersey, and Philadelphia health departments already had full complements of trained contact tracers on the job, the region’s current slowdown in new cases would be a chance to get ahead of the pandemic.
In a recent Spotlight PA report, experts said there should be thousands of contact tracers working in Pennsylvania, rather than hundreds. New Jersey last week announced a statewide contact tracing initiative, and Philadelphia also has begun training sessions. But delays in scaling up are confounding, especially since both states and the city have long had contact tracing programs for other infectious diseases. Massachusetts has been all-in on contact tracing since April 3; surely, New Jersey and Pennsylvania could have found the wherewithal to do so as well.
Contact tracing has helped Japan, Germany, and other countries keep infection and death rates from the coronavirus far lower than the U.S. The U.S. lacks a consistent plan; some states are succeeding with robust contact tracing, and others are facing challenges. The Centers for Disease Control and Prevention offers some guidance, funding is available through the CARES Act, and in early April, the Johns Hopkins Bloomberg School of Public Health released a national contact tracing plan that could serve as a larger blueprint.
But President Donald Trump’s public statements about contact tracing have been erratic; the pandemic had barely begun when he claimed an administration plan for contact tracing already was a success. Other presidential remarks and tweets have sown confusion, as battles over wearing masks suggest.
Still, it is state leaders like Govs. Tom Wolf and Phil Murphy — and the health department leaders who report to them — who are accountable for the painfully slow expansion of contact tracing. Like their counterparts nationwide, Wolf and Murphy were quick to seize on the notion of “armies” and “corps” of tracers. But nearly four months into the pandemic — Philadelphia’s first known COVID-19 death was reported March 25 — they are still in recruiting mode.
The phased reopening of business in Pennsylvania and New Jersey may provide relief for those who want to “get back to normal.” But until the states fully deploy contact tracing — one of a handful of tools to prevent new infections — “normal” may be another way of saying “risky and dangerous.”