NEW YORK (AP) – Coronavirus contact screening programs in the United States have reduced their ambitions as cases have increased in the winter, but New York City has relied on its $ 600 million screening initiative.
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The city hired more trackers during the holiday season’s rise and in early March reached its goal of reaching at least 90% of people with a positive test, a milestone it had not achieved since Thanksgiving. Last week, the number reached 96%.
Overloaded tracking programs elsewhere have faced the wave by switching to automated calls, limiting the types of cases they track or telling infected people to simply contact their own contacts.
But New York remains committed, saying the screening has helped stem the city’s second sudden increase and is even more necessary now, as vaccination campaigns are underway to overcome the spread of worrying viral variants.
“This is the danger zone, where we cannot let our guard down,” said the head of the search engine, Dr. Ted Long.
Still, considerable challenges remain. Less than half of those with a positive test name someone who may have been exposed to the virus. Some stop responding to a storm of accompaniment that aims to ensure that they are isolated.
There is some debate among public health experts about whether local governments should reduce contact tracking and focus more on vaccination.
After enduring the country’s deadliest coronavirus outbreak last spring, New York City has established what appears to be the largest contact tracking effort in any city in the U.S., now with about 4,000 trackers and a US budget. $ 582 million for this fiscal year and the next. Another $ 184 million is budgeted for services such as voluntary hotel stays for people who are unable to isolate themselves at home.
Tracking infected people was easier in mid-August, when the city had about 200 new cases a day. It became a monumental effort in mid-January, when new cases exceeded 6,000 a day.
Since then, the number of daily cases has dropped by about half. Still, the city’s five districts have infection rates in the top 2% of counties across the country. Long argues that the city’s tracking program helped limit the increase to considerably fewer new deaths per person than in the United States as a whole.
Tracer Jessica Morris said “it was very intense for two and a half consecutive months” during the wave.
Overwhelmed with calls to make and callbacks to answer, the trackers struggled to compress their conversations without skipping important information. “I have mastered the art of breaking the ice very efficiently,” she said.
Although the responses vary, Morris said she “is usually able to overcome to some extent – perhaps not a full contact sharing, but at least a willingness to stay at home” and respond to monitoring.
Some infected people report that they were already in quarantine, so they had no contact. Others simply do not cite names, saying that they personally called their contacts and felt that they did not need the city’s involvement.
City tracking efforts can be intense.
Emmaia Gelman, a graduate student in New York City, said contact trackers called her about 70 times after she tested positive. Each day she brought calls, text messages or both to monitor her and her two children, which were negative.
Gelman briefly stopped taking calls. She also hid some names of people she had come into contact with before her symptoms appeared, for reasons that include people’s immigration status.
“You are always cautious because you are putting people’s names on a list,” said Gelman, who said he had notified all of his contacts before a tracker called her.
Long said the city now plans to let one person answer for a family.
“But I defend our persistence,” he said. “One of the characteristics of our program that I am proud of is that we are a group of people who do not give up.”
In the face of their own outbreaks, some other state and local governments have decided to slow down their tracking efforts.
In Philadelphia, the trackers were so stretched that they tried to reach only half of the new cases in early February – and less recently, as most employees have temporarily moved to help with vaccination and distribution call centers, the spokesman said. from the Department of Public Health Matt Rankin.
Chicago began automating calls and instructing recipients to notify their own contacts in December, conducting personal interviews only in groups and for cases considered priority, according to Department of Health spokeswoman Alyse Kittner. Automation is allowing the city to reach more than 90% of newly diagnosed people, she said.
New York City did not have to take these steps, said Long.
However, some other public health experts are having doubts about the United States’ contact tracking efforts.
A new study of 300 people who had antibodies to the virus found that 60% had no idea that they had been infected, making it unlikely that the trackers would also know. The study, which has not yet been reviewed by other scientists, also found that less than 18% were asked about their contacts.
“Contact tracking is not a tactic that works well, given the speed, scale and discretion with which this virus spreads,” said lead author Denis Nash, professor of epidemiology at City University of New York. He argues that resources can be better spent on tackling vaccination disparities, among other strategies.
Philadelphia-based epidemiologist Carolyn Cannuscio saw contact tracking reach its limits while helping to lead the Penn Medicine program. The increase in the holiday season has forced trackers to focus on cases considered to be at high risk of spread, although trackers have resumed trying to reach all of their patients with a positive test.
Still, she said the screening remains valuable and can help answer questions like whether vaccinated people can transmit the virus.
“We shouldn’t just give up and think, ‘Now is not the time for tracking contacts,'” she said.
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