In the U.S., contact tracing experiences too many obstacles to be widely effective

by Caroline Bottger

As Americans enter the fifth month of living with coronavirus, state and local governments are still struggling to fully implement contact tracing. A method used by public health workers to contact those who have come into contact with an infected person, contact tracing has come up against a swathe of difficulties up and down the process, from reaching people to lags in testing to politicization. But there are some cases in which it has helped disadvantaged communities fight off the disease. Here’s where the country stands with contact tracing.

The first step of contact tracing is already presenting problems. Contact tracers report that they cannot reach 100% of those infected in their district or city. Workers in Washington, DC, Louisiana, New York and more report a middling success rate in reaching people on the first try. Cities in Florida have abandoned contact tracing altogether because cases are so high. In some cases, Bloomberg reported, people are willing to answer the call and complete an interview, but not provide a list of personal contacts. Other community members simply won’t cooperate when called.

That being said, every successful call helps: “You don’t have to be perfect to have an impact,” said Emily Gurley, an infectious disease expert at the Johns Hopkins School of Public Health told Bloomberg. “And just because cases are still going up doesn’t mean you’re not having an impact, as well.”

The tech industry, meanwhile, is attempting to fill the gap. According to a forthcoming study, the public was more willing to download a contact tracing app than support expanded traditional contact tracing measures. On August 13, neighborhood safety mobile app Citizen launched SafePass, a COVID-19 contact tracing tool. Additionally, Alphabet’s (Google’s parent company) life sciences unit Verily is opening in its own lab to process tests faster. The state of Virginia just released Covidwise, its contact tracing app built on the Apple-Google API, and already boasts 300,000 downloads.

Further down the chain, lags in testing are hampering the effectiveness of contact tracing. Testing supplies at laboratories have been slow to arrive, and U.S. labs, the majority of which are private companies, are also not set up to coordinate with each other. “When we talk about public health, that’s not something you leave to the forces of the free market,” said Nada Sanders, professor of supply chain management at Northeastern University.

But there are some communities that are benefiting from contact tracing. In the Fort Apache reservation in Arizona, cases are high, but deaths are low. Thanks to a tight-knit community and the distribution of pulse oximeters, doctors and contact tracers can keep daily tabs on vulnerable individuals. Isolation on reservations is nigh on impossible: homes are typically small and intergenerational, with grandparents, children, and grandchildren sharing the same space. A 2017 U.S. Department of Housing and Urban Development report found that 16 percent of Indigenous homes were overcrowded, compared with 2 percent of all U.S. households. However, this case study could provide a blueprint for reaching other disadvantaged Indigenous communities, many of which lack adequate healthcare.

Caroline Bottger is a freelance writer who writes on issues of technology, privacy, and security. 
 
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