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“Contact tracing works best and is most effective in settings where there is not the level of endemic transmission that there is now,” said Nicole Lurie, former deputy secretary for preparedness and preparedness. intervention at the Department of Health and Human Services and a public health advisor on Biden’s campaign. “There must be measures to reduce the level of the virus before it can be effective.”
States are so overwhelmed that earlier this week the Centers for Disease Control and Prevention released recommendations on who the tracers should prioritize if the severity of the pandemic leaves them inundated with cases.
Still, Biden’s plan for a public health body, which is expected to cost $ 3.6 billion, would immediately run into a deadlocked Congress that is far from passing another round of pandemic aid – and, potentially, a GOP-controlled Senate reluctant to free up more funds for state and local health services and oppose a stronger federal role in the pandemic response. A bill from Sen. Chris Coons (D-Del.), A close ally of Biden, which mirrors Biden’s proposal for a national contact tracing body, languished, with no Republican cosponsors.
Still, infectious disease experts say a plan like Biden’s is long overdue, especially because the United States entered the pandemic with a piecemeal contact tracing staff that had been decimated after more than a decade of budget cuts. With tens of millions of people out of work because of the pandemic, the plan could duplicate a public health program and a job.
The large-scale multiplication now, even as infections are getting out of hand, could also help authorities better understand where and how outbreaks are occurring – allowing them to deploy resources and possibly vaccines to particular areas.
“It’s like you have a bowl of spaghetti and try to follow a strand of it with your eyes. It becomes an impossible task, ”said Dr Celine Gounder, member of the Biden Pandemic Advisory Committee. She said she always supported some degree of contact tracing “less with the idea that it is for the specific people involved in this chain, but rather to better understand how transmission occurs in the community in more ways. general … so it always informs the policy.
Public health officials who have met with Biden’s team are also urging that the body of 100,000 men be made permanent, so that it can be deployed to work on other infectious diseases once the pandemic is over.
“Biden has spoken of ‘building back better’ and that must be true for public health as well,” said David Harvey, executive director of the National Coalition of STD Directors. “We want them to remember we’re here for the long haul.”
Biden’s more nationalized strategy would mark a shift from the Trump administration, which has left contact tracing – as well as most aspects of the pandemic response – to states, and has done little to educate the public on how it works or to encourage them to participate.
Disinformation and conspiracy theories flourished due to the information vacuum, and public cooperation with tracers fell dangerously low. Biden’s team hopes to overcome some of this mistrust by hiring members of minority and underserved populations to lead “culturally competent” advocacy in their own communities. But Marcus Plescia, the chief medical officer of the Association of State and Territory Health Officials, says it won’t work unless it’s paired with another Biden pledge – fixing the weak social safety net of the country with more economic assistance for low-income workers. who do not have sick leave.
“If you ask people to quarantine themselves, they’ll be really reluctant to do that if they’re living paycheck to paycheck,” he says. “Without more policies and support for people in this situation, it doesn’t matter how many contact tracers you hire.”
Now, as cases rise and hospitalizations have hit daily records for more than two weeks, the already strained workforce has been completely overwhelmed and in many cases forced to scale back its efforts.
“Many states have started looking for ways to re-prioritize certain populations or situations that present a particularly high risk and to reframe their goals,” Plescia said. “There are only a handful of places that have the capacity to even start dealing with the surge in cases.”
Alaska became the latest state on Monday to ask residents who test positive for Covid-19 to tell their own close contacts because contact tracers in the state cannot follow – joining officials in Kentucky, from Missouri, North Dakota, Wisconsin and several other states that have done the same.
States like Utah and Washington rely on the National Guard to bolster their research efforts, but federal funding for this work could wane at the end of the year.
New Mexico Governor Michelle Lujan Grisham, who is in the running to become Biden’s health secretary, signed a law on Wednesday that provided the state with $ 10 million in new funds for additional contact tracers .
Since many states are unable or unwilling to invest that much, the CDC has advised local health officials to sort out and focus on calling people who have tested positive in the past six. days, members of their immediate household, the elderly and vulnerable groups such as individuals. with health issues or jobs that make them more vulnerable to the virus.
The current surge in cases has even left some wondering if Biden’s call for 100,000 contact tracers is enough to respond right now.
Biden’s plan envisions federal corporations potentially expanding to “a lot more” than that benchmark number.
According to a calculator created by the Fitzhugh Mullan Institute for Health Workforce Equity at George Washington University, California alone would need more than 60,000 new contact tracers based on current virus levels.
“The bare minimum is 100,000 – we probably need over 300,000 people,” Harvey said.
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