Docs, contact tracing expert urge economic, social support for COVID-19 reopening strategy to succeed
CHICAGO – The Committee to Protect Medicare and a pioneer in America’s use of contact tracing during a previous pandemic today called for robust investments in public health and social services to overcome public doubts about COVID-19 contact tracing, one of the strategies public health experts say is essential to safely reopening the economy. The discussion on contact tracing was held via Zoom as states begin to lift stay-at-home orders and debate grows about the safest ways to do so without risking new outbreaks.
“It’s not just the function of public health departments to do the contact tracing itself, it’s providing a system around contact tracing that says to people, ‘We’ll take care of you, that if you find out that you’re positive, you’re not going to lose your job,’” said Tom Sheridan, former director of the AIDS Action Council, who designed one of the nation’s first policies of contact tracing for a new emerging disease, HIV/AIDS, in the late 1980s. “If we talk to your family and your friends and other people you’ve been in contact with, they’re not going to lose their jobs, their homes. Unless we look at contact tracing from a systems perspective, which means we have to be able to provide appropriate healthcare and the appropriate social services and economic support to draw people into contact tracing as a collective good, I think we will not be able to use this strategy as effectively as we could.”
Rob Davidson, MD, Committee to Protect Medicare executive director and a 20-year veteran emergency physician, said providers are concerned about the cascading implications on people with COVID-19.
“If a person becomes a COVID-19 case, they have to go in isolation while we find out who their contacts are,” Davidson said. “These are ever-expanding circles of contacts potentially. The critical aspect for us to move forward is that the person who is sick can go back to their job after isolation, that the person who’s in quarantine can take two weeks away and still pay the rent and pay the groceries, and still go back to their job and not be seen as a vector for disease.”
Contact tracing involves isolating a person assumed to have a disease, and working backwards to track that individual’s previous contacts. Those contacts are then asked about their contacts, and so on, until contact tracers build a spider web of transmission as the disease spreads from person to person.
Contact tracing hasn’t been a widely implemented strategy in the COVID-19 response because the epidemic surged quickly. Low rates of testing prevented public health experts from identifying who had COVID-19. Because of that, states were forced to use the blunt public health instrument of social isolation and stay-at-home orders.
Sheridan said contact tracing can succeed by focusing on two pillars:
Deploying well-trained public health professionals who know how to do contact tracing, who can get into public health systems quickly and who have knowledge of local communities. Sheridan emphasized how a successful contact tracing program requires gaining the trust of people with COVID-19 exposure in order to get them to participate.
“You cannot bring in people from outside communities, knock on people’s doors and say, ‘Tell me the most intimate thing about your healthcare and your family,’” Sheridan said. “When people knock on your door and say, ‘I’m from the government,’ most people shut the door and run out the back door.”
Contact tracing should be part of a larger public health strategy that includes investments in wraparound services to support families, especially low-income families with limited resources, with economic and social needs, including putting millions of people who’ve lost their jobs because of COVID-19 back to work. Sheridan said this program could be modeled on federal programs like Americorps and FDR’s Works Progress Administration program that put millions of Americans to work during the Great Depression.
“When you think back on every crisis in America, the thing you’ll remember are economic stimulus packages,” Sheridan said. “All of us on the frontlines of this pandemic need to call on our political leaders to do something bold, something epic.”
The COVID-19 pandemic has killed more than 100,000 Americans since late February.
Sheridan said contact tracing can reassure people under quarantine that science-based and data-driven efforts are underway to make communities safer and minimize such outbreaks.
“I can feel like I can go to the grocery store and breathe a little easier, with my mask on,” Sheridan said. “When you talk about contact tracing under quarantine, people feel protected and supported. We can help each other stay healthier and safer.”
About the Committee to Protect Medicare
The Committee to Protect Medicare is an advocacy organization made up of frontline doctors engaging in direct advocacy and communications in support of a stronger healthcare system in America. To learn more: https://committeetoprotect.org/
Az Ibrahim, 616-227-1940, firstname.lastname@example.org