Contact tracing’s participation challenge

The ability for states, municipalities, public health departments, and providers to effectively trace infected COVID-19 patients and their contacts—an activity commonly known as contact tracing—is expected to be essential to efforts to control the spread of COVID-19 in months to come.

Comprehensive contact tracing initiatives in South Korea and Germany are credited with dramatically slowing the spread of COVID-19, allowing those countries to start reopening their economies on a faster timeline than harder-hit regions. However, a large-scale effort requires significant coordination and manpower; The New York Times reports that between 100,000 to 300,000 people may be needed for contact tracing roles in the United States.

Massachusetts—an early domestic epicenter of COVID-19 cases—has emerged with one of the first state-level contact tracing initiatives in the nation. On a recent webinar, leaders of the Massachusetts Community Tracing Collaborative detailed their efforts in concert with hospitals, local boards of health, public health departments and other state organizations.

The collaborative has employed 1,500 case investigators to both apprise people of exposure to COVID-19 patients and confirm they’re able to quarantine at home, Emily Wroe, MD, chief medical officer for Partners in Health and director of implementation and design with the collaborative, said.

Paterson, New Jersey, has also emerged as an early test case for contact tracing, the New York Times reports. The city has been able to successfully investigate and trace roughly 90 percent of its COVID-19 cases to date, and has seen its daily positive tests drop from 260 cases in mid-April to 50 to 70 cases per day at present.

For hospitals and other participating organizations, simply convincing people to answer their phones will be critical. A recent Axios/Ipsos survey found that only 51 percent of Americans said they would participate in a voluntary contact tracing effort. Massachusetts contact tracing experts suggested texting people in advance to confirm that the requests are legitimate, noting that a fear of scams may dampen participation.

“We’re trying to build trust and have people know it’s not a scam, but a call about caring,” Kelly Driscoll, lead for the Massachusetts Community Tracing Collaborative, said on the webinar. “It’s only by mass participation and mass answering that we can curb COVID-19. “

 

Patients start returning, but volumes remain shy of pre-COVID levels

Since the start of May, many hospitals and physician practices who eliminated services or discouraged non-urgent visits at the height of the first wave of COVID-19 have begun resuming scheduled procedures or encouraging patients to return to care settings, as state and local restrictions have eased. But providers are still faced with the significant existential question of whether their patients will actually show up.

A new Commonwealth Fund report finds evidence of a recent rebound in visits to ambulatory practices. After declining by nearly 60 percent in early April, visits have rebounded, largely through in-person appointments, the study finds. However, overall visit volumes are still roughly a third lower than before the pandemic.

Kaufman Hall recently developed an approach to demand modeling to help hospitals plan for multiple scenarios for the COVID-19 pandemic through 2021.

 

In Brief

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