Jan 28, 2022 - Health

Contact tracing fizzles across America

Illustration of a clipboard with a dirty contract tracing form on it reading "meh"

Illustration: Sarah Grillo/Axios

States across the country are scaling back their contact tracing efforts, often focusing on vulnerable communities and relying more on Americans to alert close contacts themselves after testing positive for COVID.

Why it matters: As vaccines have become available, the virus has become more infectious and life has slowly headed more toward normal, health officials have come to view contact tracing as a relatively inefficient use of resources.

State of play: The Virginia Department of Health announced this week that it will no longer attempt to trace the contacts of every new COVID case, and will instead focus on high-risk settings.

  • The Omicron variant drove the change. "We can't trace and isolate that many cases, we don't have enough staff for it. It's just too many people for this Omicron surge," Mount Rogers Health District's Breanne Forbes Hubbard told WCYB.
  • The availability of at-home COVID tests has also meant that public health agencies aren't made aware of many positive cases.

The big picture: Well over a dozen states — including Nebraska, Wyoming and Massachusetts — have already taken steps to dial back contact tracing and have asked the public to do more of it themselves, according to the National Academy for State Health Policy, which is tracking the trend.

  • Local health departments and school districts within those states may still operate more robust programs, and there's also a lot of variety among states' approaches.
  • “Contact tracing is a tool that we know works for communicable diseases, but, for example with Omicron — which is incredibly contagious — it is hard to keep up with it in a way that is helpful," said NASHP's Elinor Higgins.

What they're saying: Several groups representing public health officials released a statement this week in support of health departments' decision to transition away from investigating every case and "to a more strategic approach of outbreak investigations and targeted case investigations."

  • "Only a very small portion of total cases and close contacts are being reached by public health contact tracers in time to prevent onward transmission," the groups wrote.

Between the lines: American behavior has changed as well. For many individuals and businesses, contact tracing is now baked into everyday culture.

  • It's completely normal to receive a text message from a recent contact saying they tested positive for the virus. And unlike pre-vaccines, this isn't a signal to vaccinated people that they should go into quarantine, or even necessarily get tested unless they develop symptoms.
  • Contact tracing or exposure notification has also become more automated through technology, further reducing the need for as many human contact tracers.

The bottom line: Contact tracing was initially hailed as key to slowing the spread of COVID. But as the virus evolves, it's another example of how we'll have to keep evolving with it.

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