Public health experts say one crucial key in lifting stay-at-home orders and re-opening the economy is to identify all coronavirus cases and to trace contacts of each identified case.
The practice is called contact tracing, and it is tedious work.
“It is a very time-consuming, time-intensive process,” said Palak Panchal, the lead epidemiologist in the surveillance, control and prevention of vaccine-preventable diseases for the Cook County Department of Public Health. “We have to build trust with [positive patients] and have an empathetic conversation, so that they feel comfortable to give providers deep detailed information.”
Among that information includes places visited and people contacted within 48 hours at the onset of symptoms. A close contact is identified as anyone who was within six feet of proximity for at least 10 minutes, Panchal said. Tracers then reach out to those close contacts to advise them to monitor symptoms and self-isolate.
“We are essentially cutting off the oxygen for the virus to transmit from one person to another,” Panchal said.
Researchers at Johns Hopkins University estimate that each infected person can spread to virus to three other people, meaning that first positive case can turn into more than 59,000 cases in 10 rounds of infections.
But as the number of cases steadily climbs, Panchal and her team of 25 tracers must prioritize who to call first.
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“These include health care providers, people who are vulnerable, such as elder people, those who have severe illness or underlying conditions,” Panchal said.
Experts said the U.S. would need to add at least 100,000 – and upwards of 300,000 – tracers to the public health workforce in order to safely re-open the economy.
It will take a massive financial investment from Congress. A bipartisan group of former public health officials is proposing a $46.5 billion plan to expand the contact tracing workforce and to implement income support for people who voluntarily self-isolate.
“As we open up some measures, we would need to very quickly identify a case, when they are early in their course, and make sure that they are separated or isolated from others,” said Dr. Susan Bleasdale, an infectious disease physician at the University of Illinois.
In Indiana, Gov. Eric Holcomb announced Wednesday that a call center of 500 contact tracers will go live on May 11. He said those who test positive will receive an email or text, asking them to contact the call center. The center will also send daily texts or emails to monitor a person’s symptoms, Indiana officials said.
“We feel very good and confident in the mission,” Holcomb said.
Illinois Gov. J.B. Pritzker offered few details when asked about the state’s tracing program but said plans are in the works.
“It’s not something that will happen overnight,” said Pritzker. “But there’s no doubt that we are hiring a number of people – we are in the process of putting the infrastructure together to hire people.”
Technology will also play a crucial role in contact tracing.
NBC 5 Investigates profiled an app being developed by the Massachusetts Institute of Technology that aims to help public health officials with contact tracing.
“Part of the process of dealing with this virus, this pandemic, is when somebody gets sick, you have to find out who else they might have infected,” said MIT Professor Alex Pentland.
Google and Apple released Wednesday new software to assist app developers in their contact tracing efforts.
The city of Chicago also launched Chi COVID Coach earlier this week to connect Chicagoans who test positive for the virus with COVID-19 resources.
Dr. Allison Arwady with the Chicago Department of Public Health said the app could be further developed into a contact tracing tool.
“We definitely think that technology plays some role in (contact tracing) and in fact, the app very well may be a piece of that, so it's on our list as an example of a modification that we are exploring, adding as we have more contact tracing capability,” Arwady said.
