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Rolling out contact tracing in Illinois a daunting task, but essential, expert says

It takes about a day to trace the contacts of COVID-19 patients at the Howard Brown Health clinic in Hyde Park, its director says. About 2⁄3 of those contacts end up testing positive.

Tracing the contacts of infected coronavirus patients can take a full day per patient, one expert says.
AP

Roughly a quarter of the coronavirus tests conducted at the Howard Brown Health clinic in Hyde Park have been coming back positive, amounting to about 20 new confirmed cases a day.

The initial diagnosis is just the start of the staff’s work, though. What comes next is the arduous task of tracking down every person that patient may have encountered, a time-tested public health practice known commonly as contact tracing.

Though local and state officials have said that process is key to slowing the pandemic and reopening the state, a large-scale initiative hasn’t been announced to address the daunting task of tracking down every person who has come into contact with the growing number of COVID-19 patients. On Wednesday, 2,253 new cases were reported across Illinois as the total number of cases eclipsed 50,000.

One day per patient

Dr. John Schneider, a University of Chicago faculty member who serves as the Howard Brown clinic’s medical director, explained that a single staff member requires around a full day to call an infected person’s entire chain of direct and indirect contacts. That web of connections typically consists of roughly 10 people, most of whom haven’t even been around the original patient.

While roughly two-thirds of those contacts wind up testing positive, Schneider said close contacts living with an infected person are even more likely to come down with the disease. Facing a deadly virus that can spread insidiously to carriers who don’t show symptoms, contact tracers must move swiftly to interrupt the chain of infection.

Dr. John Schneider, Howard Brown’s medical director,
Provided

“There’s definitely cases where we’ve observed that if we had intervened a couple days earlier, we could’ve prevented transmission events,” said Schneider, whose team consists of 15 contact tracers and three “data people.”

Schneider believes the state has been slow to launch a larger effort and holds that getting a contact tracing system in place is vital for responding to the current outbreak and a possible resurgence in a few months.

“I really think it’s about doing the best we can now, knowing it’s not going to be perfect,” he said.

State system a work in progress, gov says

Officials haven’t said how many people will be needed to ramp up contact tracing statewide.

Gov. J.B. Pritzker told reporters on Tuesday that state officials were still trying to “spin up” a system, which he said is “a very large endeavor” that requires both hiring and technology. And Illinois Department of Public Health Director Ngozi Ezike alluded to a large-scale deployment of contact tracers in an interview last week with the New Yorker, saying thousands would likely be needed across the state.

In addition to traditional community outreach, Chicago Public Health Commissioner Allison Arwady said Tuesday that an app rolled out by the city earlier this week to offer coronavirus-related assistance and allow Chicagoans to pre-register for a vaccine could ultimately be used for contact tracing.

“That kind of technology would be a total game-changer here,” Lightfoot said about similar technology being developed in Germany.

Limited tracing taking place already

For now, public health workers in Chicago and Cook County are already conducting limited contact tracing of COVID-19 patients.

The county was employing 29 contact tracers as of April 16, including four dedicated to congregate settings like nursing homes and the Cook County Jail. Meanwhile, the city’s current contact tracing efforts are also focused on those types of facilities.

As a result, investigators from both departments sometimes collect the same information, which is then routed to a statewide system state officials use to track cases. According to Schneider, it can actually be useful to have multiple tracers reaching out to a single person.

“We’ve learned that when people get multiple folks calling them, they’re more likely to engage or to be contacted,” he said. “You don’t wanna be completely inefficient but some overlap is okay.”

Private firm recruiting in Chicago

In recent days, a Washington, D.C.-based recruitment firm that launched just a week ago has started hiring contact tracers in Chicago and other major cities. Contrace Public Health Corps ultimately hopes to recruit 20,000 workers nationwide by May 15, the company’s founder and CEO Steve Waters said in an interview.

“Contact tracing is the largest US civilian mobilization since World War II,” the company says in its job postings, which advertise pay of $17-22 an hour.

Waters said the newly-minted company has not been contracted by any government agencies in Illinois. Instead, applicants from Chicago will likely be hired by a local employment agency or nonprofit, who he said will prioritize the hiring of residents with “an understanding of local geography and culture.”

“Our model is based on the premise that as we are not operating as a traditional recruiting company,” said Waters. “We can help local and state agencies and nonprofits stand up contact tracing efforts, at scale, much more quickly and at a much, much lower cost than traditional recruiters.”