The Question: How many total staff do States have assigned to do contact tracing?
For example, Nebraska has 60+ contact tracers for every 100,000 people, but only 20 of them are currently assigned while the other 40+ are trained reserves. Meanwhile, they are still planning to hire almost 20 more contact tracers per 100k pop.
The Question: Are there enough contact tracers for the number of new cases popping up every day?
In the same way that hospitals can be overloaded to a point of inefficiency, contact tracing is only a sustainable method of COVID-19 mitigation when the daily new cases are at or below 10 cases per day for every 100,000 people. For states to the left of the red line, we can expect that contact tracing is still an effective method, but for those to the right of the red line, contact tracers are likely overwhelmed. The grey lines are margins that indicate the proportion of contact tracers to cases. For example, Virginia is just above contact tracing’s theoretical threshold of effectiveness, but has a good proportion of around 2-3 contact tracers per case.
The Question: Is the number of contact tracing staff in your state/territory posted publicly on a government website?
The number of active contact tracers can be a good indictor of susceptiblity to outbreak, but few states make this information publicly available.
The Question: Is data about contact tracing and transmission being posted publicly on a government website?
The data and results gathered from contact tracing can be even more useful to citizens, allowing the public to see whether cases are rising or falling and in what areas. This kind of information is more publicly available than the number of active contact tracers in each state, but is still only available in 32.7% of states.
The Question: Are states using or planning to use digital contact tracing apps or other related technology?
Enabling technologies can be a great asset in contact tracing.
Contact tracing is an essential tool of the public health response to COVID-19. Successful contact tracing programs identify contacts of infected cases early and enable contacts of cases to quarantine safely. This can help break chains of transmission and reduce the burden of disease in communities, making it safer for reopening schools and businesses.
Contact tracing is a resource intensive and complicated undertaking that relies on the effectiveness of other public health interventions, including physical distancing and rapid diagnostic testing, to be successful. In communities with rising or sustained high daily incidence levels, contact tracing can become quickly overwhelmed – tracers simply cannot keep up with the volume. When incidence is below 10 cases per 100,000 population per day, contact tracing becomes more possible and can help keep control of community spread.
In April 2020, experts at the Johns Hopkins Center for Health Security estimated that at least 100,000 new contact tracers would be needed across US. The authors called for a national plan and an initiative to provide guidance and resources to state and territorial health departments to scale up and manage contact tracing programs throughout this prolonged public health crisis.
To date, very few national data have been collected on the status and effectiveness of contact tracing programs in each state. These data will allow us to understand how this intervention is working and where additional resources may be needed. The Johns Hopkins COVID-19 Contact Tracing Data Initiative seeks to fill that data gap.
The Johns Hopkins Center for Health Security is partnering with NPR to collect state data on contact tracing efforts. They will continue a series of surveys that ask state and territorial public health departments questions about COVID-19 contact tracing. Selena Simmons-Duffin and colleagues at NPR fielded 3 previous surveys in April, June, and July of 2020. Crystal Watson, DrPH, MPH, and Lucia Mullen, MPH at the Johns Hopkins Center for Health Security will field surveys, with NPR, to collect data every 6 weeks. The resulting data will be reported publicly on the Johns Hopkins Coronavirus Resource Center website. NPR will also report on the results of each survey as it is released.