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Features
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TUESDAY, AUGUST 18, 2020
Jennifer Peltz
NEW YORK (AP) - Joseph Ortiz headed for the home
of a stranger who tested positive for COVID19, un-
sure how his unexpected visit would go.
The person hadn't answered phone calls from
New York City's contact tracing programme, a mas-
sive effort to keep the coronavirus from spreading
by getting newly diagnosed people to identify oth-
ers they might have infected before those people
spread it further.
Ortiz was out to try to bring the person into the
fold. "It's a mixed bag. You never know what you're
going to get," Ortiz, 30, said as he approached the
person's Queens apartment building this month.
"Sometimes you have people who are really appre-
ciative... They like that we're out here trying to end
the pandemic so everyone can get back to normal."
"But other times, you might have a client who
slams the door."
Such is the on-the-ground work of what appears
to be the biggest contact tracing effort in any Unit-
ed States (US) city, with over 3,000 people making
calls, knocking on doors and checking in on people's
health and sequestration.
Mayor Bill de Blasio, a Democrat, has credited the
effort with "so far, amazing success". After a knotty
June start, the city said it's now meeting its goal of
reaching about 90 per cent of all newly diagnosed
people and completing interviews with 75 per cent.
But in the programme's irst two months, more
than 11,000 infected people - over half of all new
cases - didn't provide any names of others they might
have exposed. When people have identiied contacts,
tracers have inished interviews with six in 10 of them,
short of the city's goal. The city has yet to say how
quickly it's connecting with people or what it's glean-
ing about potential sources of exposure.
Comparing US state and city contact tracing
programmes is dificult because they vary widely in
what they release, but some public health scholars
say the numbers that New York reports are promis-
ing. Still, some outside experts suggest New York
should get more from the initiative.
"The way you hear the metrics and the progress
described, it's like their job is done after making
these contacts. But it's not mission accomplished,
at all," said Dr Denis Nash, a City University of New
York epidemiology professor. He feels the city is
missing opportunities to assess people's success at
isolating themselves and scout exposure patterns to
learn "where the holes in the safety net are and as-
sess how big they are."
Programme director Dr Ted Long acknowledg-
es there's more work to do. But Long, a physician
and executive with city-run hospital system Health
+ Hospitals, estimates the tracers' efforts have pre-
vented thousands of coronavirus cases and helped
keep new infections, hospitalisations and deaths at
relatively low levels. New conirmed cases topped
6,000 on some days in April; they now average
about 200 a day amid far more testing.
"That's what tells me that what we are doing is
working," Long said.
Contact tracing is a time-honoured public health
technique, but the pandemic is putting it to a gruel-
ling new test around the world. The stakes are par-
ticularly clear to the US city that has suffered more
COVID19 deaths than any other but wrestled its
outbreak into relative control late this spring.
Making calls from her East Harlem apartment,
tracer Maryama Diaw said she strives to "be sensitive
and compassionate and actually talk to the person
as a human being, and not just read off a script".
When a woman was crestfallen to hear she'd test-
ed positive, Diaw recalled, she temporarily put aside
her planned questions to ask, "Are you doing okay?"
"We talked for a little bit, like person to person,"
said Diaw, 25, a graduate student in public health.
"That was really rewarding because I actually helped
someone through what could be a very dificult day
for them, and I know that she left the call with the
resources that she needed."
New York's tracers also offer assistance that can
include food deliveries and free hotel rooms.
The Director of Centers for Disease Control and
Prevention (CDC) has estimated the country will
need nearly 100,000 tracers. By the end of July, the
total was over 41,000, according to an NPR and Johns
Hopkins University survey with data from 45 states,
excluding some local government programmes.
The US tracing has been hampered by factors
including coronavirus resurgences, a patchwork
state-by-state approach and stubbornly slow test re-
sult turnaround times, experts said.
"We're not in a good place," said Lori Tremmel
Freema, CEO of the National Association of Coun-
ty and City Health Oficials. But "New York City's a
bright spot."
The city already had a couple of hundred people
tracing HIV and other infectious diseases before the
pandemic. But COVID19 took the work to "a scale
that is unprecedented", said Deputy Health Com-
missioner Dr Demetre Daskalakis.
New York City appears to have the biggest city-
level programme. By comparison, 2,600 tracers are
covering nearly all of massive Los Angeles County.
Chicago said it has over 200 tracers now and ex-
pects the number to grow to about 800 by mid-Sep-
tember. Houston said this spring it was hiring 300.
New York state, which has 2,000 tracers working
outside the city, has reached about 90 per cent of
newly diagnosed people and nearly 88 per cent of
contacts, state oficial Larry Schwartz said; it's un-
clear what percentage completed interviews.
‘Are you doing okay?’
On the ground with New York City contact tracers.
Contact tracer Joseph Ortiz uses his tablet to gather information as he heads to a potential patient's home in
New York. PHOTO: AP