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Contact tracing may look different from the pandemic's start, but it's still useful


Remember the contact tracing efforts at the start of the pandemic? States hired thousands of public health workers, so whenever a positive test came in, they could retrace that person's steps and call any close contacts within hours. Well, the explosion of cases during the delta and omicron waves made it much more complicated to do that.

But some public health officials say it is still worth trying, like Lorna Thorpe. She is director of epidemiology at New York University. Welcome to ALL THINGS CONSIDERED.

LORNA THORPE: Thank you very much. It's a pleasure to be here.

SHAPIRO: Last spring, NPR surveyed health departments and found that most of them were scaling back contact tracing. Today, are most of the efforts from a year or two ago still going on, or have any states and cities given up?

THORPE: I think many states are thinking about how to do contact tracing in the context of widespread transmission and large number of cases. So it varies across the country, but some are changing their tactics about how they notify cases and what support services they give to those cases. They also share information via electronic means, perhaps, without - instead of using the telephone to contact them because the number of cases and the ability to reach everybody individually just gets harder.

SHAPIRO: It seems like there are pros and cons to both. I mean, it might be hard to reach people on the telephone, but I've heard from many people during the omicron wave that the automatic alerts became so constant that they took off the alerts from their phone.

THORPE: The role of these electronic alerts and the role of contact tracing in general is to provide support services that help people stop the spread of the virus, and it is a challenge. We all know that when you receive a number of alerts, your attention to those alerts is reduced. But if you've recently had a contact and you need to know where to get tested, it is important to get that information out.

SHAPIRO: So take a step back and tell us over the last couple of years what the big-picture lessons are that you've learned about what does work and what doesn't work in contact tracing, what is worth the investment and what's not.

THORPE: I think what we have learned is contact tracing is often much more than contact tracing. It's really a spectrum of services that help people get tested, that help people be notified and that help people get the services that they need when they're isolating.

SHAPIRO: So you're saying contact tracing really has to be integrated into the larger public health set of resources.

THORPE: Correct. And, you know, here in New York City, they call it the Test & Trace program, but there's really three T's - test, trace and take care. And I think that is something we have to learn how to do better.

SHAPIRO: Do you think there's a point at which community transmission becomes so widespread that contact tracing ceases to be useful? When we look at the numbers in early January in cities like Washington, D.C., and New York, I mean, at that point, is it even worthwhile to say you came in close contact with somebody who had omicron? - because it seems like everybody did.

THORPE: Contact tracing, I think, is a tool that works for diseases that have certain criteria. We don't use contact tracing for flu. We don't use contact tracing for a number of other infectious diseases. But we do use contact tracing when the clinical outcomes are sufficiently severe and when we have proven tools to stop transmission.

So ultimately, as we learned this January, contact tracing had to pivot. There was no way to continue to do contact tracing the way we had done it, and I think we actually can get to a state where we no longer need contact tracing. But that depends on the severity of the disease and other factors, like the number of cases.

SHAPIRO: That's professor Lorna Thorpe, director of epidemiology at NYU. She evaluates New York City's contact tracing efforts. Thanks a lot.

THORPE: Thank you very much. Transcript provided by NPR, Copyright NPR.

Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.
Gus Contreras
Christopher Intagliata is an editor at All Things Considered, where he writes news and edits interviews with politicians, musicians, restaurant owners, scientists and many of the other voices heard on the air.
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