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Contact Tracing: How things have changed since the pandemic started

Staffing shortages are affecting how health departments track the virus
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WXMI — As the novel coronavirus morphs and the nature of fighting the illness changes, so too does the nature of contact tracing for exposure.

Almost two-years into the pandemic, and local and state officials are no longer placing hundreds and hundreds of daily calls to everyone who might’ve been exposed. While they’re still placing calls seven days a week, they’re now relying more on the public to take the reins of notifying people they may have exposed, as resources are placed elsewhere.

“I don’t think it’s for a lack of effort on the public health workforce, the demeanor I think has changed in terms of the public’s engagement with the public health effort that we’re making,” said Joe Coyle who heads up the Michigan Department of Health and Human Service’s Communicable Disease Division. “We have a finite amount of staff and time and resources and I think we’re always continually looking at, what is the return on investment of some of our activities related to COVID mitigation.”

Coyle says there simply isn’t enough staff to make contact tracing calls on days where the state averages thousands of cases. Additionally, funding resources are increasingly going to other priorities like testing and vaccination and booster efforts.

In March of 2021, the Michigan legislature approved $555 million in funding – a lot of it for contact tracing. The entire grant amount was provided to MDHHS who, when asked, told FOX17 they’d already used around $56.3 million on contact tracing alone. The following June, the CDC awarded Michigan with another $31.8 million for testing, vaccinations, and contact tracing.

“When we see a really significant investment in case investigation and contact tracing and that sort of diminishing return in the public participation in it, it does beg the question, are we getting the most bang for our buck there, and how can we pivot to make sure that we’re doing the best we can to be stewards of the dollars we have and provide the best value to the public’s health,” said Coyle.

Across the world, contact tracing is changing as the pandemic progresses. Germany announced contact tracing is ending in some states because of lack of staffing – the nation’s top doctor recently told German media that “comprehensive follow up is almost no longer taking place at the moment.” In South Africa, contact tracing there has either ended due to staffing shortages or populations reaching her immunity as high as 80%. In the U.S. the same pattern is taking shape at local health departments as well.

“We’re doing things a lot differently than we were at the beginning of COVID,” said Anne Barna with the Barry-Eaton District Health Department. “For the most part we’re relying on individuals who test positive to let other people know that they’ve been around that they’ve been exposed.”

Barna notes another wrench in the realm of contact tracing: home testing kits. While the home option is convenient – scarce though it may be – local departments also have no way of knowing who is testing positive from home.

“As we see more at home testing, we don’t necessarily know the results of that,” she said. “So what we’re asking the public to do is, if they take an at-home test, and they test positive for COVID, put your epidemiologist hat on and let your close contacts know that you’ve tested positive for COVID.”

For now, MDHHS is relying on newly implemented systems like texting and online resources to help people spread the word of their positive result on their own.