The State of America's Direct Support Workforce Crisis 2024

New report sheds light on persistent problems facing community providers due to ongoing recruitment and retention challenges
Browse the Data
Capitol Correspondence - 09.08.20

Big Picture: Challenges Surrounding Contact Tracing Could Affect Economic Recovery

Share this page

We share this reporting by Politico Pro so our members can stay informed on broader social behaviors which could ultimately affect the pace at which their state re-opens, and consequently the measures they have to continue to take to maintain the safety of individuals they support.

“Large numbers of Covid-19 patients are refusing to tell public health workers who they’ve had contact with, thwarting state efforts to slow disease spread at a fragile turnaround in the pandemic.

Contact tracing data provided to POLITICO shows more than three-quarters of people interviewed in hard-hit states like California and Louisiana refused to cooperate with efforts to identify relatives or acquaintances who may have been exposed to the disease.

Tracing programs, paired with expansive testing, have been credited with controlling the spread of Covid-19 in countries like South Korea and New Zealand. But state officials and public health experts say U.S. efforts have been undercut by the Trump administration’s failure to advocate for tracing. Conspiracy theories linking interviews to government plots to set up surveillance cameras and gun confiscations haven’t helped. That lingering distrust could hinder immunization programs once a Covid-19 vaccine is found.

‘We’ve had people worry that we’re the FBI or other government agencies,’ said Kirstin Short, the bureau chief of epidemiology at the Houston Health Department. ‘It’s a challenge we’ve been fighting for a number of years since the change in the federal administration.’

POLITICO requested tracing data from all of the states showing the percentage of confirmed cases tracers reached and interviews that ended with information on contacts. A total of 14 states and New York City supplied results showing widespread public reluctance to participate in disease tracking as officials were tracking new hot spots and trying to prevent uncontrolled spread. Only a few, including Massachusetts and Vermont, have persuaded the majority of their COVID-positive residents to reveal who they may have infected.

Tracing efforts got off to a slow start this spring, as states like Georgia, Texas and Colorado that moved fastest to reopen struggled to find enough health workers to follow new outbreaks. Meanwhile, the Trump administration did little to explain the process while the president downplayed the virus threat and contradicted his own scientists.

[…]

A spokesperson for the Centers for Disease Control acknowledged that many state health departments face challenges, adding his agency is currently advising several state and local health departments and has developed public service announcements and social media messaging to encourage cooperation. The agency did not respond to questions about when and where the spots were airing.

Health officials and experts are pressing for more high-profile campaigns — from radio and TV ads to billboards, digital alerts or even personal appeals from President Donald Trump or Vice President Mike Pence. But other than a handful of supportive social media posts from CDC Director Robert Redfield and some suggested best practices, the Trump administration has been largely silent.

[…]

The lack of messaging is intersecting with other factors that discourage cooperation with tracers. A proliferation of spam calls has made people increasingly unwilling to pick up a call from an unknown number — a barrier some states have circumvented through text messages or a ‘health department’ caller ID.

[…]

Beyond misinformation, the coronavirus has spread so widely in some areas that tracing may be futile, because residents can’t be sure which infected people who didn’t show symptoms gave it to others. […]

Fallout from the economic crash and fears of an eroding safety also factor in participation, making some reluctant to divulge names of acquaintances knowing the person cannot afford to miss work in order to quarantine.

The low response rates are also colliding with recent CDC guidelines recommending against testing asymptomatic individuals who may have been exposed. Public health experts worry the change will further confuse people about testing and the virus’ incubation period.”