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U.S. Sees A Spike In Contact Tracing Workers, NPR Survey Shows


Just imagine having to call up a stranger right before Christmas and tell them they have been exposed to COVID-19 and they need to quarantine for 14 days. That is the job of contact tracers right now. And as cases are surging all over the country, it is incredibly hard for them to keep up. And yet there are glimmers of hope. NPR's Selena Simmons-Duffin is here to tell us what they are, including the results of NPR's latest contact tracing survey. Hey, Selena.


KELLY: I am all for glimmers of hope. Bring on the glimmers. What have you got for us?

SIMMONS-DUFFIN: Well, first of all, vaccinations are starting up. And that's injected a huge amount of optimism into the public health response. Right now, there are too many cases, and they're growing too fast to keep up. But the hope is that vaccinations could start to slow that spread in the coming months. Also, there's $22 billion passed in the congressional year-end package for testing and tracing that would give a big boost to these efforts, although it's up in the air because President Trump isn't happy with the bill. And then finally, in NPR's latest survey of state and territorial health departments, we found a dramatic increase in that workforce. It has now topped 70,000 contact tracers across the country, and many departments plan to hire more. And we did the survey in collaboration with the Johns Hopkins Center for Health Security.

KELLY: Well, that is fascinating because early on in the pandemic, it felt like we were hearing all the time about contact tracing. And then as cases exploded, these departments just seemed to get overwhelmed. That number you just gave us - 70,000 contact tracers - I'm guessing that is still not enough to keep on top of new cases.

SIMMONS-DUFFIN: Yeah, you're guessing correctly. It's not even close. Only two states - Montana and Hawaii - would have enough tracers if you include their reserve staff, according to an NPR analysis of each state's staff and current case numbers. What we heard in the survey is that most departments are having to triage and only make the most important calls. So some places are focusing on calling people over age 65 or focusing on trying to identify outbreaks.

KELLY: Now, I notice that this time around, our survey also asked about care coordination. And, first of all, just explain what that is.

SIMMONS-DUFFIN: Right. So at this point, we all have some idea that contact tracing calls involve public health workers calling you to say, hey, you've tested positive or, hey, you've been exposed and here's what to do. But there is a critical second part of the contact tracing call, that's - what do you need to be able to stay home safely? Is it food or rental assistance or medication? So just to give you an idea, here is Laura Sofia Ortega-Flores, a tracer in Utah, talking about a call she made a few weeks ago to somebody who tested positive, and she heard crying in the background.

LAURA SOFIA ORTEGA-FLORES: It was a Spanish-speaking family. And, you know, her daughter was crying because she was hungry. It is heartbreaking, you know, to see that.

SIMMONS-DUFFIN: And she was able to connect that family to a food bank in their local area.

KELLY: So what do we learn from the survey about how care coordination is working or not across the country?

SIMMONS-DUFFIN: Yeah. So for this part of the survey, we collaborated with the nonprofit Partners In Health. And we found that the vast majority of health departments do formally screen for these kinds of needs. Where there was some variation was on the referrals process, whether somebody on the contact tracing team actively connected people to services, or was it just passing on a number for an outside agency? And not every department followed up to see if those needs were met. So the experts I talked to were encouraged that this is on the radar for programs, but hoped that follow-through could become more consistent across the board.

KELLY: Right. And let me circle us back to the $22 billion number. This is the money that Congress has passed if the stimulus bill actually goes through, which is now up in the air because Trump is threatening not to sign it. But if it's real, what would that money mean for contact tracing?

SIMMONS-DUFFIN: It would be huge. I mean, NPR has been surveying and reporting on this since April. It has been chronically underfunded and gotten much less attention than testing and some other parts of the pandemic response. So sources I talked to say that $22 billion for testing and tracing would be a significant sum that could really make a difference. And it's urgently needed. There are health departments whose funding could run out come December 31. They're really holding their breath, hoping this money does come through after all.

KELLY: Thank you, Selena.


KELLY: NPR's Selena Simmons-Duffin. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.