There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” White House health advisor Dr. Anthony Fauci said Friday.
Contact tracing occurs when trained personnel contact infected people to investigate where they might have been infected and who they might have exposed to the virus. Along with widespread testing and ability to isolate potentially infectious people, tracing is an age-old public health intervention now being ramped up at an unprecedented scale.
“It’s not going well. I have to tell you, it’s not going well,” Fauci said in an interview with CNBC’s Meg Tirrell that was aired by the Milken Institute. “What we need to do is we need to rethink, and we are right now, the idea of many more tests getting into the community and even pooling tests.”
The White House advised states not to reopen until they had built the infrastructure to conduct widespread testing and contact tracing, though the federal government did not specify what a robust tracing infrastructure would look like. Rather than developing a coordinated national tracing plan, which some countries, such as Germany, have done, the Centers for Disease Control and Prevention has sought instead to support local efforts.
Earlier this week, CDC Director Dr. Robert Redfield testified that about 27,000 or 28,000 people are doing contact tracing work across the country. He later acknowledged that he estimates the necessary workforce to be about 100,000 tracers. Former CDC Director Dr. Tom Frieden thinks the country will need even more, up to 300,000.
“To just say you’re going to go out and identify, contact trace and isolate, that doesn’t mean anything until you do it,” Fauci said. “Not checking the box that you did it, but actually do it. Get people on the ground. Not on the phone. When you identify somebody, have a place to put them to get them out of social interaction.”
In lieu of federal leadership on tracing, underfunded and overwhelmed local health departments have scrambled to get the necessary systems in place, contact tracing specialists who previously spoke with CNBC said. States have submitted their plans to ramp up tracing through July to the CDC, Redfield told reporters on a conference call Thursday.
The CDC has allocated more than $10 billion for states to ramp up testing, tracing and isolation, but Fauci said he doesn’t see local officials making the kind of progress he’d like to see. He added that some states have done well in ramping up their programs. Getting more jurisdictions to do that work in preparation for the fall, when Fauci said he expects cases to surge again, will be key.
“When the fall comes, we better be ready that there will be surges in cases, and as I’ve said so many times now for months, we have a few months to prepare for that,” he said. “So when that happens, we have to be able to do the proper and effective way of identification, isolation and contact tracing.”
To ramp up testing more rapidly, the coronavirus task force, which Fauci is a member of, is now considering “pooling tests,” he said. That’s when health officials conduct up to 40 tests all at once and if it comes back negative, it indicates that everyone in the group is not infected.
“If you get a positive, then you backtrack and try to figure out who that positive is,” he said. “We really need to start doing that, because the idea of doing individual identification, isolation, contact tracing, particularly in some communities where people don’t want to cooperate — they don’t want to tell you where they’ve been and who they’ve been with.”
It appears that infected people can spread the virus before they develop symptoms or have only mild symptoms, Fauci said, which underscores the need to conduct even more tests than the U.S. is already doing. He said he personally is an advocate of “flooding the system with testing, so you really get a good handle about what is going on in the community.”
“I think we need to do that,” he said.
The nation’s seven-day average of new Covid-19 cases reached a record high of more than 33,000 cases on Thursday compared with a week ago, according to a CNBC analysis of Johns Hopkins University data. Since the start of the outbreak there have been more than 2.42 million cases confirmed in the U.S. and at least 124,468 people have died.
As coronavirus cases spike Fauci warned Friday that the country will soon “be seeing more deaths.”