NEW YORK. The ambitious New York City contact tracing program, a major initiative in the fight against coronavirus, began an alarming start at a time when the city’s opening on Monday was entering a new phase: outdoor dinners, shopping in stores and office work were resuming.
3,000 detectives and disease monitors were hired in the city, who should identify anyone who has encountered hundreds of people who still give a positive result for the virus in the city. But the first statistics of the program, which began on June 1, indicate that tracers often cannot detect infected people or collect information from them.
Only 35% of the 5,347 residents of the city who gave a positive or supposedly positive result on COVID-19 in the first two weeks of the program provided information on close contacts with tracers, the city said in a publication of the first statistics.
Contact tracing is one of the few tools that health officials must deal with COVID-19 instead of a vaccine, along with widespread testing and isolation of individuals exposed to coronavirus. The first results of the New York program raise new concerns about difficulties in preventing the growth of new cases as states open throughout the country.
The city has successfully tracked contacts with diseases such as tuberculosis and measles. But, as in many cases involving an outbreak of coronavirus, officials have never encountered a problem of this magnitude, with so many cases in five districts.
The urban program has so far been limited by low levels of response, meager use of technology, confidentiality issues, and a much less widespread mandate than in some other countries, where apartment buildings, shops, restaurants, and other private enterprises are often required. personal information of visitors, which facilitates tracking distribution.
China, South Korea, Germany, and other countries have developed extensive tracking programs that have helped officials make significant strides in reducing the outbreak. For example, in South Korea, people at weddings, funerals, karaoke bars, nightclubs, and online games record their names and phone numbers, and authorities can use cell phone location data, credit card transactions, and even a closed network. video recording to identify and isolate potential contacts.
Dr. Ted Long, the head of the new Testing and Tracking Corps in New York, insisted that the program was going well, but admitted that many people with a positive test did not provide contact information by phone or left an interview before they were asked. Others told investigators that they were only at home and did not put others at risk, and then did not name the family members.
Long said one of the encouraging signs was that almost all of the people for whom there were numbers in the city at least answered the phone. He added that he believes that investigators will be more successful when they start going to people’s homes next week or two, rather than just relying on phone communication.
“I think the program, especially because it is only two weeks old, does an outstanding job,” he said.
Since the closure began in March, the city has made significant strides in reducing the outbreak, and on Thursday there were only 327 new cases, compared with several thousand cases per day during the peak. But the second phase of the reopening of Monday presents new risks, with the likelihood of 300,000 people returning to their jobs.
Perry Halkitis, Dean of the School of Public Health at Rutgers University, who oversees the attraction of thousands of tracers in New Jersey, called the 35 percent connection rate in New York “very poor.”
“For each person, you should be in touch with 75% of their contacts during the day,” he said.
He suggested that the poor result was partly due to the inexperience of contact trackers and inadequate training.
“It’s a skill,” he said. “You need to practice.”
All over the world, authorities hastened to create contact tracing programs, hiring hundreds of thousands of people, including many with no previous experience. Although the goal is to cover all patient contacts and provide them with effective quarantine for two weeks, the reality is often much more confusing.
In May, in Massachusetts, where one of the most popular tracing programs in the country operates, health officials said that only about 60% of infected patients make phone calls. In Louisiana, less than half responded. In England, the program struggled to show results with a low-paying, inexperienced workforce.
A growing number of countries are using telephone applications to track people with positive results. Several U.S. states, including North Dakota, which attempted to use digital applications, have encountered privacy issues.
But in New York, as in most countries, contact tracking tools typically only use low-tech tools, such as phone calls and a questionnaire, in part to solve privacy issues.
Tracers look for the names and phone numbers of each person with whom the confirmed positive patient was in close contact several days before the onset of symptoms, defined as within 6 feet for at least 15 minutes. Then each contact is called up, they tell him that he or she may have been exposed to the virus, and are asked to quarantine it.
The relative silence of patients with viruses in New York is one of several problems associated with the contact tracking program.
Mayor Bill de Blasio, who had tense relations with senior officials in his own Ministry of Health, deprived the department of program oversight in May by moving it under the auspices of the city government hospital agency. This has led some former health professionals to be concerned that expertise would be lost in the process.
Long said 50 experts from the Ministry of Health – city investigators prior to COVID-19 who had been involved in epidemics such as measles and Ebola – manage the wanted corps, but don’t keep track of themselves.
Long is a primary care physician and vice president of ambulatory care at a public hospital corporation. The Ministry of Health’s search efforts were led by epidemiologists.
“I urge everyone to show me how we are not cooperating,” he said about the relationship between the two agencies. “They were just partners.”
The city has made great strides thanks to its test program, which is ahead of schedule, and officials say the goal of 50,000 tests per day will be reached in July rather than August.
But the initiative to allocate hotel rooms for people who have tested positive for isolation from families is not popular. City officials rented 1,200 hotel rooms for free use by viral patients, but in recent weeks, 60 to 80 rooms have been occupied, city officials said. According to Long, in the two and a half weeks since the start of tracking, only 40 patients requested tracking numbers.
According to him, more than 1000 patients with viruses have turned to home isolation for help, such as help in delivering food and medicine, because they preferred to stay with their families.
According to Long, in an effort to establish a connection between contacts and tracers, half of all tracers hired live in communities that are highly affected by the virus, mainly blacks and Hispanics.
Sivanthy Vasanthan, 23, who had just graduated from Columbia University’s School of Public Health at Mailman School, said recruiters contacted her based on her LinkedIn profile, highlighting her interest in public health and human rights.
After about two weeks of training, Vasantan, who lives in the Washington Heights area of Manhattan, began to call positive patients a little over a week ago.
“Most of the people I spoke with already knew about the results of their tests and were at home,” she said.
The city did not give indicators for whether it successfully persuaded those with whom it contacted to undergo testing or quarantine.
Experts say that although tracking in the city was not where it should be, the program was clearly useful and should move forward.
“It’s hard to look at these numbers and say it’s a resounding success,” said Dr. Crystal Watson, contact tracking expert at the Johns Hopkins School of Public Health. “But I think this is the beginning, and it will be based on itself.”
Halkitis from Rutgers said that, in his opinion, the low level of cooperation is probably due to several factors, including the inexperience of tracers; Americans’ widespread reluctance to share personal information with the government; and de Blasio’s decision to move the program from the city health department.
“You took it from people who really know how to do it,” he said. “DOH people, they are experienced. They know that. ”
On Tuesday, the city laid out strategies to bridge the gap in tracking. According to Long, for 15% of the positive cases that came without an exact phone number, investigators began to consult doctors and study the database to get this information.
And for those who test positive and don’t answer the phone, field workers like Daniel Okpar, a medical student in East Harlem, will soon try to interview them in person.
Okpare, 30, is still in training, but was told that he will mainly visit patients in Harlem, not far from where he lives. He said that he hoped that his experience as a former orthopedic student at the New York University School of Global Public Health, as well as being an immigrant from Nigeria, would help alleviate the situation of people.
Wearing personal protective equipment and carrying an urban iPad and mobile phone, he will work alone, knocking on the door.
“This is an opportunity to be part of the forefront of response as a specialist in public health,” he said, “to have eye contact with someone, to say:“ Yes, you have COVID, but we will find all possible ways that you will in safety.
This article originally appeared in New York Times,
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