The ability of state governors to initiate lifting stay-at-home orders, and for business leaders and consumers to have the confidence and safety to return to work is contingent upon the trust that each of us feels about our ability to stay protected from Coronavirus infection.
As we learn from the earlier COVID-19 experience of other countries, a systemic approach to testing and tracing COVID-19 cases will be instrumental in providing the public health response necessary to both flatten the curve and bend the trend downward, allowing a gradual reopening of businesses. Such an approach is now being contemplated in many states and starting to be implemented in others. Massachusetts and Utah are two states working on the type of comprehensive test and trace strategies that public health experts agree, in combination with effective isolation and quarantine of positive cases, are needed to arrest the spread and lift the severe social distancing measures that have impacted so much of the economy.
The primary components of such a strategy include a significant increase in testing capacity as well as a virtual army of tracers whose role it is to contact people who have tested positive, identify the individuals they have been in contact with, direct them to testing resources, counsel them on isolation and follow-up with them. The Massachusetts approach, announced on April 3, 2020 (the COVID-19 Community Tracing Collaborative)1 is an initiative between the state administration and Partners In Health who will provide staff and contribute technical expertise in community tracing. The collaborative will deploy about 1,000 tracers and be supported by the state’s COVID-19 command center, leveraging the efforts underway by local boards of health. Enthusiasm for the initiative is high, with over 9,000 applicants for the 1,000 positions announced.2 The initiative has been made possible now that significant increased testing capacity is available through private laboratories and the Broad Institute of MIT and Harvard.3
Utah is taking a slightly different approach, launching a “Healthy Together” beta app. The mobile application and ability to analyze self-reported data is intended to give state health workers a faster and more accurate picture of where and how the Coronavirus is spreading within the community. The application prompts users to complete a daily symptom assessment and when it identifies someone in need of testing, connects the user with testing in their area, and provides test results back through the app. Should a user test positive, they will be contacted by a public health worker who can work with them on contact tracing of individuals who may have been exposed to the virus through close contact.4
After several months in which the dearth of testing has curtailed efforts to identify the spread of Coronavirus and COVID-19 with resulting major social and economic impact, Americans are impatient to get back to a semblance of normalcy. It is encouraging to see states implementing both time-tested epidemiologic methods and innovative technologies to help mitigate the spread of the virus.