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Contact tracing:
A springboard to
population health
MERRILL GOOZNER
ontact tracing bears a strong resemblance to programs for Congress to listen to their voices and
aimed at improving community health. With states address these issues in a systematic way.
A recent report from the Public Health
Chiring temporary contact tracers, lawmakers should Leadership Forum estimated a mere
consider expanding the program to carry out both tasks. $4.5 billion a year would fill the yawn-
ing gaps in the nation’s public health in-
frastructure that have been exposed by
Contact tracing involves interviewing that training, the U.S. will remain as un- COVID-19. Hospitals, too, can play a role
every new COVID-19 patient and reach- prepared for the next pandemic as it was by expanding their population health
ing out to everyone they’ve recently con- for this one. management programs to cover their en-
tacted so those people can be tested and It makes far more sense to perma- tire communities, not just “covered lives”
possibly quarantined. To be successful, nently employ a cadre of population for whom they’ve taken on financial risk.
tracing programs also need to provide health experts who can rapidly switch to As with everything COVID-19-relat-
food and social service support for the pandemic response when the need aris- ed, the imminent expansion of contact
people asked to stay isolated indoors. All es. Over the last decade, cash-strapped tracing is generating fear and political
this must be done in a supportive—not state and local governments cut 56,000 opposition. The concern, ably expressed
coercive—manner. public health positions. Epidemiologists by Peggy Noonan in a recent Wall Street
How different is that from popula- project the U.S. now needs 150,000 to Journal column, is that tracing will be-
tion health management programs that 300,000 contact tracers to reduce the vi- come “an onerous system that provokes
canvas communities for people with rus’ spread and stamp out the pandemic. resentment, spurs anxiety, and invites
undiagnosed chronic conditions like Permanently retaining a sizable frac- pushback.”
hypertension, asthma and diabetes? tion of that workforce in the nation’s There’s no doubt contact tracing,
The goal there is to get people treatment public health departments after the poorly executed, has that potential.
and address the social conditions that pandemic ends would preserve those Americans’ deeply ingrained individual-
made them sick in the first place. skills, in effect serving as a fire depart- ism, their distrust of government and the
Both programs require culturally sen- ment for future pandemics. And in the fear of an invasion of privacy guarantee
sitive teams with the professional skills absence of those rare events, they could there will be opposition. Look around.
needed to follow up and follow through. serve as community health workers Far too many people still refuse to wear
Both have their greatest impact on poor taking on the nation’s enormous public masks or observe social distancing.
and minority communities, which have health challenges. But Americans also have a barn-rais-
been disproportionately harmed by ing tradition where communities turn to
COVID-19 because of the high preva- The senseless murders of African collective action to help those in need.
lence of preexisting medical conditions. Americans at the hands of rogue police The barn our healthcare system needs
Throwing briefly trained recruits into and vigilantes, and the ensuing civic now is a contact-tracing program with
a raging pandemic risks alienating the unrest, have brought home to average adequate privacy protections that can
very people they hope to help. Sadly, it’s Americans the enduring discrimination serve as a springboard to improving
the best we’ve got given the nation’s ut- against minority and low-income com- population health. l
ter lack of preparedness. munities. They suffer most from the un-
And when COVID-19 subsides, what treated chronic conditions and deaths
The viewpoints expressed by the authors do not
will happen to what they learned on the of despair borne of economic depriva- necessarily reflect the opinions, viewpoints and
job? Unless steps are taken to preserve tion and inequality. It’s way past time official policies of Modern Healthcare and its staff.

20 Modern Healthcare | June 8, 2020