Contact tracing is an important tool for public health officials. With the COVID-19 vaccine rolling out, here’s an interesting take on countries where contract tracing has had success. (Spoiler alert: Countries where laws and culture encourage compliance with government science). In the UK and USA, not so much, But private business contact tracing can help until “herd immunity” is achieved.
The following is an excerpt from a news feature article published by Nature Research on December 14, 2020 by Dyani Lewis. Read the full article at Nature.com >>
NEWS FEATURE 14 DECEMBER 2020
Why many countries failed at COVID contact-tracing — but some got it right
Rich nations have struggled with one of the most basic and important methods for controlling infectious diseases.
When Ebola ripped through communities in West Africa between 2014 and 2016, Tolbert Nyenswah saw at first hand how health workers extinguished the epidemic by finding and quarantining contacts of those who caught the disease. The former director of Liberia’s public-health institute thought contact-tracers would again rise to the challenge this year, keeping COVID-19 in check as it swept the globe. “Contact-tracing is one of the greatest tools that countries should deploy and use effectively to contain the outbreak,” he says.
But nine months after the World Health Organization (WHO) declared COVID-19 a pandemic, few countries are wielding contact-tracing effectively. “By now, what I was expecting is that 100% of people coming in contact with COVID-19 would have been traced,” says Nyenswah, now an infectious-diseases researcher at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.
Across the Western world, countries have floundered with this most basic public-health procedure. In England, tracers fail to get in touch with one in eight people who test positive for COVID-19; 18% of those who are reached provide no details for close contacts. In some regions of the United States, more than half of people who test positive provide no details of contacts when asked. These statistics come not from the first wave of COVID-19, but from November, long after initial lockdowns gave countries time to develop better contact-tracing systems.
The reasons for the failures are complex and systemic. Antiquated technology and underfunded health-care systems have proved ill-equipped to respond. Wealthy nations have struggled to hire enough contact-tracers, marshal them efficiently or make sure that people do self-isolate when infected or that they quarantine when a close contact has the disease. And overstretched contact-tracers have been met with distrust by people wary both of health authorities and of the technologies being deployed to fight the pandemic. Meanwhile, researchers who are keen to draw lessons from contact-tracing operations are stymied by a dearth of data.
A handful of places stand out as exemplars of successful contact-tracing — including South Korea, Vietnam, Japan and Taiwan. Many of these have cracked down on COVID-19 early, isolated infected people and their contacts and used personal data such as mobile-phone signals to track obedience. Not all of those techniques are transferable to countries now struggling to contain massive outbreaks. But they still provide some lessons.
Measures that work include tracing multiple layers of contacts, investigating outbreak clusters and providing people who are advised to quarantine with safe places to do so and with financial compensation. Technology might help, too: from software that streamlines conventional contact-tracing efforts, to smartphone apps that alert people that they might have been exposed to SARS-CoV-2.