Is contact tracing a thing of the past? Many NC health departments, organizations shifting gears

Coronavirus

DURHAM, N.C. (WNCN) – Contact tracing is still seen as a method that likely saved thousands of lives during the COVID-19 pandemic.

“Identifying those individuals that are positive doing contact tracing was a very effective tool. In fact, that helped us keep very low numbers on the campus,” said Dr. Thomas Denny with the Duke Human Vaccine Institute.

That was early on when there was a window of five to seven days. But the omicron variant has closed that gap by two to three days. That means by the time you’re notified by a contact tracer, you’re already at the height of being ill and contagious.

“You really don’t have a window there to interrupt that, and the numbers are just so massive you just can’t staff that amount of people to do contact tracing,” Denny said.

Duke, UNC Health, and the Orange County Health Department join other medical providers as the resources once used for contact tracing are needed elsewhere.

“We can’t have all of our essential workers in society sick the same week. We need to make sure that public transportation keeps going and the cashiers at the grocery stores are able to help people out and the hospital workers are able to make the hospitals function and day cares and schools,” said Dr. Erica Pettigrew, the Orange County Health Department Medical Director and Medical Director of Occupational Health at UNC Health Care.

“We need to figure out a way to flatten the curve in that making sure that people aren’t getting this infection all at once, all in the same week. We have to be able to spread it out even if we might not be able to stop it from affecting so many people.

“Even though omicron seems to be less severe for most people, the fact that it is so contagious, we are seeing absolute numbers of sick people climbing dramatically. And so hospitalizations are definitely increasing and are very much stressing the health care systems in our state. And so we need to figure out a way to flatten that curve to not have all of those patients all at once.”

In a statement, UNC Health said:

“There are multiple components to the contact tracing process and UNC is engaged in a modified approach this semester based on the guidance of our public health experts who have determined that contact tracing now has less efficacy in mitigating the spread of COVID given the high level of transmission of the Omicron variant.

UNC does source case investigation of every positive student case. Students receive electronic isolation instructions including duration based on CDC guidelines, information about excused absences for classes and information about how to access other resources. Students also receive instruction about contacting Campus Health if they develop symptoms or existing symptoms worsen.

Due to the significant spread and transmission of the variant throughout the nation and region, close contact tracing is not used extensively as a mitigation strategy-again through guidance from NCDHHS and Orange County Health Department. UNC engages in tracing when there is an event or gathering where an epi link may be established between positive cases or if medically high risk students are involved. Otherwise, most contact tracing has been discontinued by UNC.”

The North Carolina Department of Health and Human Services is also shifting gears. In a statement, it said:

“In North Carolina, there are many staff supporting case and contact outreach efforts at the LHD level, including more than 1,300 contractors through Community Care of North Carolina (CCNC) who provide a variety of COVID-19 support. NCDHHS and local health departments have flexed our case investigation and contact tracing staff to provide the best outreach we can according to the current needs of the pandemic, while creating technological tools to provide options for outreach and increase efficiency.

NCDHHS and local health departments have flexed case investigation and contact tracing staff to provide the best outreach we can according to the current needs of the pandemic, while creating technological tools to provide options for outreach and increase efficiency.

With the high case numbers, and the ability to electronically notify people diagnosed with COVID-19, NCDHHS is moving to recommending telephone-based contact tracing in high-priority settings (i.e. congregate living, health care and first responders), while recommending more efficient, lower-touch digital case patient notification for the general public. Most residents who receive a positive COVID-19 test result will receive a text or email detailing what they should do, which includes notifying their close contacts or using the NCDHHS webpage link to send anonymous automated notifications. Contact tracers will make phone calls to those who have tested positive for COVID-19 and can’t be reached digitally as staffing allows. Local health departments may offer additional or different services.”

Is contact tracing for COVID-19 a thing of the past? Denny said it depends on what the next variant looks like and how sick it makes people.

“That requires us to change policies and to adapt to that. So, it can be confusing, but it’s all meant to try to stay ahead of this as best we can,” he said.

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