106: Contact Tracing’s Role Today

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Thursday, January 27th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

Some public health departments are starting to move away from widespread use of case investigation and contact tracing to fight the COVID-19 virus. Both have been important tools in the nation's pandemic response, but many jurisdictions are considering whether they're a good use of time and resources today given the contagious nature of the variant. ASTHO's chief medical officer Dr. Marcus Plescia explains the latest thinking in today's morning conversation.

Why the new approach to case investigation and contact tracing?

DR. MARCUS PLESCIA:

So, the issue with contact tracing is not that it's not effective, and contact tracing does work. The issue is right now, particularly with the situation we're in with Omicron, it's just not very impactful.

So, the feeling is we really need to step back, scale back, and focus on the things where we can have the greatest impact. With contact tracing—just because Omicron strikes so quickly, the incubation time is much shorter—we're having a hard time really getting to people's contacts before they actually get sick.

And so, the thought is it's time to move away from this and really focus on other things like vaccination, distancing, masking, ventilation. We've got a lot of other tools in the toolbox, and I think all of the states are beginning to feel like it's time to make that shift.

JOHNSON:

To be clear, we're not abandoning these tools?

PLESCIA:

I think in a situation like this pandemic, you just have to constantly reassess and decide what are the things that are going to work best in the situation that you're in. So, no, we're not abandoning contact tracing. It's possible we could come back to contact tracing if other aspects of the pandemic call for it.

But you know, we do need to learn as we go along and we need to pay attention to what we're learning. And when we're finding that something is maybe not serving us well, it's time to make changes. And that's what we're suggesting here.

JOHNSON:

In fact, we would be irresponsible if we stuck to one way of doing public health work right now if we knew that that work wasn't really getting the job done, if we decided it's better to just stay the course then to adjust?

PLESCIA:

That's correct. We try to practice good public health science. Good public health science means you monitor what's going on. You make changes when the data suggests that things aren't working as well.

And we also need to be good stewards of public resources, and I think what a lot of people feel like is this is probably not the best place to put the resources right now. We should focus more on some of the other tools that we have.

JOHNSON:

Isn't the bottom line here flexibility?

PLESCIA:

Yeah, it is. I think, increasingly, we need to be flexible. We need to look at everything we're doing. It, you know, the landscape of the COVID virus keeps changing, and we need to be able to change with that if we're going to be effective in ultimately controlling it.

JOHNSON:

What are some of the other pandemic fighting tools that you are excited about here in the new year?

PLESCIA:

Vaccination is still probably our strongest tool. There's been some setbacks with the Omicron virus, but the vaccine still works really well, and it keeps people from getting severely ill.

I'm very excited about the therapeutics that are on the horizon. Unfortunately, we have limited supplies of those right now, so we're not able to really use them as one of our strongest tools; but that's going to change in the next few months. And then we'll be at a place when somebody does happen to get sick—whether they're vaccinated or not, and we know they're high risk—we can go ahead and treat them and really lessen the chance that they would have any kind of a severe reaction.

And then, finally, we are making some progress as of late with testing. At-home tests are really convenient and people are likely to use those. And I think as the supply picks up, that's going to be another thing that's very encouraging.

JOHNSON:

ASTHO joins several other national public health groups to issue a statement this week supporting departments who've made or could make the change to their pandemic strategies. You can read the full statement using the link in today's show notes.

ASTHO's president-elect, Dr. Anne Zink of Alaska, is among those evaluating how best to use contact tracing at this point in her department's COVID-19 response. She says everyone on the team is ready to pivot when necessary.

DR. ANNE ZINK:

So if that is, you know, changing our percent positivity—because it's not reflecting anything meaningful, and having negative tests stopped being reported in because it's just a lot of extra paperwork—then let's do it. If that means stopping doing mass contact tracing—because people know what to do with COVID, they don't want our call anymore, they know what to do and we need to use those services for our most at-risk individuals; I need my epi team thinking about these overall projections, I need them invested in how we can save the most amount of lives with the tools and resources we have—then let's do it, let's move that direction.

JOHNSON:

Also today, ASTHO has released an updated version of its popular COVID-19 Vaccine Comparison Chart. The document includes the latest information about available vaccines and updated guidance about booster doses and side effects.

Download the chart following the link in the show notes.

Finally this morning, we're grateful that you're along with us each day for the show, but did you know there are others you can follow in addition to ours, each offering a unique take on public health practice?

ASTHO has written a blog listing seven podcasts you may want to consider. There's a link to the list in the show notes.

That'll do it for today's report.

Be sure to join us again tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.