Public Health Officials Wind Down COVID Contact Tracing

As of last week, the Centers for Disease Control and Prevention (CDC) no longer universally recommends contact tracing to track and contain COVID-19. Now, they're only recommending the tool in settings and for groups at high risk.

The agency recommends that local health departments pivot to investigating COVID-19 cases and outbreaks in high-risk settings like long-term care facilities and correctional facilities. And they suggest health departments prioritize notifying people of potential exposure who aren't vaccinated/up to date on vaccinations or are at an increased risk for severe outcomes.

State and local health departments have already started to scale back contact tracing efforts, which have been a key part of attempting to control COVID-19 transmission throughout the pandemic.

Contact tracing is a valuable tool that helps public health officials study and control infectious diseases, but experts say the necessity of the practice for COVID has begun to wane.

Since January, several public health organizations have issued statements in favor of no longer tracing every case of COVID.

For example, a statement from the National Association of County and City Health Officials (NACCHO) reads:

“Although universal case investigation and contact tracing was implemented in spring 2020 to slow COVID-19 transmission, much has changed over the past year prompting the need for a revised public health approach.”

Here’s what experts say reducing contact tracing efforts for COVID is the right move.

How Contact Tracing Works

Contact tracing is a tool that public health departments have used since the early 20th century to help prevent the spread of infectious diseases.

The goal of the practice is to break the chain of disease transmission by finding every person that an infected person had been in contact with.

The process begins when a person is identified as being infected with a disease. Based on how long they have been able to spread the disease (infectious period), the person is asked where they have been and who they have been in contact with.

An infected person’s contacts can then be alerted by health department workers that they have been exposed to the disease.

In the past, smallpox, syphilis, and HIV/AIDS have been tracked with contact tracing. Then came COVID-19.

Not a Sign of Surrender

Georges C. Benjamin, MD, the executive director of the American Public Health Association, told Verywell that given the sheer size and rapid spread of the first wave of the pandemic, contact tracing put a huge strain on public health departments.

“When this thing first hit two years ago, in places like New York where they just had so many cases, you were just unable to keep up with contact tracing,” said Benjamin.

As the pandemic evolved, the strategies that we have needed to fight it have changed, too.

“Contact tracing is a critical part of case identification and disease control, no question about that,” said Benjamin. “But a lot of things have changed since the pandemic started,” Benjamin said.

As an example, Benjamin pointed out that the Omicron variant of the COVID virus has such a short incubation period that contact tracing just can't keep up with it.

Still, reducing contact tracing efforts should not be seen as a white flag of surrender. “It isn’t giving up,” said Benjamin. “It is truly a strategy to try to maximize and optimize resources.”

Still Helpful, But Less Need

Speaking at a media briefing, Crystal Watson, DrPH, a senior scholar with the Johns Hopkins Center for Health Security and an assistant professor at Johns Hopkins Bloomberg School of Public Health, said that contact tracing “is still very important, but it has evolved through the pandemic response.”

According to Watson, contact tracing “has been a key component of our response at the height of these really large surges, especially Omicron” but that “it becomes less useful in terms of curbing transmission because this is a resource-intensive activity. It gets quickly overwhelmed.”

However, the practice can still make a difference in institutional settings like nursing homes where vulnerable populations need special protections.

Watson said that continuing to follow and disrupt how the infection is passed from person to person in the community is an important task for public health.

“We do want to keep in mind that there will probably be future surges of the virus,” said Watson. “And we don’t know what those new variants will look like. It’s important not to eliminate this capacity.”

Using Different Tools

Throughout the United States, states are taking steps to reel in contact tracing.

For example, Black Hawk County, Iowa announced that it is moving away from county-wide efforts to trace COVID cases. Similar scaling back has started in several New York counties after Governor Kathy Hochul announced that the practice was no longer required.  

Broader community-based communication tools will be used to continue to monitor and attempt to curb the pandemic.

According to Benjamin, public health officials can “use other ways to try to help people realize that they’re either infected or have risks and then to do the appropriate things to be tested.”

Benjamin added that the wider availability of at-home testing has also changed the need for contact tracing. Now, people don’t need to go to a healthcare provider or health department to find out if they’ve been infected.

However, Watson said that people who test positive using a home test kit should report their status to their provider and their local health department. They may need to have a follow-up polymerase chain reaction (PCR) test done to ensure their case is followed.

Building Trust

There has been widespread resistance to vaccination and to requirements for masking and social distancing throughout the pandemic.

According to Watson, there have also been reports of people refusing to respond to the public health workers tasked with tracing contacts.

“There will always be some people who are hesitant to engage with contact tracers,” said Watson. “I know that happens in all sorts of settings with different outbreaks.”

However, most people who were contacted were willing to work with contact tracers. Watson added that the methods used by health department staffers have helped them engage effectively with the public.

“People are always protective of their personal information,” said Benjamin. “Not only are you asking them for personal information, [but] you’re also asking them, ‘Who are you around and when were you around them?’ And obviously, that’s a privacy issue.”

Public health staffers completing contact tracing are very good at personal interaction and have the communications skills needed to make people feel comfortable sharing their personal information.

As it has been throughout the pandemic and will continue to be, Benjamin said that “building the trust is necessary.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.