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With COVID-19 cases in the U.S. still rising, many experts say the next phase in the pandemic response will require aggressive contact tracing. The technique has been used extensively in prior disease outbreaks elsewhere, but the U.S. currently lacks a nationwide tracing infrastructure. And while apps tracking movement and interactions could help, they raise privacy concerns. Amna Nawaz reports.
With, as we heard earlier, the number of cases expected to climb in coming weeks, many experts say the next phase in the response to the COVID-19 pandemic will require aggressive contact tracing.
Amna Nawaz reports on how tracing works, why it could help, and the concerns over privacy.
Krysta Cass' path to medicine was not the norm. A West Point grad, she served three tours of duty for the U.S. Army, then went on to become a physician's assistant in Boston.
In March, like many places during the pandemic, all elective surgeries here were paused.
We can't operate and replace hips and knees right now. I just kept thinking, what can I do? How can I help? How can I be involved in this public health crisis?
Massachusetts has nearly 70,000 confirmed cases of COVID-19. And, last month, Governor Charlie Baker gave Krysta her answer, announcing a new phase in the state's fight against the virus: aggressive contact tracing.
I was one of the first applicants. I could not wait to get my hands on this.
Krysta was hired by Partners In Health, a Boston-based global health nonprofit working with the state to hire, train and deploy 1,000 new contact tracers, at a cost of $44 million.
The process is straightforward, but time-intensive. First, contact all new confirmed cases of COVID-19. Find out everyone they came into contact with while sick. Then reach out to those people to tell them they may have been exposed, and will need to quarantine.
What are the first lines you deliver to people?
I would say, hi, I'm Krysta. I'm calling from the community tracing collaborative for the Department of Health.
I'm calling to let you know that you have been exposed in the past week to someone who was diagnosed recently with COVID-19. And then I take a break, because that's a — that's a lot to handle and a lot to hear.
The work, she says, is about more than just informing people they might have been exposed. Contact tracers explain how to quarantine the right way, how people can protect their families, get groceries and medicine, pay their bills, even find help for domestic abuse.
We are not just collecting data. We're doing more than that. We are becoming extensions of our client, of our contact's social support system, and we're connecting them with the resources they need.
Used around the globe in response to diseases like cholera, HIV and Ebola, contact tracing has long been a critical public health tool to map and control outbreaks.
This is how you stop running away from the virus and start chasing it down.
Now with the Center for Global Development, Jeremy Konyndyk helped manage the Obama administration's Ebola response in West Africa, relying heavily on contact tracing.
Ramping up a national program here, he says, could not only help stop the spread. It could help avoid large-scale shutdowns.
Because of inadequate testing and because we don't have a national contact tracing infrastructure in place in the United States, we, in effect, have to presumptively quarantine the whole population.
But with contact tracing at scale and testing at scale, then you have the ability to quarantine only those people who have actually been exposed to the virus.
Digital tools to track people's movements, he says, like those used in Singapore, Israel, South Korea, and many other countries could also help.
But tackling the scale of infection here in the U.S., on top of years of slashing state health budgets, means more federal leadership is needed.
The estimates now from Johns Hopkins are that we may need somewhere around 100,000 contact tracers across the United States. And I think that that's the sort of order of magnitude we need to be thinking on here.
That's a lot of people, but, also, that's an achievable thing.
Some estimate the U.S. will need nearly double that number of contact tracers, but, so far, states are largely rolling out their own individual plans.
North and South Dakota are two of a handful of states which have not issued stay-at-home orders during COVID-19. Together, they have so far seen around 3,500 confirmed cases, with fewer than 50 deaths.
Officials now hope a new location-based app can aid their efforts to keep the virus at bay.
It turns out that most people, including myself, can't remember on a good day where I was five days ago, let alone if you're sick.
Tim Brookins is an app developer in Fargo, North Dakota. In 2014, he developed Bison Tracker, an app that let North Dakota state football fans track each other as they traveled together to away games.
In April, he repurposed that app into this one, the Care19 app, which tracks and compiles users' locations, so, if they do test positive, they can easily share that data with a contact tracer.
Brookins says it will protect users' identities, while making the process more efficient and accurate. But he acknowledges these efforts require buy in.
It's hard. People need to really take time to digest, you know, what is the new normal after this, and, you know, come to terms with the idea of location tracking.
Google and Apple recently announced they're working on contact tracing technology, too, to roll out in mid-may. But the rushed tech response has some privacy experts worried.
We're essentially building the airplane while it's flying.
Jon Callas is a former security expert at Apple, now with the American Civil Liberties Union. They recently published a report outlining principles to protect privacy and civil rights in contact tracing technologies.
Among those principles, that the technology used should be voluntary, tracking information should be stored on a user's phone, rather than a government or company server, the data should be routinely cleared out, and these programs should end when the pandemic does.
Callas says these are necessary steps, not only to protect the public from increased surveillance, as seen in China, but for public health efforts to fight the pandemic to be effective.
We have to get the trust of the people who are using this. If people don't trust that this is a system that will benefit them and their community, they won't use it. They will balk. They will push back.
I mean, we already see people in the United States who are pushing back on things.
Ultimately, though, experts agree the digital tools should complement human contact tracers, not replace them.
While the app may be efficient, it's not familiar, nor does it have a human voice on the other end of it saying, by the way, I know I'm telling you that you have been exposed, and the second thing I want you to know is, I'm here for you through this process.
A process to slow the spread, save lives, and maybe even prevent future waves of the virus.
For the "PBS NewsHour," I'm Amna Nawaz in Washington.
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Amna Nawaz joined PBS NewsHour in April 2018 and serves as the program's chief correspondent and primary substitute anchor.
Frank Carlson is a general assignment producer at the PBS NewsHour, where he's been making video since 2010. @frankncarlson
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