With omicron push, some wonder if Covid contact tracing still works

Alejandra Perez-Handler had a 2 month old baby and was in desperate need of homework. So she took a job as a contact tracker in Connecticut.

From October to November, she made about 20 calls a day to people who had been exposed to Covid-19, working painstakingly on a long list of names. Now she makes about 30 calls a day as cases increase, in large part because of the omicron variant of the coronavirus.

“It’s mentally exhausting,” said Perez-Handler, 23. “It’s just exhausting.”

Her eight-hour days turned into 11-hour days, creating an increasingly stressful scenario for her family. Some calls last 10 minutes, while others can last half an hour or more. Some people thank her; some hang up on him; some threaten to harm her, shouting and demanding that she tell them where she lives; and others are devastated.

“A week before Christmas, I had to call a mom about her baby, who was less than 30 days old and had Covid,” Perez-Handler said. “After the phone call, I said to my supervisor, ‘I just had a very difficult call, I need a break,’ then I broke down. “

The changing nature of Covid-19 means major pitfalls for contact tracers, including extraordinary workloads and unsuccessful attempts to reach people who have been exposed.

Some epidemiologists argue that contact tracing is a crucial preventive measure that deserves to be continued, albeit with significant changes.

“This is important because it provides a landscape of who has been in contact with someone who is positive, so it helps us identify who may be the next positive or prevent the sick person from transmitting the virus to a healthy person. health, “said Luisa N. Borrell, professor of public health policy at the City University of New York.

While some calls fail, others can stop the chains of infection, which is enough to keep contact tracing going, Borrell said. Ideally, this should strengthen other regulations, such as masking, testing, quarantine and isolation, she said.

Lorna Thorpe, director of epidemiology at New York University’s Grossman School of Medicine, who is leading the evaluation of New York City’s contact tracing program, said some aspects of contact tracing are beneficial even when the program is in difficulty. Counseling people on how to get tested or where to seek medical help is also helpful, even when a contact tracer cannot collect the names of everyone at risk.

“What’s not as good is what the status of these contacts is, how many of them have actually been tested or how many of them have already been tested or have shown symptoms,” Thorpe said. “It’s not that robust.”

If a contact tracer calls too late, people may already be at the end of their infections, she said. As a growing body of research shows that vaccinated people are less likely to spread the virus, the highly transmissible variant of omicron has raised new concerns.

The scarcity of testing creates another hurdle, reinforcing Borrell’s argument that other preventative measures must be put in place for contact tracing to work.

Last week, the Centers for Disease Control and Prevention shortened the recommended isolation time for people who test positive from 10 days to five days if they are asymptomatic or if their symptoms go away. But some health experts said they were concerned the reduced time could increase the spread.

The seven-day average of Covid cases across the country peaked on Monday with an average of 740,594 new infections per day. Due to the outbreak, more people were exposed, and the tracers had to adjust to the increase. Perez-Handler said no one had explicitly asked her to call 30 people a day instead of 20. But supervisors would suggest she call more people, and not doing so would result in illicit reviews or a negative review, making him fear for his job.

Nicolette Vigiano, who worked as a Covid contact tracer in Long Island, New York, from December 2020 to August, said she was fired because her employer believed contact tracing would no longer be necessary.

“Most of my team have been made redundant,” said Vigiano. “Only two or three people stayed. It was just as the shots were coming out and everything, and the delta variant hadn’t really hit the mark yet. It was a moment of hope. ”

In November, as the Delta variant began to take over hospitals, Vigiano received an email asking if she could resume her job as a contact tracer. But as a graduate public health student working in home health care, she could no longer provide contact tracing.

“The email specifically said, ‘Please don’t respond unless you can work full time and get hired immediately,'” she said.

Perez-Handler, whose contract ends next month, said the indeterminate state of contact tracing, coupled with the heavy workload, is hardly attractive to employees. There are times when she takes pride in helping prevent the spread of the coronavirus, she said, but she is looking for health helpline jobs that don’t involve looking for contracts. .

“When my parents first heard how many calls I had to make, they were like, ‘Can you really do that much? Like, is that realistic? How can you do that? ‘ “, did she say. “And I’m like, ‘Yes, it is possible. I do it every day.'”