Swamped by thousands of calls a day, contact tracing programs have been forced to adapt. Even though they can't call everyone, experts say it's too early to give up on this pillar of disease control.



The speed with which the American variant spread through the United States overwhelmed programs dedicated to contact tracing. Some public health departments are scaling back.


UNIDENTIFIED REPORTER: The Virginia Department of Health is no longer using contact tracing when it comes to positive COVID-19 cases.

ASA HUTCHINSON: As a result of omicron, we're not able to do contact tracing.

TOM WILLIS: The Department of Health is ending its COVID-19 contact tracing at Duval County schools.

FLORIDO: Some headlines have gone so far as to declare that contact tracing is dead, it's over. NPR's Selena Simmons-Duffin has been following contact tracing efforts since the pandemic began. She says, not so fast.

Hey, Selena.


FLORIDO: So is it that the number of cases in the omicron wave was just too much to keep up with?

SIMMONS-DUFFIN: Yeah. I mean, that's certainly a big part of it. The other thing is speed is really important, right? Contact tracing works to slow the spread when people who have COVID-19 know to stay home and their close contacts know to quarantine in case they're sick, too.

But this variant spread so quickly that by the time you get the lab result and the contact tracing staff has made that call, close contacts may already have COVID. They may have already spread it. It's just too late to break the chain of transmission.

And at the same time, this isn't March 2020. There are now vaccines and treatments. Contact tracing isn't the only tool here, so that's why you see so many health departments changing how they work.

FLORIDO: So what does that look like? What are health departments doing? Are they literally shutting things down now?

SIMMONS-DUFFIN: Yeah. I mean, some are, especially health departments that hired contractors to make these calls. I've heard of contracts just ending early; that's it.

But I would say most are pivoting. Maybe they're not calling everyone. They're just calling people over age 60, for instance, or people who are in settings like day cares or nursing homes or jails where outbreaks are a big concern.

The way that health departments communicate this change is really important, too. One health department director I talked with is Jodie Pond. She's in Teton County, Wyo., and they've always been able to call everyone who tested positive in the county until omicron.

JODIE POND: The numbers were just staggering. So we, you know, made the call of how we would prioritize cases. And, you know, our phone lines were just ringing off the hook because people were like, I haven't heard from you.

SIMMONS-DUFFIN: They ended up going on local news and putting out an alert saying, you may not get a call from us. We cannot reach everyone right now. Because if people are expecting a call for days and it never comes, that could play into the sense that public health is broken, you can't trust it.

And that's why there's a big push now to explain to the public that these changes to contact tracing are happening, that they're intentional. And several big public health groups recently put out a press release endorsing the move away from universal contact tracing to this more targeted approach.

FLORIDO: Are there any ways in which the contact tracing process is getting better at this point?

SIMMONS-DUFFIN: Oh, definitely. There are lessons learned here. There are some pragmatic changes, like a lot of people can call their own close contacts. It's simpler and faster. Plus, your friends might screen the health department's call, but they might answer yours.

And there have been innovations since the scrappy early days of contact tracing. Marcia Pearlowitz runs the contact tracing unit for Maryland's Department of Health. And when somebody tests positive there at home or on a lab test, right away they get a link to an online survey that asks them demographic information, if they have symptoms, when did those start?

MARCIA PEARLOWITZ: And then that allows us after they've completed the survey to push out personalized isolation information for them.

SIMMONS-DUFFIN: So that's handy for the person with COVID, right? Because they get a date, like isolate until Wednesday, instead of a long list of general guidelines. And then for the health department, they get data about where outbreaks are happening, and it helps them figure out who's at higher risk. Then those people get an old-fashioned follow-up phone call.

FLORIDO: So it sounds like maybe you're saying that, you know, reports of contact tracing's death might be a little exaggerated, a little premature.

SIMMONS-DUFFIN: Basically, yes. I mean, everyone I talked to in health departments, policy centers, academia, they all say it does not make sense to give up on this process. It still has a role. It can still save lives.

Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security, made a good point to me. She said she thinks people are eager to close the book on contact tracing because it would signal COVID is just a regular seasonal virus. But she says, we're not there yet.

FLORIDO: That's NPR's health policy correspondent Selena Simmons-Duffin. Thanks, Selena.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.