Contact Tracing Could Be Key To Easing Social Distancing Rules
Contact Tracing Could Be Key To Easing Social Distancing Rules
NPR's Rachel Martin talks to NPR's Geoff Brumfiel and to Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security, about the proposal for a national contact tracing program.
RACHEL MARTIN, HOST:
Despite President Trump's hopes of reopening the country by Easter, Sunday came and went with most of the U.S. on lockdown. But public health officials are looking to a time when those restrictions can be lifted. Speaking yesterday on ABC's "This Week," Food and Drug Administration Commissioner Stephen Hahn said he is hopeful at least parts of the country could reopen by May 1.
(SOUNDBITE OF TV SHOW, "THIS WEEK")
STEPHEN HAHN: It is a target. And obviously, we're hopeful about that target, but I think it's just too early to be able to tell that. We see light at the end of the tunnel.
MARTIN: Public health experts, though, say that before the nation can reopen, investments have got to be made in testing and tracing the sick. Joining me to talk about this, NPR science correspondent Geoff Brumfiel. Hi Geoff.
GEOFF BRUMFIEL, BYLINE: Good morning, Rachel.
MARTIN: So a term being used a lot right now is contact tracing, which sort of means what it sounds like. But explain.
BRUMFIEL: Well basically, when somebody tests positive for the disease, public health officials call that person. And the first thing they do is they actually ask, how are you doing? Do you need any extra medical help? But after that, they ask who they've been in contact with. And then they call those contacts and ask them to go into quarantine to make sure that they don't spread the disease if they'd been infected. Now, this isn't exactly rocket science, but it requires a lot of phone calls and follow-ups.
MARTIN: It also requires trust, right? You have to trust that those people will self-quarantine if they've been in touch with someone with COVID. How is this possibly going to work on a national scale?
BRUMFIEL: Well, right now, there's about half a million people with COVID-19 in the U.S. And that's just too many to contact trace all of them. So first of all, that's why we're all in lockdown - is so that the number of active cases goes down. But assuming those numbers do eventually drop, you're right. I mean, trust is going to be so important. And that's why this is going to come down to state and local governments - governments that people deal with every day. So for example, Massachusetts is starting a statewide program to trace COVID-19 patients and their contacts. They're going to hire around 1,000 people and train them up. And then they're going to start tracing people as soon as they can.
MARTIN: But does that mean that the country would be ready in a matter of a month or two to open up?
BRUMFIEL: It's going to be pretty tough. I mean, look. First of all, nationwide, we're talking about hiring tens of thousands of people, maybe even hundreds of thousands. And contact tracing doesn't really require super specialized training. You can train people who've never done it before. But those individuals also need to be plugged into a system. That system has to include widespread and rapid testing so that tracers can call people before they go out and get other people sick. It also needs to include, like, computer databases and things like that so that you know, the tracers can work together and follow up on all these phone numbers. And last of all, you need support for the sick and those who are put into quarantine. I mean, if you're going to tell people not to go to the grocery store for 14 days, you better have a plan for getting them groceries.
BRUMFIEL: And, you know, you put this all together, and we're talking about a huge national effort. I mean it's sort of like a Hoover Dam or something. Governments - I mean, the government could fund this. And there are plenty of people who need jobs right now. So, I mean, it's possible. We'll just have to see if it can happen.
MARTIN: Is there any technology that's being worked on right now that could help with contact tracing?
BRUMFIEL: Yeah. Well, you know, we have technology that we actually have in our pockets right now, these brilliant devices called cell phones that, you know...
BRUMFIEL: ...Trace our movements and can tell us where we've been and who we've been in contact with. And South Korea and China have been using cell phones to help with contact tracing. Sometimes, they've been pretty aggressive. Here in the U.S., there's concerns about privacy, obviously - the ACLU has raised some of those. Google and Apple are working on ways that they can use the technology - hopefully, without causing privacy problems. Bottom line, it's hard to imagine that tech won't play a role, but it's not going to be an app that gets us out of this.
MARTIN: All right. NPR science correspondent Geoff Brumfiel. Thanks, Geoff. We appreciate it.
BRUMFIEL: Thank you.
MARTIN: We're now going to get a different perspective from Professor Crystal Watson. She is a senior scholar at the Johns Hopkins Center for Health Security. Along with her colleagues, she has just published a report that outlines a national plan to ease social distancing through contact tracing. She's here with more perspective. Thanks so much for being with us.
CRYSTAL WATSON: Thank you very much.
MARTIN: So we've heard a lot from the White House about how the president would like to ease social distancing guidelines - open up the economy in the next few weeks. Based on your team's assessment, under what circumstances could we safely start to ease those guidelines?
WATSON: Yeah. It's going to be a combination of a case reduction. We want to see an extended reduction in cases - daily reported cases over time. Also, that hospital capacity is increased - that we can care for the patients safely that are presenting at hospitals. Testing - we need to build up our testing capacity to identify every case. And then we need to build the system for contact tracing all around the country.
MARTIN: So Geoff just outlined what contact tracing is. Can you explain what you're proposing? What would that look like?
WATSON: Yeah. The U.S. really needs to implement a robust and comprehensive system to identify all COVID-19 cases and trace all of their close contacts of each identified case. So this system is really necessary in order to reduce that burden on hospitals and ease that strict social distancing measures that we have in place right now. And then that helps us confidently make progress towards returning to work and school.
MARTIN: So this would - how would this work? I mean, if someone has COVID, then you're reliant on that person to be able to communicate who they've been in contact with? Or you're relying on those friends and acquaintances to self-identify to authorities?
WATSON: Yeah. So it's a combination of that and possibly the application of technology. So public health does contact tracing all the time for other diseases. So this is something that they know well. But yeah, you would ask a person who's been sick who they have come into close contact with. But we can also pair that with technologies to help identify people who have been in the area of this person.
MARTIN: So we heard that other countries have employed this. South Korea in particular used cell phone technology, as Geoff mentioned, to identify - track these movements. But there are privacy concerns, right? I mean, how would you implement a program like this while preserving Americans' right to privacy?
WATSON: Right. Privacy is very important. We need to make sure to address privacy concerns because we need the trust and help of people in our communities to do this. There are - as he said, there are some technologies like Bluetooth that help preserve privacy. They don't explicitly identify you. So we can employ those technologies. But I think people need to understand also that this is going to be important for your health. So imagine that you were in the grocery store. You were near somebody who was actively sick with COVID-19. And then you receive a text message a couple of weeks later, possibly, to say, oh, you might be - you might have been exposed. I would want to receive that text message, so I know what to do and what to look out for. And I think we are going to have to accept some tradeoffs in privacy to try and get this pandemic under control. But privacy is obviously very important. We should minimize any invasion of privacy to the extent we can.
MARTIN: Throughout the pandemic, the Trump administration has been reluctant to make anything a matter of federal policy - right? - instead leaving the response up to state governments. What's at stake here? What could happen if something like this is left to the states without federal support?
WATSON: The states need to implement this, along with local health departments. That is going to be their job. But what we need from the federal government is planning, guidance and technical support. That is their job. And they need to do that coordination at the top levels, so we can - so public health can do their job on the ground.
MARTIN: Professor Crystal Watson, senior scholar at the Johns Hopkins Center for Health Security. We appreciate your perspective. Thank you so much.
WATSON: Thank you.
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