How Do You Do Contact Tracing? U.S. Can Look To The Developing World For Models : Goats and Soda As parts of the U.S. aim to move out of lockdown, a key tool to contain coronavirus cases will be contact tracing. It's something health workers in low-income countries have lots of experience with.

How Do You Do Contact Tracing? Poor Countries Have Plenty Of Advice

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All right. As you heard Emma say, public health experts say that contact tracing is really important to reopening. Here's Robert Redfield, who's the head of the CDC.


ROBERT REDFIELD: The major thrust of how we're going to control and make sure that we continue to keep this nation open is early case recognition, isolation and contact tracing. That's the fundamentals of public health. That's what we're going to do.

KING: Some health officials say this country might need 300,000 people to do contact tracing. So how do we scale that up? NPR's Jason Beaubien took a look at how this is being done in the developing world.

JASON BEAUBIEN, BYLINE: Raj Panjabi grew up in Liberia. During the Ebola outbreak in 2014, his organization Last Mile Health helped set up contact tracing there.

RAJ PANJABI: We couldn't break the chain of transmission and drive the epidemic down to zero cases in Liberia without contact tracing.

BEAUBIEN: In the remote part of West Africa where Punjabi's group was working, his contact tracers investigated each case of Ebola and identified any other people who may have been infected. Punjabi says, for each patient, there was usually about 10 additional so-called contacts. The contact tracers monitored those people twice a day.

PANJABI: Morning and afternoon, throughout the 21-days post-exposure period - and, again, 21 days being the period for Ebola - to identify and record whether the contact had any symptoms of Ebola.

BEAUBIEN: And this is how contact tracing can break epidemics - because if the contact becomes ill, the contact tracer will know about it. They'll get the person isolated at a treatment center. The patient benefits by getting health care quickly. And there's much less chance of the virus continuing to spread.

PANJABI: You've got to track each contact of an infected person. And if you do that right, that strategy will eventually extinguish all transmission lines and end an epidemic. And in fact, with our very last cases in Liberia, that was exactly the practice that led to the last case being identified, and then the epidemic halted.

BEAUBIEN: Contact tracing is a standard practice to contain many different infectious diseases. It's used all over the world, including in the United States, to manage tuberculosis. In India, contact tracers are on the front lines of TB control and treatment. Shelly Batra is the co-founder of a group called Operation Asha. Her group had been going door to door to track down people with TB and monitor them as they take their medications. But now India is under a strict lockdown to prevent the spread of the coronavirus.

SHELLY BATRA: Now all these activities have come to a halt because the government is talking of social distancing, stay at home. No movement in the field at all.

BEAUBIEN: This has forced Batra's health workers to monitor tuberculosis patients by cellphone.

BATRA: Like in India, people say there are more phones than toilets. That is what's really working for us.

BEAUBIEN: Now instead of visiting TB patients in their homes and knocking on the doors of neighbors, her contact tracers must cajole patients over the phone into taking their daily medicines.

BATRA: So what our health workers are doing - suppose they give medicines for a week on Sunday. Monday morning, they'll call up after breakfast. Hey, guy, you had your breakfast? Have you had your meds or not? And if he says, no - why not?

BEAUBIEN: Now they've been able to adapt that network of contact tracers to screen and monitor for COVID-19. With so many people in India out of work because of the lockdown, Batra says this effort against the coronavirus is also providing desperately needed jobs.

BATRA: And there is no requirement for any degree at all if you are able to read or write a little bit. There are so many people who want jobs. So they are doing something good. They're serving the community. And they will get a little payment for it.

BEAUBIEN: And as the U.S. is looking at how it's going to build an army of contact tracers, it could be a way to put people back to work in this country and confront the COVID-19 crisis at the same time.

Jason Beaubien, NPR News.

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