With Testing Delays And Cases Surges, Contact Tracing Is Stymied In Some States : Shots - Health News With the coronavirus spreading out of control in many parts of the U.S., some experts say the strategy of testing and tracing can't contain the pandemic until lockdowns bring case numbers down.
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Pandemic Is Overwhelming U.S. Public Health Capacity In Many States. What Now?

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Pandemic Is Overwhelming U.S. Public Health Capacity In Many States. What Now?

Pandemic Is Overwhelming U.S. Public Health Capacity In Many States. What Now?

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STEVE INSKEEP, HOST:

Now here's a big question - is it time for a new strategy against the pandemic? It's out of control in many parts of the country. Almost 150,000 people in the U.S. have died. And experts say it may be too late to rely on testing, contact tracing and quarantining. Here's NPR health correspondent Rob Stein.

ROB STEIN, BYLINE: When the pandemic began, public health experts had high hopes for America. After all, the U.S. literally invented the tactics that have been used for decades to quash outbreaks around the world - quickly spot everyone who gets infected, track down everyone they might have infected, test everyone, isolate and quarantine to stop the virus from spreading by quickly dousing every ember from a campfire to keep it from erupting into a forest fire. Today, it's that hope that's been extinguished - not the fire.

MICHAEL OSTERHOLM: Right now we are experiencing a national forest fire of COVID...

STEIN: Michael Osterholm is an infectious disease expert at the University of Minnesota.

OSTERHOLM: ...That is readily consuming any human wood that's available to burn.

STEIN: So that strategy that everyone hoped would prevent a viral conflagration by relentlessly testing, tracing, isolating and quarantining, it's just too late.

OSTERHOLM: When you have something like this happening, there's no way that traditional testing and tracing is going to have any meaningful impact. I liken it to trying to plant your petunias in the middle of a Category 5 hurricane.

STEIN: But why? Why is it too late? I asked Dr. Jeffrey Engel that question. He's at the Council of State and Territorial Epidemiologists. They're on the front lines of fighting the virus. I got this beleaguered, almost resigned response.

JEFFREY ENGEL: It's just this massive effort, you know? Test, test, test, test and quarantine and contact trace. And, you know, it's just not feasible. So...

STEIN: Because there are just too many people getting infected too fast now. There still aren't enough tests, so it can take days to get results. By that time, anyone who's infected probably already spread the virus to who knows how many other people, and half the time the test results don't even include the basic information needed to find them, like phone numbers or addresses. And even if you do get to them in time, Engel says good luck convincing their contacts to quarantine.

ENGEL: It's voluntary, and they have other things to do, like their lives. Whatever the situation, they may be essential workers. They may need to get to work. You know, life takes over.

STEIN: So if that won't work, what now? Well, Jennifer Nuzzo at Johns Hopkins says the short answer is a word no one wants to hear.

JENNIFER NUZZO: Given our basic failure to fix the gaps in testing and the bottlenecks, that really puts us on a path where there is no viable alternative beyond shutdowns.

STEIN: Now, there may be some places where there still isn't a lot of virus that could avoid shutting down, but Nuzzo says probably not many. But Nuzzo hopes the shutdowns won't have to be as draconian this time and can at least be less dramatic in some places than others.

NUZZO: Because I do really worry about forcing, you know, an entire state or country to retreat to our homes for extended periods. These are harmful measures in themselves. They may be necessary, but I hope that we can take action to do everything in our power to avoid them.

STEIN: Like finally get everyone to wear masks, stay away from other people as much as possible - especially indoors - and keep testing and contact tracing as much as possible. It is still working in some places and can help target shutdowns at the places where the virus is spreading the most, like crowded bars, where people who've been drinking often end up infecting each other. Michael Osterholm at the University of Minnesota hopes more measured lockdowns may work in some places, too. But in the hottest of the hot spots, he's not so sure.

OSTERHOLM: If we want to be like other countries in the world that have successfully contained this virus, then we have got to take the medicine now. We will not get there. We will not get there unless we bring this virus level down again. And there is just no other way to do it, literally, but a kind of second lockdown. And this time, let's get it right.

STEIN: That could knock the virus back enough to let kids safely go back to school, get some people back to work and give the nation time to hopefully, finally get enough tests, hire enough contact tracers to get off this deadly, miserable roller coaster and regain at least some version of our old lives.

Rob Stein, NPR News.

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