A Year in the Life of America’s Largest Contact Tracing Program

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Every New Yorker has their own memories of the days after March 1, 2020 – the day authorities confirmed the city’s first case of COVID-19. Empty streets and sidewalks. Ambulance sirens punctuate the disturbing silence. Mobile morgues installed outside hospitals. During those terrifying days, I developed a fixation on daily briefings. One of them changed my life – and the trajectory of the virus in New York City.

On April 22, 2020, New York State Governor Andrew Cuomo and former New York City Mayor Mike Bloomberg announced the creation of the largest contact tracing program in our country’s history. Six weeks later, the NYC Test & Trace Corps, part of the New York City hospital and health system, was launched with a team of 2,500 contact tracers. I was one of them. This army has grown to 4,000 and includes several types of contact tracers: case investigators, monitors and community engagement specialists.

“I knew that to be successful we had to be a program of New Yorkers helping other New Yorkers,” said Dr. Ted Long, executive director of Test & Trace. “This new program would ensure that we would never go back to what I experienced in the first months of 2020.”

On March 29, 2020, New York City hospital admissions peaked with an average of 1,566 admissions per day. “My scariest moment was when I was like, ‘What if we don’t make it here? What would happen? ‘ Long remembered. “And I realized for the first time: failure really wasn’t an option.”

“Launching a program of this size in such a short period of time was definitely the most difficult thing in my professional life that I have done,” said Dr Neil Vora, former director of Trace. His previous work as an epidemic intelligence officer for the Centers for Disease Control and Prevention involved tracing infectious diseases, including Ebola, HIV, and SARS. He now had three weeks to build the COVID-19 trace program for a June 1 launch.

“People are dying, people are getting sick, businesses are in ruins,” Vora said. “We didn’t have time to wait for the perfect contact tracing system, we just had to get something going. “

And they did.

The start

June has arrived with New Yorkers on the lower half of the first wave.

The frontline of the battle against COVID-19 in New York has relied on investigators like Danielle Martinetti. She is contacting people recently diagnosed with COVID-19 and trying to gather information about their close contacts.

“Sure, there are New Yorkers yelling at you, ‘I won’t tell you anything and never call me again’, but there are so many good things, and if you have a shred of empathy, you can carry out and get the job done, ”Martinetti said.

Many tracers felt compelled to do just that in the wake of their own COVID-19-related tragedies. In April 2020, Maria Fischer’s husband learned that his uncle had contracted the virus. He was hospitalized, put on a ventilator and died – joining hundreds of others who have succumbed to the same fate.

“We couldn’t visit him when he was sick or even attend his funeral. It was surreal, ”Fisher said. “I knew I had to find a way to help.”

Fischer came to Test & Trace as a contact monitor, just like me. Monitors call cases and contacts throughout their period of isolation or quarantine to perform wellness checks and assess the city’s need for free resources. The calls also connect New Yorkers with a battalion of 400 resource navigators who organize everything from food deliveries to dog walking services.

“It’s great, because honestly, when you’re sick, or if a member of your family is sick, you shouldn’t have to worry about anything other than getting well,” Fischer said.

When trackers fail to reach customers by phone, community engagement specialists like Akanksha Anand hide and come to their doorstep. “During those first few months it was scary to be there,” recalls 25-year-old Anand. “You don’t know where to touch, you don’t know where to breathe.”
Between July 26 and August 8, 2020, 78% of cases were treated, exceeding the program target of 75%. Former Trace director Neil Vora explained that this goal was based on previous scientific experience with contact tracing for other diseases.

“All of our protocols and what we do are science-based, but the art of contact tracing makes that human-to-human connection,” Vora said.

In July, that connection helped New Yorkers get what Long calls a “well-deserved reprieve.”

“In a city of 8.3 million people, to have 200 to 300 cases on some days, you can’t do much better than that,” Long said. “New York City had better control and suppression of the virus than almost any other place in the country. “

But by the end of September, the seven-day average of cases had again exceeded 500. By the end of October, it was over 800.

“The two questions that kept me awake at night at that time were, ‘Can we hold the line? And “Can we make the situation less serious?” “” Long said.

The second wave

The city’s case volume increased by over 2,000% between September 2020 and January 2021, with the daily caseload increasing from 235 to 5,800. I had an average of 30 calls per day. It put a strain on my vocal cords, lower back, and sanity.

“I remember waking up one morning and heaving a deep sigh and thinking, ‘Where am I going to find the strength to do this today and keep doing this work?'”, Martinetti said.

Meanwhile, Trace’s community engagement specialists logged more door-to-door miles and created pop-up sites.
“Compared to the five largest states, we had the lowest peak in terms of new daily cases. The credit goes entirely to New Yorkers doing their part – wearing masks, getting tested – and you and everyone on the phone as contact tracers, ”Long explained.

Vora agrees. He credits Test & Trace with a second wave death rate that is 10 times lower than the first wave.
“We saw too many New Yorkers die in their homes in the first wave, and Trace hadn’t been created at the time. But in the second wave, you would call all of those cases and say, “If you come across any emergency warning signs, you need to call 911 or go to the emergency room,” Vora said. “And you also recommended that contacts get tested, so people would start seeking treatment early if they were indeed positive.”

The turnaround

On December 14, 2020, the first vaccine was administered in the United States – and it happened in Queens. Weeks later, a nearly empty Times Square joined the rest of the world to welcome 2021. Despite a cold and gloomy winter, spring has finally arrived.

On this first day of the new season, the city reported 2,910 new cases of COVID; less than 55 deaths and only 262 hospitalizations. As more New Yorkers get vaccinated, the numbers continue to improve.

Now the calls are more about, “How do we get you out of your house?” How are you protected and can you get back to normal? Said supervisor Jason Rubenstein.

“When I look back on the whole year, the main thought I have is the amazing work that we have done together, and we have earned this summer where I am going to take my kids outside every day,” Long said.

Looking forward

Only one thing is certain: COVID-19 will not go away. Long thinks vaccines are the solution we’ve been waiting for, but sees the possible need for boosters.

Unless things change globally, Vora believes the next pandemic is 10 to 15 years away. To combat this, he left Test & Trace in March 2021 for a new position at Conservation International.

“Every epidemic I have ever responded to, except measles, was the result of an outpouring of animals on humans,” Vora said. “And it’s going to continue to happen unless we find out why, and it comes down to: we cut down rainforests, we traffic in wildlife, and we breed domestic animals in dangerous ways.”

As Test & Trace enters its second year, we can be proud of New York to have an army of 4000 people and the cooperation of the neighbors we called upon helped us get here. Despite our differences, we have come together to defeat an enemy. Just like we did after September 11. Just like we did after Super Storm Sandy. Just as we always will when something threatens this incomparable place we call home.

I have worked as a broadcast journalist, corporate video producer and television host. Right before the pandemic hit, I was ready to make a major career change to become a personal trainer with an interest in the health and wellness of seniors. Then the gyms closed. Then I took an online Johns Hopkins Contact Tracing course and became a member of NYC Test & Trace.

—Laura DeAngelis,
1991 Graduated from St. Mary’s High School

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