CDC no longer recommends universal contact tracing and case investigation

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The Centers for Disease Control and Prevention (CDC) announced this week that it no longer recommends universal case investigation and contact tracing.

In its place, the agency said state, tribal, local, and territorial (STLT) health departments should prioritize specific settings and groups at increased risk.

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The updated guidelines indicate that these institutions should focus their efforts on promoting prevention strategies to reduce the transmission of COVID-19 in the community.

Decisions to initiate contact tracing and case investigation should be made separately, with investigations targeting COVID-19 cases and close contacts with outbreaks and exposures in the previous 5 days for settings and groups at increased risk.

In addition, STLT Health Services should consult with schools, businesses and organizations that provide essential services to help them implement appropriate COVID-19 prevention measures, support public health education , offer vaccines against COVID-19 and have the authority to determine how case investigation and contact tracing should be implemented locally.

Students wear face masks and sit with empty desks separating them from classmates in a 2nd grade classroom at School 16 in Yonkers, NY on October 20, 2020.
(AP Photo/Mary Altaffer, File)

“Case investigation and contact tracing are separate processes that have distinct benefits and outcomes,” the CDC said. “Implementation of each activity should be considered separately. Not every case that is investigated will result in the elicitation and notification of close contacts. It is important to prioritize the investigation on COVID-19 cases with onset of symptoms or positive viral test within the previous 5 days. Notification of close contacts should occur within 5 days of their last known exposure to someone with COVID-19.”

“This time-based strategy will have the greatest impact on onward transmission and will ensure that priority cases and their priority close contacts can be reached in sufficient time, follow recommended isolation and quarantine guidance and trace treatment where appropriate,” the agency added.

Health services should focus on investigating cases, clusters and outbreaks involving long-term care facilities, correctional facilities and homeless shelters, unusual clusters of cases and new or emerging variants which could present significant risks of serious illness, hospitalization and death.

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Alternatively, departments should emphasize the elicitation and notification of close contact with exposure within the previous five days identified during investigations, including those recommended for quarantine and those at increased risk of problems serious health and death.

However, the CDC noted that widespread notification of potential exposure and testing “could be more effective” than contact tracing in responding to outbreaks and controlling transmission of the virus.

As the recommendations adjust, the agency wrote that health departments may need to adjust staffing levels accordingly.

In addition, to complement these activities, STLT health services should offer vaccination and testing, implement testing strategies, connect people with COVID-19 who are at risk of serious health problems to antiviral and other treatments. , encouraging HIV-positive people to notify close contacts, expanding the use of digital tools, promoting the use of well-fitting masks and physical distancing in community settings, and promoting the benefits of being up-to-date with COVID-19 vaccination .

These changes come as public health experts remain cautiously optimistic about current pandemic trends, with new cases and hospitalizations continuing to decline.

Data from the Johns Hopkins Coronavirus Resource Center shows 52,355 new cases and nearly 2,100 new deaths over the past day.

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The New York City contact tracing program will end its universal tracing efforts late next month, and Indiana state officials announced Thursday that its schools and child care programs children will no longer have to conduct contact tracing or report cases of COVID-19 to the state Department of Health starting next Wednesday.

The Associated Press contributed to this report.

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