CDC updates guidance on contact tracing and case investigation

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Nearly two years after the director of the Centers for Disease Control and Prevention called for 100,000 contact tracers to contain the coronavirus, the CDC said this week it no longer recommends universal case investigation and tracing. contacts. Instead, it encourages health departments to focus these practices on high-risk settings.

The turning point comes as the national outlook continues to improve rapidly, with new cases, hospitalizations and deaths continuing to decline even as the exit from the pandemic remains complicated. It also reflects the reality that contact tracing programs in about half of US states have been eliminated.

Britain ended contact tracing last week, while Denmark and Finland are among other countries that have reduced the use of contact tracers. New York City announced on Tuesday that it was ending its main contact tracing program at the end of April and moving towards treating the coronavirus as another manageable virus.

“It’s a big change,” said Crystal Watson, senior fellow at the Johns Hopkins Center for Health Security, in an interview Tuesday. “This reflects what is already happening in states and localities, especially with Omicron. There was no way contact tracing could track that. Many cases go unreported, so there is no way to know the incidence.

The initial goal of contact tracing in the United States was to reach people who have spent more than 15 minutes within six feet of an infected person and ask them to voluntarily self-quarantine at home for two weeks, even if their test is negative. The goal was to reduce transmission while Americans who tested positive self-monitored for symptoms while in isolation. Case investigation is used to identify and understand cases, clusters and outbreaks that require health service response.

But from the start of the pandemic, states and cities struggled to detect the prevalence of the virus due to spotty and sometimes rationed diagnostic testing and long delays in getting results.

Now, the CDC is pushing health departments to focus only on high-risk settings, like long-term care facilities, prisons and shelters. However, many immunocompromised Americans feel left behind by the lifting of precautions and restrictions across the country.

“The updated guidelines respond to changes in the nature of the pandemic and the increasing availability of new tools to prevent transmission and mitigate disease,” CDC spokeswoman Kristen Nordlund said Tuesday.

She said the predominance of variants with very short incubation periods and rapid transmissibility combined with high levels of infection or vaccine-induced immunity and the wide availability of vaccines for most age groups made change possible.

Dr Watson, who was the lead author of a 2020 report recommending the country have 100,000 contact tracers, said she feared the new guidelines would lead to a dismantling of infrastructure that has been set up to support up to 70,000 people. contact tracers, the maximum number reached by the country during the winter wave of 2020.

“We anticipate there will be a need for contact tracing,” she said, “so some of the investments made to rebuild public health staff should be used more broadly so that we can call on them when of the next emergency.”

More than 20 states still have statewide contact tracing programs, according to Hemi Tewarson, executive director of the National Academy for State Health Policy.

“I actually think the federal government’s decision is consistent with what the states are doing,” she said in an interview on Tuesday. “They are already focusing contact tracing on high-risk settings.”

Ms Tewarson said contact tracing could not keep up with the rise of Omicron and was no longer such an effective tool if people were testing at home and not reporting results.

“As a longer-term plan, it will be more sustainable,” she said. “We are at a different stage of the pandemic.”

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