With omicron surge, some wonder if Covid contact tracing still works

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Alejandra Perez-Handler had a 2-month-old baby and desperately needed to work from home, so she took a job as a contact tracer in Connecticut.

From October to November, she made around 20 calls a day to people who had been exposed to Covid-19, working painstakingly through a long list of names. Now she’s making around 30 calls a day as cases rise, largely due to the omicron variant of the coronavirus.

“It’s mentally exhausting,” Perez-Handler, 23, said. “It’s just exhausting.”

Her eight-hour days turned into 11-hour days, creating an increasingly stressful scenario for her family. Some calls last 10 minutes, while others can last half an hour or more. Some people thank her; some hang up on him; some threaten to hurt her, shout and demand that she tell them where she lives; and others are devastated.

“A week before Christmas, I had to call a mom about her baby, who was less than 30 days old and had Covid,” Perez-Handler said. “After the phone call, I said to my supervisor, ‘I just got a very difficult call, I need a break,’ and then I collapsed.”

The changing nature of Covid-19 means major pitfalls for contact tracers, including extraordinary workloads and failed attempts to reach people who have been exposed.

Some epidemiologists argue that contact tracing is a crucial preventative measure worth pursuing, albeit with significant changes.

“It’s important because it provides a landscape of who has been in contact with someone who is positive, so it helps us to identify who may be the next positive or to prevent the sick person from transmitting the virus to a sick person. good health,” said Luisa N. Borrell, a professor of public health policy at the City University of New York.

While some calls fail, others can stop infection chains, which is enough to keep contact tracing going, Borrell said. Ideally, this should reinforce other regulations, such as masking, testing, quarantine and isolation, she said.

Lorna Thorpe, director of epidemiology at New York University’s Grossman School of Medicine, who is leading the evaluation of New York City’s contact tracing program, said some aspects of contact tracing are beneficial even when the program is struggling. Advising people on how to get tested or where to seek medical help also helps, even when a contact tracer cannot gather the names of everyone exposed.

“What’s less good is what the status of those contacts is, how many of them have actually been tested or how many of them have already been tested or had symptoms,” Thorpe said. “It’s not as robust.”

If a contact tracer calls too late, people may already be at the end of their infections, she said. As a growing body of research shows that vaccinated people are less likely to spread the virus, the highly transmissible omicron variant has created new concerns.

The paucity of testing is another hurdle, reinforcing Borrell’s point that other preventative measures need to be in place for contact tracing to work.

Last week, the Centers for Disease Control and Prevention shortened the recommended isolation time for people who test positive from 10 days to five if they are asymptomatic or their symptoms resolve. But some health experts said they fear the reduced weather could increase the spread.

The seven-day average of Covid cases across the country peaked on Monday with an average of 740,594 new infections per day. Due to the increase, there were more people exposed and the tracers had to adapt to the increase. Perez-Handler said no one explicitly asked her to call 30 people a day instead of 20. But supervisors would suggest she call more people, and failure to do so would result in illicit criticism or negative review, making her fear for her job.

Nicolette Vigiano, who worked as a Covid contact tracer on Long Island, New York, from December 2020 to August, said she was fired because her employer thought contact tracing would no longer be necessary.

“Most of my team was fired,” Vigiano said. “Only two or three people remained. It was just when the vaccines were coming out and all, and the delta variant hadn’t really hit yet. It was a moment of hope. »

In November, as the delta variant began to overwhelm hospitals, Vigiano received an email asking if she could return to work as a contact tracer. But as a graduate student in public health working in home health care, she could no longer deal with contact tracing.

“The email specifically said, ‘Please don’t respond unless you can work full-time and be hired immediately,'” she said.

Perez-Handler, whose contract ends next month, said the indeterminate state of contact tracing, coupled with the intensive workload, is doing little to attract employees. There are times when she’s proud to help prevent the spread of the coronavirus, she said, but she’s looking for healthcare helpline jobs that don’t involve looking for contracts. .

“When my parents first heard how many calls I had to make, they were like, ‘Can you actually do that much? Like, is that realistic? How can you do that?’” A she said. “And I’m like, ‘Yes, it’s possible. I do it every day.'”

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