COVID-19 cases dropped about 5 percent this week, while testing rose 12 percent as backlogs in reported tests—always a little slower to recover than reported cases—rolled in following disruptive mid-February storms. The number of people hospitalized with COVID-19 dropped almost 16 percent week over week, making this the seventh straight week of sharp declines in hospitalizations. States and territories reported 12,927 deaths this week, including a substantial backlog from the Commonwealth of Virginia.
The decline in cases has been a point of confusion in the past week, as daily reports briefly jogged up after a large drop following the long Presidents’ Day weekend and disruptive winter storms in mid-February. A look at percentage change in reported cases since November 1 helps illustrate the dips and rises in reported cases seen around Thanksgiving, Christmas, New Year’s Day, and—more recently—the winter storms in mid-February. (On November 8, California did not report data in time to be included in our daily compilation.) Cases may plateau or rise at any point, and a close watch of the numbers is essential as vaccinations roll out alongside the spread of SARS-CoV-2 variants. But we would urge data watchers to be wary of conflating reporting artifacts with real changes in the state of the pandemic.
Although it seems unlikely, based on current figures, that a new surge is showing up in the case numbers, it is quite possible that case declines are beginning to slow. With reported tests up 12 percent this week—likely also because of a storm-related dip and rise—it’s impossible to be certain whether the case decline is slowing because of an increase in testing, or because disease prevalence itself is declining, albeit more slowly. We can look to other metrics, however, to help us interpret the past two weeks of case numbers.
One way to confirm that a change in reported cases—especially one preceded by a disruptive event like a holiday or a major storm—reflects reality is to look at new hospital admissions. This metric, which is available in the federal hospitalization data set, has tracked very closely with cases since the hospitalization data set stabilized last fall, but has not shown the same vulnerability to reporting disruptions produced by holidays or severe weather. Charting federal case data against new-admissions data shows that the decline in new admissions continues, though slightly more slowly than the decline in cases.
This signal helps confirm that the brief rise in daily reported cases in the past week was very unlikely to signal a new surge in cases—though, again, cases may not be dropping as quickly as they were in late January and early February. It’s nevertheless important to note that cases remain extremely high, and have only this week dipped below the peak of the summer’s case surge. (Though we’re almost certainly detecting a larger percentage of cases now than we were in the summer, as our testing capacity in the U.S. has increased.) The sustained decline in cases and hospitalizations is very encouraging, but with multiple variants of SARS-CoV-2 gaining footholds in U.S. cities, it remains vitally important to further reduce the virus’s spread via masking, social distancing, and avoiding indoor gatherings.
Although it may seem that the decline in hospitalizations is slowing down in recent weeks, the percentage decrease remains robust.
Reported COVID-19 deaths, too, continue to decline. The particularly sharp drop in the week beginning February 11, which included Presidents’ Day and the beginning of the winter storms that affected data reporting in many states, was balanced by a smaller drop in the week of February 18. This week, deaths dropped by an encouraging 11 percent.
It’s important to note that many states have recently added large numbers of COVID-19 deaths from previous months to their totals. In Virginia, cases and hospitalizations have been dropping for weeks, but after reporting fewer than 100 deaths a day for the entirety of the pandemic up to this week, the Commonwealth is now reporting hundreds of deaths every day—most of which occurred in December and January.
The addition of these backlogged deaths—like the 4,000 deaths from previous months recently reported by Ohio—obscures the reality of rapidly declining recent deaths. It also underlines the fact that deaths at the peak of the winter surge were actually much higher than the already-devastating numbers reported in December and January.
For the week ending February 25, COVID-19 deaths in long-term-care facilities have continued to decline as a share of all COVID-19 deaths in the U.S. (As we did in last week’s analysis, we have excluded from this chart all data for four states—Indiana, Missouri, New York, and Ohio—that recently added large numbers of undated deaths from previous months to their totals. The addition of these historical death figures to recent weeks made it impossible to follow recent trends at the national level without this exclusion.)
It’s our final week of compiling and interpreting data here at the COVID Tracking Project, and we’ve spent much of the past few weeks explaining how to use data from the federal government in place of our patchwork data set. We’ve packaged up everything we’ve learned about federal case numbers, death numbers, hospitalization data, and testing data, as well as long-term-care-facility data. For more casual data users, we’ve also written a short primer on how to find easy-to-use charts and metrics from the CDC. It’s even possible to replicate three-quarters of our daily four-up top-line chart using data from the CDC, although the data are one day behind the state-reported data we compile.
In this version, new hospital admissions are included instead of tests—test data are available from the federal government, but are not in a date-of-report arrangement that matches the other top-line metrics. (We’ll be publishing a separate post showing how to produce this visual within the next few days.)
Long-term-care data wrap-up: Tonight marks our final compilation of data at the Long-Term-Care COVID Tracker, and we’ve just published a look at the subset of long-term-care-facility data available in the Centers for Medicare and Medicaid Services Nursing Home data set. This federal data set includes only nursing homes and accounts for about 27 percent of all COVID-19 deaths in the U.S. to date. The long-term-care data set we stitched together from state reports, by contrast, includes assisted-living facilities where states report them, and accounts for at least 35 percent of all U.S. COVID-19 deaths.
Race and ethnicity data wrap-up: For 11 months, we have shown that the COVID-19 race and ethnicity data published by U.S. states are patchy and incomplete—and that they nevertheless have indicated major inequities in the pandemic’s effects. Both of these things are true of the demographic data available from the CDC: Many data are missing, and what data are reported show ongoing disparities. Our introduction to the federal data will be posted later this week, and we’ll be publishing deeper analyses in the coming weeks.
As we wind down our compilation efforts, the United States is at a crucial moment in the pandemic: Decisive action now is our best chance at preventing a fourth surge in cases and outpacing the variants, which may be more transmissible than the original virus according to preliminary (preprint) data. Over the weekend, the FDA issued a third Emergency Use Authorization for a COVID-19 vaccine, this time for Janssen/Johnson & Johnson’s adenovirus vector vaccine, which showed impressive safety and efficacy results in its global clinical trials. The Biden administration announced Tuesday that the U.S. should have enough COVID-19 vaccine doses for every adult by the end of May—a dramatic acceleration from previous timelines.
Today’s weekly update is our 39th and last. We began writing them back in June 2020 as a way of offering a deeper interpretation of data points that was less jittery than those in the daily tweets. As we puzzled through the data and watched for indications of changing trends, we’ve tried to help people understand what has happened to us as the pandemic has ebbed and surged.
Although our data compilation will come to an end on Sunday, March 7, our work at the COVID Tracking Project will continue in other forms for another few months, as our teams complete their long-term analyses and wrap up documentation and archiving efforts. We’ll continue to post our work on the CTP site and link to it on Twitter until we finally close up shop in late spring.
Throughout the year that we’ve compiled this data, we’ve tried to explain not only what we think the data mean, but how we came to our conclusions—and how we tested and challenged our own analyses. We hope that one result of our doing this work in public is that our readers feel better prepared to do the same for themselves and their communities.
The federal government is now publishing more and better COVID-19 data than ever before. Some gaps remain, but far fewer than at any previous moment in the pandemic. To those of you who have relied on our work this year, thank you for your trust. We’ve tried very hard to deserve it, and we believe that we’re leaving you in good hands.
Mandy Brown, Artis Curiskis, Alice Goldfarb, Erin Kissane, Alexis C. Madrigal, Kara Oehler, Jessica Malaty Rivera, and Peter Walker contributed to this report.
The COVID Tracking Project is a volunteer organization launched from The Atlantic and dedicated to collecting and publishing the data required to understand the COVID-19 outbreak in the United States.
[…] Read: Reduced dividends, softer growth and an economy haunted by zombie companies — that’s the post-pandemic future seen by this Odey fund manager He believes bitcoin could prevent society from functioning in a […]
[…] wherever they are The long-term strategies for managing the changing guidelines during the pandemic Future-proofing your business against long term reputational and financial risk Achieving a safet […]
[…] early months, but seizures of fentanyl slowly increased over two years, independent of the pandemic. “Future research should harmonize data on seizures with other studies of drug use, availability an […]
[…] opportunities of remote auditing within the certification industry Lessons learnt from the COVID pandemic Future challenges and opportunities for businesses with accredited certification There will be a Q& […]
We intuit that the future will not be like the past, that 2020 was a pivot point for the Arts and Media in Higher Education. To continue teaching and learning amidst lock-downs, we adapted traditions, some centuries-old, to technologies only a few years old.
[…] urgent in-the-moment needs How onboarding isn’t just about external hiring in the emerging post-pandemic future of work Why onboarding has evolved and matured to apply to all the major milestones across th […]
The coronavirus pandemic has a lot of dark sides. Around the world, people get ill and die, schools close, the healthcare system is overloaded, employees lose their jobs, companies face bankruptcy, stock markets collapse and countries have to spend billions on bailouts and medical aid. And for everyone, whether directly hurt or not, Covid-19 is a huge stressor shaking up our psyche, triggering our fears and uncertainties.
No matter how serious and sad all of this is, there are upsides as well. Therefore, along the Monty Python song “Always look on the bright side of life” let’s not forget those and make the best of what the crisis gives us. As the good old SWOT analysis tells us, there are not only threats, but also opportunities. With opportunities I don’t mean that the crisis provides extra business for companies like Zoom and Go to Webinar that enable virtual meetings, or for Amazon, which is planning to hire another 100,000 employees. The latter is probably more a threat than an opportunity for most, especially for the mom & pop stores that go through difficult times already.
With opportunities I mean general opportunities that are available for most people affected by the crisis. The current crisis offers at least seven of them:
Opportunity 1: More time
In today’s overheated economy time is often seen as the most valuable and sparse thing we have. Covid-19 shows why: because we have stacked our week with social gatherings and entertainment such as going to the theater, birthdays, cinema, restaurant, bar, sportclub, gym, music, festivals, concerts and what is more. Suddenly, all of that is cancelled or forbidden, giving us significant amounts of extra time. And still, live goes on. This shows us how easy it is to clear our calendars. Obviously this doesn’t apply to the health-care sector and other crucial sectors, but beyond those it applies to a large majority of sectors.
The opportunity is that we can spend this time on other things—or even better, on nothing and enjoy the free time. Looking at the crowded parks, waste collection points, garden centres and DIY stores in the last week, many people seem to have a hard time with the latter. Instead of enjoying the extra free time, they fill it immediately with other activities. To seize this first opportunity though, re-arranging how you spend your time and reserving time for nothingness is key. Not just during the crisis, but also after it. The advices in my previous article on the Covid-19 crisis could help in realizing this.
This offers a great opportunity to rethink our habits and routines and make changes. Now that you haven’t been able to go to the restaurant twice a week, commute 2 hours per day, hang out with your friends or go to a party every weekend, you can reflect on whether you really want to continue doing so after the crisis. The virus forces you to make changes to your daily life that you might actually want to keep also after the crisis.
Opportunity 3: Speed and innovation
Many organizations suffer from slow procedures, complex bureaucracies and rigid hierarchies making organizational life less than pleasant. The coronavirus has forced many of them to break through these rigid systems and act instantly. Suddenly procedures can be skipped or accelerated, rules can be side-tracked and decisions can be made more autonomously without formal approval. And suddenly employees are allowed to work from home without direct supervision.
Covid-19 shows that, as soon as there is a strong enough stimulus, things can change. This leads to remarkable innovations. Not being allowed to open their doors, restaurants, for example, are shifting to delivery mode. And schools suddenly do much of the teaching and even some of the testing online. This brings the opportunity to create innovations now that can be maintained after the crisis. And it also can help to keep the current speed and innovation mode afterwards.
Opportunity 4: Better meetings
As referred to in an earlier article, people spend up to 23 hours per week in meetings, half of which are considered a failure or waste of time. The current crisis has forced us to rethink how we deal with meetings. Because in many countries it is not allowed anymore to meet with a group of persons, many meetings are cancelled. And when they still take place they are mostly virtual and shorter.
As such, it provides an excellent opportunity for resolving one of the most disliked parts of organizational life. The technology for this is already present and mature for a couple of years, but the coronavirus triggers a sudden need for it. The real opportunity here is to make systematic changes so that meetings will be more effective, also after the crisis.
Opportunity 5: Reconnect and help
Challenging times offer a great opportunity for social bonding and other ways of connecting to and helping people. Of course, not being able to visit friends or family has increased isolation and feelings of loneliness in some cases. But the feeling of “we’re in this together” has also triggered interesting ways of connecting. Some of those have gone viral—such as Italians singing together from their windows and balconies—but there are many small, local initiatives too to connect and help people who need it.
In the individualized societies many of us live in, this provides opportunities to reconnect and create more social coherence. Not only during the crisis, but also afterwards. This opportunity comes with a big caveat though. Parallel to these nice initiatives we also witness how far people go to protect themselves and their families. People hoard food, medicine, toilet paper and guns without thinking a second of others. However, while it triggers self-serving egocentric behavior too, the Covid-19 crisis does provide us the opportunity to reconnect and show our social side.
Opportunity 6: Cleaner environment
The virus caused a shutdown or dramatical decrease of industrial activities. Factories are closed or operate far below their capacity, road traffic has reduced radically and air traffic collapsed, and the lack of tourism has emptied the streets in overcrowded cities like Venice, Amsterdam and New York. While this may be bad news for most people and especially those working in the affected industries, this is also good news for our planet. Covid-19 causes a significant reduction in green house gasses and other air, water and land polluting outputs. In Venice this has allegedly led to dolphins return after just a couple of weeks (although some argued this to be a hoax).
Whether the particular example is a hoax or not is not so relevant. The fact is that the shutdown and lockdown of large parts of our economy is good for nature—at least on the short term. The opportunity this provides, is to keep parts of this in place also after the crisis to make long-term improvements. Along the line of the previous opportunities, the current crisis provides us an opportunity to reconsider our lives and reorganize it in a way that has less impact on our planet.
Opportunity 7: Modesty and acceptance
The final opportunity that the Covid-19 crisis offers, is a chance to create awareness for the moderate role we play on this planet and accept that things cannot always go as we want them to go. The Covid-19 pandemic is a global crisis chat is unprecedented in modern peace time. We had other pandemics like SARS, but their impact was less substantial. And we had the 1973 oil crisis, but that was a man-made crisis. The coronavirus is not man-made and yet disrupts lives across the planet.
As such, the virus shows us that, no matter how well-planned and organized we are and no matter how much we live in the Anthropocene—the era characterized by significant human impact—we are not in control. One simple virus is disrupting everything. This offers a great opportunity. In almost every aspect of life we want to be in control. Whether it is health, airline safety or our calendars, we live in the illusion that full control is possible. The virus can help us create awareness that this is not the case. It provides an opportunity to take a more modest role and accept that many things are simply beyond our control.
Once again, the Covid-19 crisis has a large dark side. But as these seven opportunities show, it has positive sides as well. Since all seven opportunities require a quite fundamental change in how we approach the world, seizing them can take substantial time. In that sense, and if we keep on looking at the brighter sides of life, the longer the crisis lasts, the larger the opportunities are and the bigger the chances are of actually making changes to our deeply rooted habits and convictions. Follow me on Twitter or LinkedIn. Check out my website or some of my other work here.
I help companies do strategy through training, mentoring and consulting. My drive is to bring you and your organization to the next level with strategy approaches that work. I wrote “Strategy Consulting,” “Nor More Bananas,” and “The Strategy Handbook.” Reach out to me via jeroenkraaijenbrink.com, LinkedIn or firstname.lastname@example.org
Pat Flynn 282K subscribers 26 million Americans are without a job right now, and that’s just in the U.S. alone. It’s a terrible situation, one that I’m all too familiar with myself having gotten laid off during the recession in 2008. These are tough times, but there are opportunities within them, too. I was able to build a business back in 2008 as a result of getting laid off, and I imagine that those who focus on the future, and the ability to create something new now, are the ones who are going to come out of this dire situation best.
(BANGKOK) — Authorities in the Chinese city where the coronavirus pandemic began were moving forward Wednesday with efforts to test all 11 million residents for the virus within 10 days after a handful of fresh infections were found there.
The U.S. government’s top infectious disease expert, meanwhile, issued a blunt warning that cities and states could see more COVID-19 deaths and economic damage if they lift stay-at-home orders too quickly — a sharp contrast to President Donald Trump, who is pushing to right a free-falling economy.
“There is a real risk that you will trigger an outbreak that you may not be able to control,” Dr. Anthony Fauci warned a Senate committee and the nation Tuesday as more than two dozen states have begun to lift their lockdowns.
The tension in balancing people’s safety from the virus against the severe economic fallout is playing out in many other countries, too. Italy partially lifted lockdown restrictions last week only to see a big jump in confirmed coronavirus cases in its hardest-hit region. Pakistan reported 2,000 new infections in a single day for the first time after the easing of its lockdown saw crowds of people crammed into markets throughout the country.
China, the first nation to put a large number of its citizens under lockdown and the first to ease those restrictions, has been strictly guarding against any resurgence.
District health commissions and neighborhood committees in the city of Wuhan have been told to develop a plan to test all residents in their jurisdictions, local media reports said. The directive also said the testing should focus on the elderly, densely populated areas and places with mobile populations.
A person who answered the mayor’s hotline in Wuhan on Wednesday said local districts had been given 10 days to carry out the tests. The official declined to give his name because she was not authorized to speak to reporters.
The first cases of the new coronavirus were found in Wuhan in December, and by the end of January the government had placed the entire city and the surrounding region, home to more than 50 million people, under a strict lockdown.
A cluster of six new cases was recently found in one part of the city, the first local infections the government has reported in Wuhan since before the lockdown was eased in early April.
It wasn’t clear how many people would actually still need to be tested, as one expert at Wuhan University told the Global Times newspaper that up to 5 million residents of Wuhan have already been tested since the outbreak began.
Worldwide, the virus has infected more than 4.2 million people and killed over 291,000 — with more than 82,000 deaths in the U.S. alone, the world’s highest toll. Experts say the actual numbers are likely far higher.
Progress was being made in many places, including New Zealand, which reported no new cases on Wednesday. It was the second day in a row without any and the fourth such day since early last week.
Director-General of Health Ashley Bloomfield said it was encouraging news as New Zealand prepares to ease many of its lockdown restrictions on Thursday. Most businesses, including malls, retail stores and sit-down restaurants, will be able to reopen. Social distancing rules will remain in place and gatherings will be limited to 10 people.
“The sense of anticipation is both palpable and understandable,” Bloomfield said.
Authorities in South Korea said Wednesday that they had no immediate plans to revive strict social distancing rules despite a spike in cases linked to nightclubs in Seoul.
In his Senate testimony, Dr. Fauci said more infections and deaths are inevitable as people again start gathering, but how prepared communities are to stamp out those sparks will determine how bad the rebound is.
“There is no doubt, even under the best of circumstances, when you pull back on mitigation you will see some cases appear,” Fauci said.
Move too quickly and “the consequences could be really serious,” he added. It not only would cause “some suffering and death that could be avoided, but could even set you back on the road to try to get economic recovery.”
With more than 30 million people unemployed in the U.S., Trump has been pressuring states to reopen.
A recent Associated Press review determined that 17 states did not meet a key White House benchmark for loosening restrictions — a 14-day downward trajectory in new cases or positive test rates. Yet many of those states have begun to reopen or are about to do so, including Alabama, Kentucky, Maine, Mississippi, Missouri, Nebraska, Ohio, Oklahoma, Tennessee and Utah.
Of the 33 states that have had a 14-day downward trajectory, 25 are partially opened or moving to reopen within days, the AP analysis found. Other states that have not seen a 14-day decline remain closed despite meeting some benchmarks.
Fauci expressed optimism that eventually vaccines will arrive, along with treatments in addition to the one drug that so far has shown a modest effect in fighting COVID–19. But it would be “a bridge too far” to expect them in time for fall, when schools hope to reopen, he said.
Although Trump declared this week that “we have met the moment, and we have prevailed” in increasing and improving virus testing, Republican senators on the panel were noticeably less sanguine.
A lack of testing has dogged the U.S. response from the beginning, when a test developed by the Centers for Disease Control and Prevention ran into numerous problems. Sen. Mitt Romney said the U.S. may finally have outpaced testing leader South Korea but that country has far fewer deaths because it started testing early.
“I find our testing record nothing to celebrate whatsoever,” said Romney, a Republican from Utah.
Trump administration “testing czar” Adm. Brett Giroir said the U.S. could be performing at least 40 million to 50 million tests per month by September. That would work out to between 1.3 million and 1.7 million tests per day. Harvard researchers have said the U.S. must be doing 900,000 by this Friday in order to safely reopen.
Neergaard reported from Washington. Associated Press journalists around the world contributed to this report.
NEW YORK — Three children have now died in New York state from a possible complication from the coronavirus involving swollen blood vessels and heart problems, Gov. Andrew Cuomo said Saturday.
At least 73 children in New York have been diagnosed with symptoms similar to Kawasaki disease — a rare inflammatory condition in children — and toxic shock syndrome. Most of them are toddlers and elementary-age children.
Cuomo announced two more deaths a day after discussing the death of a 5-year-old boy Thursday at a New York City hospital. He did not give information about where the two other children died, or provide their ages.
There is no proof that the virus causes the syndrome. Cuomo said the children had tested positive for COVID-19 or the antibodies but did not show the common symptoms of the virus when they were hospitalized.
“This is the last thing that we need at this time, with all that is going on, with all the anxiety we have, now for parents to have to worry about whether or not their youngster was infected,” Cuomo said at his daily briefing.
New York is helping develop national criteria for identifying and responding to the syndrome at the request of the Centers for Disease Control, Cuomo said.
Children elsewhere in the U.S. have also been hospitalized with the condition, which was also seen in Europe.
At least 3,000 U.S. children are diagnosed with Kawasaki disease each year. It is most common in children younger than 6 and in boys.
Symptoms include prolonged fever, severe abdominal pain and trouble breathing.
New York City transit officials said they’re providing buses for homeless people to shelter from unseasonably frigid weather this weekend during newly instituted overnight subway closures.
The subway system has been shutting down from 1 to 5 a.m. since Wednesday as part of an outbreak-related plan for daily train disinfecting. City outreach workers have been persuading homeless people to leave the system for shelters during the shutdowns.
With temperatures around the freezing mark and a traces of snow reported in Manhattan’s Central Park, transit officials said they also would provide a limited number of buses at end-of-line stations Saturday and Sunday.
The buses are not for transportation, “but may serve as a place for individuals to escape the elements in the short term,” according to a prepared statement from New York City Transit President Sarah Feinberg and Transport Workers Union Local 100 President Tony Utano.
“We are providing these buses only during this cold snap and expect the city to continue to step up and take responsibility for providing safe shelter for those individuals experiencing homelessness,” according to the statement.
The Metropolitan Transportation Authority did not immediately respond to an email Saturday morning asking how many buses were provided and how many people were taking shelter in them.
Three children have now died in New York state from a possible complication from the coronavirus involving swollen blood vessels and heart problems, Gov. Andrew Cuomo said Saturday. At least 73 children in New York have been diagnosed with symptoms similar to Kawasaki disease – a rare inflammatory condition in children – and toxic shock syndrome. Most of them are toddlers and elementary-age children. NEW HERE? – Hi! We’re abc7NY, also known as Channel 7 on TV, home to Eyewitness News, New York’s Number 1 news. We hope you love us on YouTube as much as you do on television! OUR SOCIAL MEDIA – FACEBOOK: https://www.facebook.com/ABC7NY/ TWITTER: https://twitter.com/abc7ny INSTAGRAM: https://www.instagram.com/abc7ny/ NEWS TIPS: Online: https://7ny.tv/36UsL9a Phone: 917-260-7700 Email: email@example.com #abc7NY#coronavirus#covid19
In the coronavirus era, a host of epidemiological terms have entered common public use. There’s the now-ubiquitous “social distancing,” and the newly politicized “flatten the curve.” And as states and local governments seek a way out of lockdowns that have brought their economies to a near-standstill, “contact tracing” has made its way into everyday conversation as well.
But what exactly is contact tracing, and how can it help society battle the COVID-19 epidemic? Here, the basics of the time-tested public health strategy, and the hopes for its use in the coronavirus pandemic:
What is contact tracing?
Contact tracing is a little like detective work: Trained staff interview people who have been diagnosed with a contagious disease to figure out who they may have recently been in contact with. Then, they go tell those people they may have been exposed, sometimes encouraging them to quarantine themselves to prevent spreading the disease any further. Think of it as part public health work, and part investigation.
The technique is a “cornerstone” of preventative medicine, says Dr. Laura Breeher, medical director of occupational health services at the Mayo Clinic. “Contact tracing, it’s having a moment of glory right now with COVID because of the crucial importance of identifying those individuals who have been exposed quickly and isolating or quarantining them,” she says.
Contact tracing was used during the 2014 Ebola virus outbreak, as well as in the SARS outbreak in 2003. It’s also used to combat sexually transmitted infections and other communicable diseases like tuberculosis. And as COVID-19 has gone global, countries like South Korea and New Zealand have aggressively used contact tracing in an attempt to control outbreaks.
Keep up to date with our daily coronavirus newsletter by clicking here.
How does contact tracing work?
Once someone has been confirmed to be infected with a virus, such as through a positive COVID-19 test, contact tracers try to track down others who have had recent prolonged exposure to that person when they may have been infectious. Typically, that exposure means being within 6 feet of the person for more than 10 minutes, says Dr. Breeher, though in a health care setting, such as a hospital, the bar is lowered to five minutes.
Healthcare workers then make an effort to reach out to every one of those contacts, tell them that they may have been exposed, and giving them instructions on what to do next. That may include telling them about possible symptoms or directing them to self-isolate.
What are the limitations of contact tracing?
For one, contact tracing is a laborious process. Interviewing infectious patients and reaching out to dozens of contacts takes time. For that reason, contact tracing works best when there are low levels of infection in a community, says Dr. Frank Esper, a pediatric infectious disease specialist at the Cleveland Clinic Children’s Hospital. “When you get to a point where there is a lot of people who are sickened with a particular disease, it quickly overwhelms the health departments’ response to be able to contact trace all those individuals,” he says.
With a virus like COVID-19, which spreads through the air, things can get complicated quickly. Contact tracers might end up trying to find those who sat near an infected individual on a plane or a bus, for instance, even if the sick person never met them. That’s a radically different task from contact tracing with a sexually transmitted infection like HIV, which tends to involve a much shorter, more well-defined list of contacts for investigators. Health care workers may also have trouble getting in touch with contacts if phone records aren’t up to date, or if an infected patient is already too sick to help identify their recent contacts.
Contact tracing also isn’t much help when states and localities have already issued lockdown orders, and when most people are self-isolating anyway. “You ride that out, which is what we’re doing [with COVID-19], until the number of cases, and the number of new cases, becomes much more manageable, and then you can reestablish contact tracing once you’re on the downslope,” says Dr. Esper. Those efforts, coupled with rigorous testing, can counteract a potential second wave and prevent cases from spiking again.
Contact tracing COVID-19 infections has proven particularly difficult, as some infected people don’t have symptoms, and the period of time between getting infected and becoming infectious appears to be relatively short. Still, even at the height of a pandemic, contact tracing can still be useful within smaller community settings, such as in health care facilities or nursing homes.
How was contact tracing used to fight Ebola?
Contact tracing was critical during the 2014-2015 Ebola outbreak in West Africa. The effort to track down cases in Liberia was one of the largest-ever such initiatives at the time, though its effectiveness was limited by organizational problems and community mistrust of health care workers.
Ebola didn’t spread far in the U.S., though around 29,000 people were monitored by state and local health departments after returning from West Africa. Dr. Breeher says the Mayo Clinic developed a plan for Ebola contact tracing, which laid the groundwork for its current COVID-19 contact tracing efforts. And the basics of the efforts during the Ebola outbreak were likely similar to the current pandemic, says Dr. Esper, but with different parameters, since Ebola mostly wasn’t spread through the air.
How are other countries using contact tracing to fight COVID-19?
Today, many countries are battling the coronavirus using a combination of old-school contact tracing techniques and more technologically sophisticated methods.
In South Korea, which had a head start on developing contact tracing plans through its response to Middle East Respiratory Syndrome (MERS) in 2015, contact tracers are combining patient interviews with cellphone GPS data, credit card transaction records and surveillance camera footage. Singapore has introduced a mobile app that uses Bluetooth to log when people are close together and then uses the data to identify contacts after new cases are confirmed. In China, around 9,000 contact tracers were employed in Wuhan alone. And closer to home, the Canadian government has launched a nationwide contact tracing program, which has brought on 27,000 volunteers.
What are U.S. states doing?
Efforts to expand contact tracing have occurred piecemeal in some U.S. states and cities, and perhaps not quickly enough. San Francisco has announced a pilot program with a tech company and around 250 outreach workers to be trained in the coming weeks. In Massachusetts, the state is bringing on around 1,000 contact tracers.
But national efforts may need to be far larger in scope — some experts estimate the country needs around 100,000 contact tracers in order to manage COVID-19 outbreaks.
Can new tech help?
Recently, there has been buzz around a joint effort between Apple and Google to add software to their smartphones that would aid in contact tracing. Google’s CEO has stressed that using it is optional, and that there is no personally identifiable information coming to the tech companies as part of the initiative.
Some experts doubt that the project will make a difference, citing issues including possible excesses of false positives. But Dr. Esper says the technology has promise, even if it identifies more contacts than necessary.
“It is better for you to identify people more than it is to miss someone who was infected or potentially infected,” he says. “Contact tracing is all trying to find that circle of individuals, those who were infected by the index patient as well as those who were not infected by the index patient, but make a ring that you can then seal off and prevent the next level of spread.”