There are only a handful of proven interventions to slow the spread of the coronavirus. One of them is locating contacts and “it’s not going well,” White House health adviser Dr. Anthony Fauci said Friday.
Contact tracing occurs when trained personnel contact infected people to investigate where they might have been infected and to whom they may have been exposed to the virus. Along with widespread testing and the ability to isolate potentially infectious people, screening is a former public health intervention that is now increasing on an unprecedented scale.
“It is not going well. I have to tell you it is not going well,” Fauci said in an interview with CNBC’s Meg Tirrell. “What we need to do is rethink, and right now, we have the idea that a lot more evidence will enter the community and even group the evidence.”
The White House advised states not to reopen until they had built the infrastructure for widespread testing and contact tracing, although the federal government did not specify what a robust tracking infrastructure would look like. Rather than developing a coordinated national monitoring plan, which some countries like Germany have done, the Centers for Disease Control and Prevention has instead sought to support local efforts.
Earlier this week, CDC Director Dr. Robert Redfield testified that there are about 27,000 to 28,000 people doing contact search work across the country. He later acknowledged that he estimates the required workforce to be about 100,000 tracers. Former CDC director Dr. Tom Frieden believes the country will need even more, up to 300,000.
“Saying you’re going to go out there and identify, contact, track and isolate, that doesn’t mean anything until you do,” Fauci said. “Don’t check the box that you did, but actually do it. Get people on the ground. Not on the phone. When you identify someone, have a place to put them out of social interaction.”
Instead of federal tracking leadership, underfunded and overwhelmed local health departments have rushed to implement the necessary systems, contact tracking specialists who previously spoke to CNBC said. States have presented their plans to increase follow-up through July to the CDC, Redfield told reporters in a conference call Thursday.
The CDC has allocated more than $ 10 billion for states to increase testing, tracing and isolation, but Fauci said he doesn’t see local officials making the kind of progress that he would like to see. He added that some states have done well to increase their programs. Getting more jurisdictions to do that work in preparation for the fall, when Fauci said he hopes cases will come up again, will be key.
“When fall comes, we had better be prepared for sudden cases and, as I have said so many times for months, we have a few months to prepare for that,” he said. “So when that happens, we must be able to do the proper and effective way of identifying, isolating, and tracing contacts.”
To speed up testing more quickly, the coronavirus working group, of which Fauci is a member, is now considering “clustering tests,” he said. That’s when health officials carry out up to 40 tests at a time, and if it turns negative, it indicates that everyone in the group is not infected.
“If you get a positive result, you go back and try to find out who that positive is,” he said. “We really need to start doing it because the idea of doing individual identification, isolation, contact tracing, particularly in some communities where people don’t want to cooperate. They don’t want to tell them where they have been and who they have been with.”
It appears that infected people can transmit the virus before they develop symptoms or have only mild symptoms, Fauci said, underscoring the need for even more testing than the US is already doing. He said he is personally a advocate of “flooding the system with evidence, so you really understand what is going on in the community well.”
“I think we need to do that,” he said.
The nation’s seven-day average of new Covid-19 cases hit a record high of more than 33,000 cases on Thursday compared to a week ago, according to a CNBC analysis of data from Johns Hopkins University. Since the start of the outbreak, more than 2.42 million cases have been confirmed in the US, and at least 124,468 people have died.
As coronavirus cases increase, Fauci warned on Friday that the country will soon “see more deaths.”
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