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Title:

A National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the US

A National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the US
Authors:
Crystal Watson, DrPH, MPH; Anita Cicero, JD; James Blumenstock, MA; Michael Fraser, PhD, CAE
Date posted:
April 10, 2020
Publication type:
Report
Publisher:
The Johns Hopkins Center for Health Security
See also:
Introduction:

In order to save lives, reduce COVID-19’s burden on our healthcare system, ease strict social distancing measures, and confidently make progress toward returning to work and school, the United States must implement a robust and comprehensive system to identify all COVID-19 cases and trace all close contacts of each identified case. It is estimated that each infected person can, on average, infect 2 to 3 others. This means that if 1 person spreads the virus to 3 others, that first positive case can turn into more than 59,000 cases in 10 rounds of infections.

COVID-19 is already spreading through communities across the United States. Therefore, a case-based intervention approach (employed routinely for diseases like TB, measles, sexually transmitted infections, and Ebola) will be impossible to achieve for COVID-19 without a new national initiative that combines a massive expansion of rapid diagnostic tests in every community with an unprecedented growth in a public health workforce and adoption of new technologies dedicated to case identification and contact tracing in each state.

To manage COVID-19 epidemics going forward, communities in the United States need: (1) ready access to rapid diagnostic tests for all symptomatic cases or those with a reasonable suspicion of COVID-19 exposure; (2) widespread serological testing to understand underlying rates of infection and identify those who have developed immunity and could potentially return to work or school without fear of becoming infected; and (3) the ability to trace all contacts of reported cases. In order to trace all contacts, safely isolate the sick, and quarantine those exposed, we estimate that our public health workforce needs to add approximately 100,000 (paid or volunteer) contact tracers to assist with this large-scale effort. This workforce could be strategically deployed to areas of greatest need and managed through state and local public health agencies that are on the front lines of COVID-19 response. To do this, we also estimate that Congress will need to appropriate approximately $3.6 billion in emergency funding to state and territorial health departments.

This plan outlines a vision for how to accomplish this goal, including ways that case identification and contact tracing capabilities can be greatly expanded; actions that the federal, state, and local governments and other organizations must take to stand up these capabilities as quickly as possible; and resources that will be needed to accomplish comprehensive case finding and contact tracing.

 

 

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