Why New York's State contact tracing is failing and why your business will do better
Updated: Nov 28, 2020
The eradication of Covid-19 in certain locales has been attributed to broad testing and limiting spread. Success of the first part here is straightforward and largely depends on supplies. The second portion of this initiative is much more complex as limiting Covid-19 spread after its detection, depends on many factors including the type and timing of the intervention.
One aspect of limiting spread is contact tracing which involves finding infected or potentially infected individuals and determining who they were infected by or whom they may have infected. Different types of contact tracing have been described and include Bluetooth technology, proximity-based solutions, and even third-party sleuthing. New York State’s version uses the last technique with newly hired “tracers”. Unfortunately, early reports have shown that the this state’s effort has had minimal success due to logistical and privacy reasons. Other causes of failed contact tracing include poor community buy-in and the large numbers of infections that require investigation. Other public health driven platforms such as in Utah’s “Healthy Together” have been unsuccessful as well for a variety of similar reasons.
Some businesses have been discouraged by the challenges of trying to limit Covid-19 spread in their workforces and have even delayed their reopenings due to this concern. These same businesses should realize they could perform far more effective contact tracing in the workplace than the public sector has been performing. These public sector initiatives have been using a highly flawed approach to their contact tracing by contacting infected individuals after the trigger of a positive test by third parties who do not know the individual.
Businesses that know their own personnel will have much more success with contact tracing.
Businesses understand how their workforce is constructed and how they interact. These businesses should have the capability to identify, quarantine, and isolate the relevant individuals once suspicion is aroused for potential Covid-19 infection, prior to the test even being performed. They can begin the quarantine process and even query potential contacts who may have been infected or are at risk for developing the disease. This proactive strategy will be more equipped to manage individual infections before it can spread to other co-workers.
Certain strategies will complement the contact tracing. Businesses could test everyone prior to returning to work for active disease and antibodies. Optimally, they would test these individuals more than once and preferably several days apart. This action would limit the number of asymptomatic infections who enter their workplace with the initial return to work initiative. The businesses could further limit infected individuals in the workplace with a uniquely constructed questionnaire which would document the absence of symptoms for 2 weeks for the employees and their primary contacts. They should ensure these individuals are effectively quarantined with their contacts for the previous 2 weeks as well. These efforts will make subsequent contact tracing more feasible.
Smart businesses could do further actions. The businesses could then continue a questionnaire for their workers when on the job to detect new cases. These types of actions would decrease the number of possible infections and allow early detections of new infections. The nature of the businesses could also lead to specialized contact tracing techniques. These businesses could use proximity-based solutions with tagged groups using predictable high duration contact. This method would be the best system for workers in a predictable area through seating charts, attendees in the same conference room, wing of a building, loading dock, floor of building, have regular interactions such as team meetings, etc. Aggressive earlier attention to the potential infections would greatly enhance the value of the contact tracing similar to the successful contact tracing efforts documented in South Korea and New Zealand.
Contact tracing by businesses could harbor privacy concerns as well but they would be less problematic than tracing efforts by the local and state government officials. In their workplace, everyone would be working for the same company and would be participating in a platform already accepted by company management. They also would be knowing that they are helping prevent infections to their coworkers and their families while preventing their own company from having a potentially devastating outbreak.
Naturally, nothing is foolproof and new infections can occur. This system might not work well with those companies that have unpredictable worker movement or constant employee intermingling such as in a factory or loading dock. However, for those circumstances the employers could use a wearable with Bluetooth technology to capture their proximity contacts.
This described workplace strategy of contact tracing would likely mitigate the potential destructive spread of new cases. Companies should not rely on public contact tracing efforts to help them protect their own workforces. With support and attention, they will do better themselves.