We can contain the spread of COVID-19 — but the federal government must step up before it’s too late
States and localities are proceeding with “opening” their economies despite the fact that most states have not met the re-opening criteria put forward by the White House.
In order to head off spikes in cases, states and localities will need aggressive testing, contact tracing, and isolation programs. Testing is only as good as what you do with that information. And the key next steps are to inform the person with the positive or negative test and then track the contacts of all positive tests — and asking those people to self-quarantine — ideally giving people a place to do so if they don’t have one of their own. Because the U.S. has such widespread cases of COVID-19, federal support of contact tracing programs is needed.
The best way for the federal government to contain the spread of the coronavirus is to provide guidance and funding to state and local programs which then do the work on the ground:
1. Numbers. Experts estimate the U.S. will need 100,000 to 300,000 contact tracers. These can be epidemiologists, nurses, and trained citizens. Ideally, these people will be employed by local health departments in their area. The National Association of County and City Health Officials says public health departments should have 30 contact tracers per 100,000 people.
2. Funding. Andy Slavitt, former director of Medicare and Medicaid in the Obama administration, and Scott Gottlieb, former director of the Food and Drug Administration for President Trump, called for $46 billion in federal funding for contact tracing and related activities to bolster public health departments and contain the spread of the virus.
3. Support local public health departments. Rather than creating a new federal entity — which would take time and additional bureaucracy — it makes the most sense to quickly funnel funding to local health departments on the ground. To inform policymakers, data should be standardized and centralized at the Centers for Disease Control and Prevention.
4. Provide cultural competency guidance. Much of the success of contact tracing relies on the contact tracer getting the interviewee to divulge who they have been in contact with. This requires the ability to create trust with people quickly over the phone — at a time when many people don’t answer calls from unknown numbers. Cultural competency is an integral part of an interviewer’s ability to quickly build rapport. It is vital that the federal government provide local jurisdictions guidance on cultural competency including local jurisdictions hire contact tracers from a variety of backgrounds and from communities that are most affected.
5. Training. The federal government should support the training of contact tracers by providing funding and guidance. The hope is that these jobs will be short-lived as once the spread is under control, the surge of contact tracers will no longer be necessary. Thus the federal government should also support transitioning contact tracers into other positions that support the health of communities.
6. Privacy. As large technology companies work to develop products that support contact tracing efforts, it is paramount that they work with public health departments. They should not solely control the data collected. Furthermore, the efforts to develop new products should be in conjunction with public health departments not siloed apart from them.
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