Louisiana is spending millions of dollars on the centerpiece of the state’s reopening plan, contact tracing, the practice of deploying callers to reach infected people and track down their contacts. But the plan is hitting a snag: people aren’t answering their phones.
Between May 15, when the state began its ramped-up contact tracing plan, and June 2, tracers successfully reached fewer than half of the infected people they called, according to data released by the Louisiana Department of Health.
The figures are similar to those seen in some other states, and raise questions about how effective the program will be in tamping down the spread of the highly-contagious coronavirus, especially as the state marches through its phased reopening plan. State leaders have urged people to answer the calls and take part in the program – especially so the people they may have exposed to the virus can be notified.
“It’s worth doing even if it’s, at this point, not as effective as we’d like it to be,” said Dr. Susan Hassig, associate professor of epidemiology at Tulane University.
“This is the trade off we’re asking people to participate in instead of everyone being stuck at home and businesses shut down and everything else until we get a vaccine,” Hassig added. “I think it’s a complicated message to communicate.”
State officials and health experts say contact tracing is vital to the state’s reopening, which began in earnest May 15 after weeks of a stay-at-home order that shuttered businesses and told people not to leave the house unless running essential errands.
As the state allows more people to interact with one another, officials need to have the ability to test large swaths of people. Once that happens, the Louisiana Department of Health deploys hundreds of people contracted with the state through call centers to reach out to those who tested positive and find out who they came into contact with.
The idea is to find those people who were exposed to the virus and urge them to self-isolate or quarantine. If successful, the practice shortens the “chains of transmission,” which otherwise can spiral out of control, sparking ever-larger outbreaks, Hassig said.
The state is spending an estimated $15 million to $20 million on the effort, which the Health Department hopes will be more effective now that cases are lower than when the outbreak began and epidemiologists were overwhelmed by the sheer volume of people who were exposed.
Some Republican lawmakers in the state Legislature have expressed skepticism of contact tracing, reflecting what they say is a mistrust of the government program among their constituents back home. The Legislature passed measures that aim to ensure the program is voluntary, which state health officials say is already the case. Gov. John Bel Edwards’ administration, which is deploying the program, has also insisted the effort protects people’s privacy. Contact tracing has existed on a smaller scale for decades, and is used to respond to outbreaks of other infectious diseases, like measles.
Hassig also noted that by having state contact tracers notifying people they may have come into contact with someone infected with the coronavirus, the state saves people from needing to make the potentially uncomfortable calls to those they came into contact with.
But amid skepticism over privacy concerns, and in an era of ubiquitous spam calls, the Health Department is struggling to reach people. The state has 4,415 infected people in its contact tracing database, and had called 97% of them as of a week ago. But the callers only reached 2,130 of those people, representing 48%.
Even the total number of people the tracers have called represent a portion of the 6,909 cases reported during that time period. Louisiana Department of Health spokeswoman Aly Neel said the people not in the state’s database that contact tracers pull from either did not have contact information associated with their test or were in a congregant setting – places like nursing homes and prisons that are handled differently.
Neel added in a statement that “we can dial, but it’s up to our residents to pick up.” She added it’s understandable that people are busy or don’t recognize the number – (877) 766-2130 – which is why the state is trying to raise awareness of the importance of answering the calls.
The state was slightly more successful reaching contacts, successfully reaching 56% of the 1,235 contacts identified. Officials define those contacts, which are urged to self-isolate or quarantine, as people who have been in close contact with someone who was infected for 15 minutes or longer.
The average length of time it takes the callers to reach infected people is 63 hours, according to Neel, and 23% are reached in less than 24 hours. The average time to reach contacts is 34 hours.
“We know that we have to test more and testing has to inform contact tracing and contact tracing has to be effective,” Gov. John Bel Edwards said at a recent press conference. “It’s not going to be effective if people don’t answer their phone.”
“I’m not going to say it’s thwarting our efforts, we just know it’s limiting the effectiveness of our efforts.”
The governor has emphasized that while the program is voluntary, participating is equivalent to “being a good neighbor.” He points to the fact that most people would want to know if they came into contact with someone who was infected.
Rep. Raymond Crews, a Republican from Bossier City, said late last month that his constituents are expressing reservations about contact tracing, saying, “without these conditions, without these protections … they don’t feel safe.” His resolution requested the governor require people who conduct contact tracing to disclose to people it is voluntary, among other things.