Survey: Cities scramble to support local contact-tracing efforts

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A contact tracer is conducting a follow-up interview with someone being monitored for infection or exposure to COVID-19. (AP Photos)

Over the past two months, contract tracing has emerged as one of the critical capacities communities need in order to stop the spread of COVID-19. And now, two-thirds of city governments are either collaborating with public-health authorities or other partners to support contract-tracing efforts or are creating contract-tracing programs of their own, according to respondents in a new poll of mayors from The U.S. Conference of Mayors and Bloomberg Philanthropies.

Contact tracing, which involves tracking down and warning every person who’s been in contact with someone infected with the virus, is one of the four pillars in a strategy Dr. Tom Frieden says is needed to “box in” the virus. Frieden, who served as director of the Centers for Disease Control and Prevention under President Obama, last month told mayors that the country would likely need an army of hundreds of thousands of contract tracers.

Generally, public-health departments fall under county government jurisdiction. But not always. In fact, a number of cities control the health board or are a consolidated city-county government. Some communities don’t have a local health department (city or county) and rely on state guidance. In the absence of a national plan to hire and deploy such an army, mayors, local public-health officials, and other organizations are stepping up.

Of the mayors who responded to the survey, 65 percent said their administrations are actively engaged in contact-tracing efforts, yet 68 percent of them said they lack the resources to fund a contract-tracing program locally. This is unsurprising as municipal budgets have taken a double hit from both declines in the local tax revenue and increased expenditures related to the public health and economic crisis.

In a survey last month, mayors raised the alarm about precipitous revenue drops that cities are expecting — and the furloughs and layoffs likely to come. In fact, over half of mayors noted that revenue shortages will result in cuts to police and public safety budgets. According to data from Bloomberg Philanthropies COVID-19 Local Action Tracker, more than one-fourth of the nation’s 80 largest cities have announced furloughs, affecting more than 40,000 municipal jobs.

One solution proposed to the contact tracing-challenge is to use technology-based tools — such as smartphone-based tracking apps. But public health officials have been skeptical of tech-heavy solutions, and only 30 percent of mayors participating in our survey noted that their local efforts are considering digital technology.

Hesitation around digital solutions is based partially on concerns over data privacy and anonymity. Recent surveys suggest the public is leery of big tech companies, the federal government, or cell phone providers providing a digital solution to contact tracing — but data are mixed. A Kaiser Family Foundation poll from April found that younger voters and Democrats are more likely than older voters and Republicans to consider using an app to share test results with public-health officials. Further, more Americans are open to digital solutions if they are told that, by downloading a contact-tracing app, they can help businesses open more quickly.

For now, two-thirds of mayors participating in our survey told us they are approaching contact tracing the traditional way — using phone calls and other low-tech methods to interview people who test positive about the people they have been in close contact with since they became infectious. Contact tracers then track down all those contacts and warn them to quarantine for 14 days so that, if they become ill, the chain of transmission stops with them.

To support those efforts, the Johns Hopkins Bloomberg School of Public Health this week launched an online course on COVID-19 contact tracing. Cities can use the six-hour course as part of training their newly hired contact tracers. It’s also open to anybody in the world to take if they want to better understand what contract tracing is all about.

The survey of mayors was fielded Friday, May 8 through Monday, May 11. Mayors in cities with 30,000 or more residents were invited to participate. There were 68 responses from the 1,400 cities with 30,000 are more residents.

Celebrating public sector progress and innovation in cities around the world. Run by @BloombergDotOrg’s Government Innovation program. bloombergcities.org

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