New Jersey will deploy the first state-coordinated wave of 1,600 coronavirus contact tracers over the coming weeks — tripling the existing workforce at local health departments — with an initial group comprising Rutgers University public health students and graduates, according to state officials. Rutgers will also provide online training for all tracers with a focus on social justice, health equity and patient privacy.
State officials said they are also working with several local health departments to test a database platform called CommCare that all tracers must use to collect and share information; New York State and Philadelphia use the same system. The product, created by the tech company Dimagi, will be in place in all 100 local health departments by the end of June, officials said.
But questions remain about who will employ the first round of contact-tracers called up by the state — whose salaries could top $1 million a week — how much the public will be charged for the Dimagi platform and why entire program has taken so long to get off the ground. Gov. Phil Murphy first stressed the importance of contact tracing when he outlined his plans for reopening in late April, some six weeks ago, and shared initial plans for the effort in mid-May.
Complex challenges of contact tracing
Contact tracing — a longstanding public health strategy to contain infectious disease — involves talking with individuals who test positive for COVID-19, identifying who they may have infected, contacting those people to inform them of their risk, encouraging them to get tested and urging them to quarantine, in some cases. (The state is focused on individuals who spent more than 10 minutes within six feet of a COVID-19 patient.) To succeed, the process requires a multilingual workforce that respects local culture.
“The role of contract tracers takes on a new urgency, especially against a virus that we are still learning about, and which we have no proven defense against,” Murphy said Wednesday.
The governor chastised reporters who questioned the delay in making the plans public, adding, “I reject completely the premise of, ‘what took us so long’,” and pointed to the 900 contact tracers who have been working for months with local health departments. But while some communities, like Paterson — which Murphy praised — have strong contact tracing programs in place, others have had to struggle to hire and train sufficient staff to do the work.
“Our job over the coming months is to grow their ranks. And we will. And we will do so rapidly,” Murphy said. “As we undertake each step in our restart, as more businesses reopen and more residents get outside and participating in our economy, we will bring on more contact tracers.”
“Moreover, our contact tracing program is meant to supplement and further support the great work of our local health departments,” he said. “We have no desire to uproot them or overstep them. We’re going to work together, with common purpose.”
New Jersey has identified more than 165,000 cases of COVID-19, including nearly 12,400 people who have died. While the rate of new infections has trended down since late April and the virus is no longer spreading at the rate it was early on, positive diagnoses — and new illness — will continue as testing options expand and the state reopens business and social spaces.
The risks of reopening
That reopening picks up pace in the weeks to come, with places of worship now allowed to welcome the faithful, restaurants offering outdoor table service starting Monday and barbershops and beauty salons reopening soon. In addition, ongoing protests over policing in communities of color provide another opportunity for the novel coronavirus to spread. Murphy urged protesters to get tested, saying that he and first lady Tammy Murphy did Wednesday after they had taken part in public protests.
“Each step of our restart will be accompanied by the onboarding of new contact tracers,” Murphy said.
Eventually, the contact tracing corps could swell to 4,000 people, the governor said; at one point, estimates for the need reached as high as 7,000, but Murphy said that was always considered a range. Pay for contact tracers starts at $25 an hour, with some managers slated to earn up to $30, a cost the Trump administration is expected to eventually cover.
“For the time being the federal government is reimbursing the testing and tracing, God willing,” Murphy said.
Rutgers University’s School of Public Health developed the 15-hour online course for the contact-tracing program, which includes lessons on interview skills, ethics and privacy. Tracers will learn to ask for only the information they need and how to keep it confidential, Murphy said, and will be taught never to request things like immigration status, criminal history or personal financial information.
The first group of state-coordinated tracers — Rutgers public health students and graduates — have completed training and will be dispatched next week to assist local departments as needed; Murphy said some would be in place Monday. It is not clear who will pay this first group. The university has also posted a job description seeking additional contact tracers, which indicates these individuals would be Rutgers employees. The state is also seeking contact tracers through its website, which officials said had generated more than 50,000 responses.
New Jersey is seeking to hire a private entity to oversee the entire contact-tracing program and posted a formal request Friday, which appears similar to the draft version made public May 12. It notes that all tracers would be hired, trained, paid and overseen by this contractor; it also stresses they would not be state employees or entitled to public benefits. Department of Health Commissioner Judy Persichilli said her team would be reviewing the responses next week, but state officials declined to say who would employ tracers hired before this company is in place.
As these efforts are rolled out, the state will also launch a public relations campaign to encourage people to participate in the process if contacted by a contact tracer and to assure them their privacy will be protected. “We need people to know that when a contact tracer calls them, picking up their phone or returning that call — if they missed it — is important to their health, and the health of their family and community,” Murphy said.
In addition, the governor underscored that the CommCare platform does not function as a personal tracking system — using GPS or other data to monitor people’s movements — but is merely a database that will ensure uniform reporting. The information stored there will be shifted to the state’s own epidemiological database after 45 days, he said.