New Jersey’s contact tracers were able to successfully contact fewer than two-thirds of the COVID-19 positive individuals they are tasked to track down in late July and just over half of those reached were willing to reveal how they may have spread the disease, state figures show.
The data made public Friday — now included on the state’s COVID-19 dashboard — underscores the challenges contact tracers face as New Jersey seeks to scale up their ranks to ensure the state has a sufficient workforce to track and help contain the spread of the novel coronavirus.
The state Department of Health launched a multilingual public awareness campaign last week to encourage the public to respond to contact tracer calls. Tracers will not ask for a Social Security number, financial information or immigration status, officials said, urging anyone with concerns about a tracer’s call to hang up, call their local health department — the departments are coordinating the work and employ most of the tracers — and ask if someone there was trying to reach them.
Not participating in the process “means all those people (you may have infected) don’t know they were exposed to COVID-19 and could be infectious,” DOH Commissioner Judy Persichilli said Friday. She urged people to consider their friends, families and co-workers and avoid “unknowingly contributing to the spread of COVID in our state.”
How many tracers exactly?
According to the dashboard, New Jersey had 1,344 contact tracers at work statewide as of Aug. 1, nearly 1,000 of whom are employed through local health departments that have been doing the bulk of this tracing work since March. The total number of tracers has been a matter of some confusion, as state officials have in the past been unable to pinpoint the exact size of the local workforce.
An agreement the state set in motion with Rutgers University’s School of Public Health in late May has resulted in 638 hires, state officials said, of whom 349 have been trained on a module the school developed and deployed to assist local tracers. The state has also hired Public Consulting Group, a Boston-based company that is also overseeing contact tracing in New York, to supplement Rutgers’ efforts in what officials described as a flexible, phased approach that will allow the state to continue to grow the corps into the fall.
“The ability to scale our contact tracing capacity is critical to break the chain of transmission, slow community spread and restart our economy,” Persichilli said, praising the ongoing work of the local public health officials.
The immediate goal is to ensure each of New Jersey’s 21 counties has at least 15 tracers per 100,000 residents, Persichilli said, a benchmark now met in 10 counties — somewhat concentrated in the north — and the City of Newark, the dashboard shows. Once all counties achieve that rate, she said the state would double the threshold and seek to install 30 tracers per 100,000 people. Deployment of new tracers will also be guided by the progression of the disease, she added.
Gov. Phil Murphy said Friday that putting contact tracers in these jobs is only “half the equation.” To make the process work, people have to participate when these professionals call. Demographics were not included in the new dashboard data, but Murphy said he suspected much of the resistance comes from younger people who may have become infected attending a house party or other banned event. Murphy has made a point of admonishing large indoor parties and blamed these gatherings, in part, for the decision to reduce the allowable capacity of indoor gatherings last week.
“This is about public health, period. No one is out on a witch hunt here,” Murphy said at his media briefing Friday. “No one is asking questions that have any focus other than trying to stop the spread of the virus.”
As of Friday, more than 184,000 New Jerseyans had been diagnosed with COVID-19, including nearly 16,000 who were confirmed or likely to have died from the disease, according to state data. While officials reported a spike in new cases in recent weeks, that appears to have declined, and hospitalizations and new deaths remained relatively low.
Trying to control the spread of the disease
Murphy has discussed contact tracing — a decades-old process used to control the spread of many infectious diseases — since April, when he first outlined a plan to reopen the state’s economy and public spaces based on data provided through extensive testing and tracking of the pandemic’s reach. While some have questioned the pace at which the state stood up its contact tracing corps, Murphy and Persichilli have stressed how this work has been ongoing at the local level. According to the dashboard, the state added nearly 100 tracers during the third week of July.
However, state officials did not appear to have a detailed, real-time view of how the outreach was proceeding among local health departments. Another contract with technology company DiMagi gave the state access to its online reporting platform, CommCare, which is now being used by tracers in all 21 counties, according to the DOH. The software also gives DOH a statewide view of their progress.
That data is now feeding the dashboard, officials said, which shows the size of the contact-tracing workforce, where tracers are deployed, and how successful they have been. Information will be updated weekly, the state said.
An “effectiveness” chart indicates that for the week of July 26 through Aug. 1 tracers had contact information for nearly all the cases, or the individuals identified as COVID-19 positive, they were charged with contacting. But, through conversations with these individuals, they were only able to obtain contact information for just over three-quarters of their contacts, or the people who they may have infected.
Without phone numbers, fewer people can be contacted to be protected. Given the lack of information, wrong numbers and other barriers, tracers successfully connected with just 63% of infected individuals and 49% of their reported contacts, according to the dashboard. Of the infected individuals tracers did reach, 45% refused to divulge any information about their close contacts. As a result, fewer than half of those contacts — all of whom are considered potentially infected — were notified of their risk.