WASHINGTON, DC – As scientists worldwide race for a cure for novel coronavirus (COVID-19), local efforts, including robust contact tracing, are key to stopping the spread of the virus and safely reopening the economy.  A group of 14 leading U.S. Senators, led by U.S. Senator Jack Reed (D-RI) is calling for Congress to include $8 billion in new funding for contact tracing initiatives in CARES Act 2 to help states and localities recruit, hire, and train contact tracers and deploy voluntary digital tools that can integrate data to quickly alert people who have crossed paths with a newly diagnosed COVID-19 patient.

Contact tracers are a combination of disease detectives and social workers who can swiftly track down and alert people who have been exposed to a confirmed COVID-19 case and request they self-quarantine and connect them to testing or treatment if needed.  Contact tracers must be trained to interview patients, do investigative work, and monitor those at risk with daily check-ins.  The work is labor intensive, and involves some old-fashioned sleuthing.  Much of the job can be done remotely by people working from home.

The 14 Senators penned a joint letter to Senate leadership calling for $8 billion to strengthen America’s contact tracing workforce.  The senators write that this funding is critical “to enable states to quickly diagnose patients and get them into appropriate care, as well as help us better understand the spread of the disease, and provide a path forward towards eventually reopening the economy.”

In addition to recruiting, hiring, and training a capable, effective contact tracing workforce, the Senators also note the need to invest in technology: “Further, we must encourage the use of technology to aid in this effort, without infringing on personal civil liberties.  Management of public health data collected in this manner should continue to follow established protocols, whereby state and local entities serve as the primary data collectors and stewards of this information, which should only be shared as aggregated, anonymized data with the CDC for purposes of public health surveillance, and not with law enforcement or national security agencies.  We must provide sufficient resources to partner with the private sector to develop and deploy voluntary apps to improve data collection, support contact tracing, and ultimately help public health officials better control the spread of the virus.  Additionally, such technology efforts should allow individuals to accurately and quickly receive alerts regarding potential exposure to COVID-19, improving rates of self-quarantine.”

In addition to Reed, the letter is signed by U.S. Senators Tom Carper (D-DE), Sherrod Brown (D-OH), Sheldon Whitehouse (D-RI), Richard Blumenthal (D-CT), Bob Casey (D-PA), Robert Menendez (D-NJ), Michael Bennet (D-CO), Jeanne Shaheen (D-NH), Chris Van Hollen (D-MD), Debbie Stabenow (D-MI), Elizabeth Warren (D-MA), Gary Peters (D-MI), and Cory Booker (D-NJ).

In order to begin to safely relax stay-at-home orders for communities nationwide, public health experts believe the U.S. needs hundreds of thousands of contact tracers on the beat.  The Association of State and Territorial Health Officials; Association of Public Health Laboratories; Council on State and Territorial Epidemiologists; National Association of County and City Health Officials, and others are urging Congress to provide at least $7.6 billion in its next emergency supplemental bill to expand the scale of disease investigation specialists and contact tracing workforce.

The Senators helped include $25 billion to increase COVID-19 testing capacity and make an initial investment in contact tracing in the recently passed Paycheck Protection Program and Health Care Enhancement Act.  However, contact tracing at the state level has been uneven to date, and the Senators are calling for a coordinated strategy with the resources to match.

The Associated Press notes: “Louisiana, which has been hit hard by the virus, had only about 70 people working on tracing contacts this week. By comparison, North Dakota, with less than a fifth of Louisiana's population and no serious outbreaks, has 250 case investigators and will soon bring on an additional 172 staffers.”

Full text of the letter follows:

April 29, 2020

Dear Majority Leader McConnell and Minority Leader Schumer:

Thank you for your bipartisan work to respond to the health and economic effects of the novel coronavirus (COVID-19) pandemic in the United States.  As you prepare for the next relief package, we respectfully request at least $8 billion in new funding for contact tracing to help states and localities recruit, hire, and train contact tracers and deploy voluntary digital tools that can integrate data to quickly alert people who have crossed paths with a newly diagnosed COVID-19 patient.  Such a fund must include a small state minimum of no less than $50 million to ensure that every state can bolster and maintain its testing and contact tracing infrastructure.

Contact tracers are a combination of disease detectives and social workers who can swiftly track down and alert people who have been exposed to a confirmed COVID-19 case and request that they quarantine and connect them to testing or treatment if needed.  Contact tracers must be trained to interview patients, identify potential sources of exposure, and monitor those at risk with daily check-ins.  The work is labor intensive, and much of the job can be done remotely by people working from home.  Contact tracers also work within the public health system to stay in communication with individuals in quarantine and ensure that they have what they need to stay healthy, such as food, medical supplies, and access to treatment.

 

We were pleased to support the Paycheck Protection Program and Health Care Enhancement Act, which provided $25 billion to increase COVID-19 testing capacity and make an initial investment in contact tracing.  Now we need to build on this funding to enable states to quickly diagnose patients and get them into appropriate care, as well as help us better understand the spread of the disease, and provide a path forward towards eventually reopening the economy.

Reports by the Association of State and Territorial Health Officials (ASTHO) and researchers at the Johns Hopkins Bloomberg School of Public Health, as well as the National Association of County and City Health Officials (NACCHO) have found that 100,000 contact tracing investigators will be necessary for full recovery, at a cost of roughly $3.7 billion, at a minimum.  Other experts like former Centers for Disease Control and Prevention (CDC) Director Thomas Frieden have said the need could be three times as much.  As the initial wave of COVID-19 cases recedes, it is critical that we are better prepared for a potential second wave as social distancing and closure guidelines begin to be relaxed.  Precision contact tracing can mitigate major outbreaks by identifying those most at risk and alerting them to help limit further infections.  As such, additional resources are needed to create a training pipeline for a national network of well-qualified contact tracers across the country. 

Further, we must encourage the use of technology to aid in this effort, without infringing on personal civil liberties.  Management of public health data collected in this manner should continue to follow established protocols, whereby state and local entities serve as the primary data collectors and stewards of this information, which should only be shared as aggregated, anonymized data with the CDC for purposes of public health surveillance, and not with law enforcement or national security agencies.  We must provide sufficient resources to partner with the private sector to develop and deploy voluntary apps to improve data collection, support contact tracing, and ultimately help public health officials better control the spread of the virus.  Additionally, such technology efforts should allow individuals to accurately and quickly receive alerts regarding potential exposure to COVID-19, improving rates of self-quarantine. 

Thank you for your attention to this critical need as you negotiate the next COVID-19 package.  The only way to safely reopen the economy and get people back to work will be with widespread testing and contact tracing, and we look forward to working with you towards that goal.

Sincerely,