The Rivera family awaits the call. And waiting. And waiting. But the call never came.
“I was surprised,” said Rivera, a nurse who has since recovered from a virus attack.
Despite claims that Florida is tracking every Covid-19 case, CNN investigations have found that health authorities in Florida, now the country’s number one hotspot for the virus, often fail to trace contacts, long considered to be the main tool in epidemic control.
Florida set a record for most cases of corona virus in the US in one day on Saturday, totaling 11,458, according to data collected by Johns Hopkins University, and on Sunday, the state surpassed 200,000 Covid-19 cases.
The challenge of Florida contact tracing is an indication of how difficult it is for countries hit by Covid-19 to conduct correct contact tracing, which is a challenge even in the best of circumstances. This virus has spread in countries like Florida so it is a very big task to track every infected person and follow up with all their close contacts.
CNN spoke with 27 Florida people, or their family members, who tested positive using Covid-19. Of those, only five said they had received a call from the health authority asking for their contact.
There are concerns about contact tracing nationally, not just in Florida. In an interview in June, CNN asked Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, how he thinks contact tracing takes place in the United States.
“I don’t think we did well,” he replied.
What is contact tracking?
Contact tracing is a centuries-old practice, and the basics have not changed much: Basically, health care workers ask for a list of infected people who have been contacted while potentially communicable. The worker then tells the contacts to quarantine themselves and monitor the symptoms.
providing detailed contact tracking guidelines to the state health department, explaining that “monitoring of COVID-19 contacts can effectively break the chain of disease transmission and prevent further spread of the virus in a community.”
White House guidelines
described contact tracing as one of the responsibilities of the core states of preparedness.
A online infographic
the Florida Department of Health described contact tracing as “a core public health function,” and stated that local epidemiologists would ask people with the virus to list all the people they had contacted for the past two weeks, and the county health department would monitor those contacts.
A spokesman for the Florida Department of Health in Miami-Dade County sent CNN a statement about tracing contacts in his country.
“When the Ministry of Health receives notification that someone has tested positive for COVID-19, the department carries out extensive epidemiological investigations in relation to [Centers for Disease Control and Prevention] to identify people who might have close contact with the virus. These people were then told by their regional health department and instructed to isolate themselves for 14 days after exposure to the virus, and to immediately contact their local health department and health care provider if they experience symptoms. “This process is followed for all those who test positive in Florida,” Olga Connor wrote in an email.
The number of contact tracers in Florida is unclear
That National Association of District and City Health Officers
estimates that during a pandemic, people need 30 contact tracers for every 100,000 people. Florida, with a population of 21.5 million people, will need 6,443 contact tracers.
Florida doesn’t have nearly that much, and it’s not alone. According to the July 3 report by Nephron Research
, only seven states have enough contact tracker to meet NACCHO standards.
It is unclear how many contact trackers are employed by the state of Florida, because a spokesman for the Department of Health gave CNN two different numbers.
“More than 1,600 people, including students, epidemiologists, and other staff from across the Department, are currently involved in tracing every positive COVID-19 case in Florida,” Candy Sims, a spokesman for the Florida Department of Health in Broward County wrote to CNN.
The department has involved private companies to hire 400 additional contact trackers, Sims added.
But Alberto Moscoso, a spokesman for the health department, citing a larger number, wrote to CNN that Florida has 2,300 “individuals involved in contact tracing.”
Sims and Moscoso did not respond to CNN’s questions about the differences in their numbers.
In a online infographic
, Florida Department of Health asks infected people to call their own contacts.
“Immediately notify people who have been in close contact with you when you are sick,” according to the picture, noting that the contact must be quarantined for 14 days.
However, giving different advice. The agency recommended that the local health department request a list of people they had close contact with an infected person starting two days before experiencing symptoms.
The Florida infographic does not explain what to do if someone is tested positive for Covid-19 but never shows symptoms. According to the CDC, in that case, people must be notified if they have close contact with an infected person two days before that person has a Covid test.
5 out of 27 Florida residents received contact tracing
Of 27 Florida residents who tested positive using Covid-19, five told CNN that they had received a call from a health worker asking for their contact.
Among the 27 cases, the earliest diagnosis was in February, and the most recent was last week.
Riveras signed Covid in early March, when contact tracers were under far less pressure than they are now. Shaila Rivera said an official from the Miami-Dade District Health Department called and asked questions about their illness but did not ask about their contacts.
“We were surprised,” said Rivera, a child nurse practitioner. “The whole conversation took less than a minute. There was no question as to who you were in contact with? Did you go to work? There was nothing like that.”
Eleven others out of 27 said they, like Riveras, received a call from a Florida health official but were not asked for their contact.
David Pugh, who lives in Broward County, said he received such calls.
“I do not know that we can rely on the state to do a thorough job. I think there are clearly deficiencies in the system,” he said.
Doubts about the usefulness of contact tracing
Contact tracing has been carried out since the first case in the United States more than five months ago, and there are several reasons why it failed to withstand an outbreak.
estimates that 35% of Covid’s cases are asymptomatic, and these people are as contagious as those who have symptoms.
“How do you track contacts when someone has no symptoms?” Fauci said in his interview with CNN. “The identification, alienation, standard and standard contact search paradigms don’t work, however good you are because you don’t know who you are tracking.”
Also, he said some people were hesitant to talk with government officials.
“The points are not connected because a lot is done by telephone,” Fauci said. “Fifty percent of people because you come from authority, don’t even want to talk to you.”
On top of all these problems, some experts doubt the usefulness of contact tracing in areas such as Florida where cases are very large.
Epidemiologist Michael Osterholm urged Florida leaders to focus on other strategies, such as finding out where the virus is spreading.
“For example, if young adults in a bar are a problem, you have to close the bar,” said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, who recently issued report
on contact tracking.
With thousands of new cases a day in Florida, Osterholm doubts that contact tracing will have much effect.
“If Florida can get back under 50 to 100 cases a day, contact tracing can help. But at the moment, it is unlikely to have a measurable impact,” he said. “It’s like trying to put out a forest fire with a fire truck. That won’t make a dent.”