![\"\"](\"http:\/\/stateofthenation.co\/wp-content\/uploads\/2020\/06\/nyc-hired-3000-workers-for-contact-tracing-its-not-going-well-the-new-york-times.jpg\")
Daniel Okpare, a public health student in East Harlem, is in training to become a contact tracer.Credit\u2026Hiroko Masuike\/The New York Times<\/p><\/div>\n
by Sharon Otterman
\nNew York Times<\/p>\n
New York City\u2019s ambitious contact-tracing program, a crucial initiative in the effort to curb the coronavirus, has gotten off to a worrisome start just as the city\u2019s\u00a0reopening enters a new phase on Monday<\/a>, with outdoor dining, in-store shopping and office work resuming.<\/p>\n The city has hired 3,000 disease detectives and case monitors, who are supposed to identify anyone who has come into contact with the hundreds of people who are still testing positive for the virus in the city every day. But the first statistics from the program, which began on June 1, indicate that tracers are often unable to locate infected people or gather information from them.<\/p>\n Only 35 percent of the 5,347 city residents who tested positive or were presumed positive for Covid-19 in the program\u2019s first two weeks gave information about close contacts to tracers, the city said in releasing the first statistics.<\/p>\n Contact tracing is one of the few tools that public health officials have to fight Covid-19 in lieu of a vaccine, along with widespread testing and isolation of those exposed to the coronavirus. The early results of New York\u2019s program raise fresh concerns about the difficulties in preventing a surge of new cases as states across the country reopen.<\/p>\n The city has successfully done contract tracing before, with diseases like tuberculosis and measles. But as with much involving the coronavirus outbreak, officials have never faced the challenge at this scale, with so many cases across the five boroughs.<\/p>\n The city\u2019s program has so far been limited by a low response rate, scant use of technology, privacy concerns and a far less sweeping mandate than that in some other countries, where apartment buildings, stores, restaurants and other private businesses are often required to collect visitors\u2019 personal information, which makes tracking the spread easier.<\/p>\n China, South Korea and Germany and other countries have set up extensive tracking programs that have helped officials make major strides in reducing the outbreak. In South Korea, for example,\u00a0people at weddings, funerals, karaoke bars, nightclubs and internet-game parlors write down<\/a>\u00a0their names and telephone numbers, and the authorities have been able to draw on cellphone location data, credit card transactions and even closed-circuit video footage to identify and isolate potential contacts.<\/p>\n Dr. Ted Long, head of New York City\u2019s new\u00a0Test and Trace Corps<\/a>, insisted that the program was going well, but acknowledged that many people who tested positive had failed to provide information over the phone to the contact tracers, or left interviews before being asked. Others told the tracers they had been only at home and had not put others at risk, and then did not name family members.<\/p>\n Dr. Long said one encouraging sign was that nearly all the people for whom the city had numbers at least answered the phone. He added that he believed that the tracers would be more successful when they start going to people\u2019s homes in the next week or two, rather than just relying on communication over the phone.<\/p>\n \u201cI do think that the program, especially because it is only two weeks old, is doing an outstanding job,\u201d he said.<\/p>\n<\/div>\n The city has made major strides in reducing the outbreak since the shutdown began in March,\u00a0with only 327 new cases reported on Thursday<\/a>, down from several thousand cases a day during the peak. But Phase 2 of the reopening on Monday presents new risks, with 300,000 people likely returning to their jobs.<\/p>\n Perry N. Halkitis, dean of the School of Public Health at Rutgers University, which is guiding an effort to bring on thousands of tracers in New Jersey, called New York City\u2019s 35 percent rate for eliciting contacts \u201cvery bad.\u201d<\/p>\n \u201cFor each person, you should be in touch with\u00a075 percent of their contacts<\/a>\u00a0within a day,\u201d he said.<\/p>\n He suggested that the poor showing stemmed in part from the inexperience of the contact tracers and insufficient hands-on training.<\/p>\n \u201cThis is a skill,\u201d he said. \u201cYou need to practice.\u201d<\/p>\n Across the world, the authorities have rushed to set up contact-tracing programs, hiring hundreds of thousands of people, including many without experience doing such work. While the goal is to reach all of a sick person\u2019s contacts, and get them to effectively quarantine for two weeks, the reality is often much messier.<\/p>\n In Massachusetts, which has one of the most established tracing programs in the country, health officials said in May that only\u00a0about 60 percent<\/a>\u00a0of infected patients were picking up the phone. In\u00a0Louisiana<\/a>, less than half were answering. In England, the program has struggled to\u00a0show results with a low-paid, inexperienced work force<\/a>.<\/p>\n<\/div>\n<\/div>\n An\u00a0increasing number of countries<\/a>\u00a0are using phone applications to help track and trace people who test positive. Several states in the United States, including North Dakota, that have tried using digital applications have\u00a0run into privacy issues<\/a>.<\/p>\n But in New York, as in most of the country, contact tracers are typically using only low-tech tools like phone calls and a questionnaire, in part to allay privacy concerns.<\/p>\n The tracers are seeking the names and phone numbers of each person a confirmed-positive patient has been in close contact with from a few days before the onset of symptoms, defined as within six feet for at least 15 minutes. Each contact is then called, told that he or she may have been exposed to the virus, and asked to quarantine.<\/p>\n The relative silence from virus patients in New York City is one of several issues troubling the contact-tracing program.<\/p>\n Mayor Bill de Blasio, who has had tense relations with senior officials in his own Department of Health, stripped the department of oversight for the program in May, moving it\u00a0under the umbrella of the city\u2019s public hospitals agency<\/a>. That has led to concerns among some former health officials that expertise would be lost in the process.<\/p>\n Dr. Long said 50 experts from the Department of Health \u2014 the city\u2019s contact tracers before Covid-19, who have handled epidemics such as measles and Ebola \u2014 are guiding the work of the tracing corps, but are not tracing themselves.<\/p>\n Dr. Long is a primary care physician and vice president of ambulatory care at the public hospitals corporation. The Health Department\u2019s tracing effort was led by\u00a0epidemiologists<\/a>.<\/p>\n<\/div>\n<\/div>\n \u201cI challenge anyone to show me how we are not collaborating,\u201d he said of the relationship between the two agencies. \u201cThey have been nothing short of partners.\u201d<\/p>\n The city has had more success with its testing program, which is ahead of schedule, with a target of 50,000 tests per day expected to be reached in July, instead of August, officials said.<\/p>\n But an initiative to set aside hotel rooms for people who have tested positive to isolate from families is not popular. Though the city rented 1,200 hotel rooms for free use by virus patients, only 60 to 80 rooms have been occupied in recent weeks, city officials said. And in the two and a half weeks since tracing began, only 40 patients have requested rooms through the tracing program, Dr. Long said.<\/p>\n<\/div>\n<\/div>\n Over 1,000 virus patients have instead asked for support to isolate at home, such as assistance with grocery and medicine deliveries, because they preferred to remain with their families, he said.<\/p>\n In an effort to build a connection between contacts and tracers, half of all tracers hired live in communities hard-hit by the virus, which are predominately black and Hispanic, Dr. Long said.<\/p>\n![\"Mr.](\"https:\/\/static01.nyt.com\/images\/2020\/06\/19\/nyregion\/00nyvirus-contacttracing-2\/merlin_173678676_4e30692c-cae9-40af-ab9b-b012a7f90551-articleLarge.jpg?quality=75&auto=webp&disable=upscale\")
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