California had high hopes last spring that Governor Gavin Newsom’s plan to train an “army” of contact tracers to track the spread of COVID-19 would be one of the state’s most effective weapons to contain the virus, but a new audit shows that the state fell well short.
When Newsom announced the initiative last April, he promised to train 10,000 state employees to help meet the 31,400 tracers that the Department of Health estimated would be required. As of January, the state’s full compliment of contact tracers numbered just 12,000, including 2,262 state workers, the Associated Press reports.
The plan had a built-in flaw: it was based on the assumption that California would see a daily infection rate of 5,000 cases. From late November through the year’s end, the state saw an average of 25,000 infections per day.
“The sheer number of cases has overwhelmed local health jurisdictions’ contact tracing efforts,” auditor Elaine Howle wrote in the report.
In January, when the state reported 834,000 COVID-19 infections, local health officials attempted to contact 85 percent of those people, but reached just 40 percent, and identified others at risk of exposure in just 16 percent of total cases that month.
California wasn’t alone in underestimating how many tracers would be needed. An April 2020 report from the National Association of County and City Health Officials predicted it would take 30 contact tracers for every 100,000 Americans nationwide to reach infected people and identify others who may have been exposed. By those numbers, California’s 12,000 COVID investigators would have sufficed to cover its nearly 40 million residents.
While California is focusing on its vaccination effort these days, Dr. Kirsten Bibbins-Domingo of University of California San Francisco’s Department of Epidemiology and Biostatistics urges that with cases on the decline, now is no time to relax tracing efforts.
“Contact tracing hits in that sweet spot when you’re concerned about transmission but you’re not overwhelmed by the number of cases,” she told the AP.
Still, officials may find that one stubborn problem with contact tracing remains no matter how many workers they hire: people must be willing to cooperate. When the program launched last year, Madera County public health director Sara Bosse warned that that obstacle might actually grow worse as other things get better.
“With so many people who are unemployed or underemployed at this point, once they have the ability to be employed, are they going to be willing to be tested?” she asked. “Wage replacement, so ability to be paid sick leave, is going to be super important—or people are not going to agree to be tested, and then our contact tracing efforts will be really limited.”
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