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CDC Director Shares Plan On Contact Tracing

AILSA CHANG, HOST:

For parts of the country to reopen, health departments will need to be ready to stamp out any new outbreaks of the coronavirus immediately, and to do that, they will need legions of health workers known as contact tracers to track down anyone who might have been exposed to someone with COVID-19. NPR health correspondent Rob Stein got an update today from the director of the Centers for Disease Control and Prevention about the agency's efforts to make that happen, and NPR health policy reporter Selena Simmons-Duffin has been surveying state officials. They join me now with the latest.

Hey, guys.

SELENA SIMMONS-DUFFIN, BYLINE: Hi.

ROB STEIN, BYLINE: Hey there.

CHANG: So, Rob, I want to start with you. What did the CDC director Robert Redfield say is the CDC's strategy now?

STEIN: So Dr. Redfield says that the country is moving into a new phase against the coronavirus - in the battle against the coronavirus that will focus on trying to prevent any new outbreaks from occurring. Let's listen to a little of what he said today.

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ROBERT REDFIELD: As we open up, we need to we reset our sights on what the primary strategy is to control this virus, and that's got to be containment. And that means we need to have the diagnosis and testing capacity to make early diagnosis. And we need a public health workforce so that when that diagnosis occurs, they rapidly can isolate and contact trace around it and contain this virus.

CHANG: OK, so what I'm hearing him say is they will need an army of people - right? - there to trace infections. Is the CDC building this army?

STEIN: Well, so the CDC has had about 600 disease detectives deployed around the country. Now Redfield says the CDC has also dispatched what he calls community protection teams to nine states that officials say haven't had any big problems yet to try to make sure they stay that way. Here's what he said about that.

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REDFIELD: We call them protection teams - to work with their health departments and begin to beef up those states. And this was actually done before we hit our peak because we wanted to see what we could do to keep those states, if you will, low states.

STEIN: And Redfield says CDC teams are now on the ground in four other states and help do things like create early warning systems to spot outbreaks in places that might be particularly vulnerable like nursing homes. And the agency is providing $45 million for the CDC Foundation to hire another 650 workers - you know, epidemiologists, nurses, microbiologists, lab technicians - at state health departments across the country.

CHANG: OK, so...

STEIN: Let's listen to what he said about that.

CHANG: Oh.

STEIN: Yeah. Oh, I'm sorry. Go right ahead, Ailsa.

CHANG: Well, it sounds like these teams are being built and deployed. OK. That's fine. But is this all happening quickly enough to match the pace of, say, cities and states that are already looking to loosen up stay-at-home restrictions?

STEIN: Well, you know, interestingly, Redfield said the goal is to have state and health - state and local health departments in much better shape by the fall. He thinks a new wave of the virus may hit the country then, and here's what he said about that.

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REDFIELD: Our nation is going to have to have a substantially enhanced public health workforce so that, during what I call the second wave of the coronavirus infection, we have the public health resources to stay in the containment mode. That's the key. We got to stay in containment mode.

STEIN: So Redfield says the CDC has started talking with other organizations like the Census Bureau and the Peace Corps and AmeriCorps to see if they might be able to bribe the thousands of workers that states ultimately will need.

(SOUNDBITE OF ARCHIVED RECORDING)

REDFIELD: We are in the process of rapidly accelerating the human capacity that will be available to the states. That's what we're working with the health departments - the state health departments now - to develop that expansion plan so that they have a substantially enhanced public health workforce.

CHANG: OK. Selena, you have been reaching out to state health departments to find out about their contact tracing efforts. Tell us what you've learned.

SIMMONS-DUFFIN: Right. So there's a lot of variation in what states are planning. Michigan says it has already trained 2,200 volunteers to do contact tracing. That's huge. That's the number that's estimated to be there for contact tracing in the whole country. Other big efforts include Massachusetts and Maryland, which are both planning to add 1,000 workers. But other efforts are on a much smaller scale. Mississippi told us they were looking to add 20 additional staff to help with contact tracing. Utah said it has reassigned 30 workers from its Medicaid program to help.

And I've heard some optimism out there that this could be a big source of jobs and give a sense of purpose for folks who are out of work. I know since I started to report on contact tracing, a number of people have reached out to me asking how they can apply to become a contact tracer.

CHANG: Wow. Well, what about, as we heard Rob say, organizations like the Peace Corps, AmeriCorps and even the census? Could those be sources of kind of ready-made workforces?

SIMMONS-DUFFIN: So the Peace Corps, which has about 7,000 volunteers who are all at home at the moment, did not respond to NPR's request for comment today. We did hear from AmeriCorps, which confirmed discussions with the CDC and said many of their volunteers are helping with COVID relief efforts already, although contact tracing would be new for them. As for the Census Bureau, they are referring questions back to the CDC. Our colleague Hansi Lo Wang, who's reported a lot on the census, says that the Census Bureau doesn't really have a field staff until at least June 1, and it's unclear how the hiring and background check process might be disrupted by the coronavirus - in other words, still a lot of questions and certainly not an easy shortcut.

CHANG: All right. Well, going back to you really briefly, Rob, how do the CDC's efforts so far match up with what other public health experts would like to see?

STEIN: Well, what I'm hearing is that it's a start, but they are really saying that it really falls far short. The CDC is only talking about directly deploying hundreds of workers, and the country probably needs tens of thousands, maybe hundreds of thousands of these contact tracers. And, you know, it's a huge gamble to think we have all summer to get this together. New waves of outbreaks could easily erupt at any time and quickly overwhelm health departments. And the big missing piece of this...

CHANG: All right.

STEIN: ...Is testing. We don't have enough testing.

CHANG: That is NPR health correspondent Rob Stein and health policy reporter Selena Simmons-Duffin.

Thanks to both of you.

STEIN: You bet.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.
Selena Simmons-Duffin reports on health policy for NPR.