Contact tracing in COVID-19: Applying a public health mainstay in new ways
Governments, employers and other entities all play a role in mitigating the effects of COVID-19, but they have different responsibilities that give the term “contact tracing” a different meaning for each sector.
During the pandemic, terms such as “social distancing” and “flatten the curve” have forged their way into the world’s common lexicon. But it’s important to be precise when using emerging terms, especially with a term like “contact tracing” that can mean different things across the private and public sectors.
While there is a common goal to balance public health and economic factors in decision making1, I find three concepts of contact tracing in my conversations with governments, employers and other entities:
Government view: Population perspective requires holistic approach
In public health, contact tracing has a long history as an effective tool against infectious diseases such as SARS, HIV and more. To mitigate the spread, contact tracing involves interviewing people who are infected to identify their contacts, finding those exposed contacts, isolating contacts who are infected, and placing exposed contacts in quarantine until it can be assured they are not infectious. Government agencies use contact tracing as one strategy among many to control outbreaks. Because governments bear responsibility for an entire population, they have unique authority to encourage and enforce isolation, quarantine, and other disease control measures.
Technology can help enable public health departments to scale contact tracing through different types of tools, including conversational artificial intelligence (AI) – aka chatbots – automation, medical monitoring, analytics and proximity tracking (via Bluetooth or GPS). An important and often overlooked challenge is keeping people safe while in isolation or quarantine.
Fundamentally, successful contact tracing depends on technology-enabled care coordination, where care managers can implement public health measures, and also attend to individuals’ social needs. In my experience, the human-centered interview model is the tried-and-true method, and additional technology platforms can help expand and scale that essential interaction.
Employer view: Balancing health, safety, ethical, economic and legal concerns
As good corporate citizens, businesses also want to mitigate the impact of the disease. But their focus is narrower than the government in that their main concern is the health and safety of their workforce, partners and customers. As we re-open business, the private sector is thinking about how to adopt public health strategies in the workplace.
Contact tracing in a workplace also carries different ethical, legal and privacy concerns. For example, more of their systems are likely to rely on employees voluntary sharing information (e.g., personal symptoms, lab results), and many employees may feel reluctant to share personal health information with their employers. COVID-19 may transform the way that employers and employees have traditionally interacted around health, but the need to maintain workplace safety while protecting personal health information still stands.
In my experience, business leaders are interested in using technology to automate this process and preserve employee privacy. Tools such as proximity alerts that are linked to badges while on-site tend to be more well-suited to a relatively confined workplace, while they may not work as well in the general public.
Hybrid organizations: Responsibilities as employer and public health entity
I’ve seen a third way to conceptualize contact tracing at organizations that have an obligation to care for a given population, such as prisons, universities and the military, and it tends to be a hybrid of the first two. Let’s use universities as an example. They tend to be large employers for faculty and staff, and they also are responsible for the public health of a student population in congregated living situations.
These organizations are taking on some public health roles to help ensure the health and safety of their campuses. Like their public health counterparts in government, they need that holistic view of care coordination to effectively manage contact tracing.
There are common threads that run through all three perspectives: Contact tracing is an important component of efforts to slow the spread of COVID-19.
There is early evidence2 about the effectiveness of contact tracing, when combined with interventions, about how it can reduce transmission of COVID-19 more than mass testing or self-isolation alone. Another research article adds3: “Optimising testing and tracing coverage and minimising tracing delays, for instance with app-based technology, further enhanced contact tracing effectiveness, with the potential to prevent up to 80% of all transmissions.”
IBM has solutions that can help governments, employers and universities facilitate human-centered contact tracing through structured interviews. We can provide care teams with a platform that is designed to support the holistic needs of individuals affected by COVID-19 and beyond.
- Pronk, NP, Kassler, WJ. “Balancing Health and Economic Factors When Reopening Business in the Age of COVID-19. J Occup Environ Med 2020/07/7 Publish Ahead of Print
- Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study. Adam J Kucharski, PhD et al. The Lancet Infectious Diseases. Published: June 16, 2020DOI: https://doi.org/10.1016/S1473-3099(20)30457-6
- Impact of delays on effectiveness of contact tracing strategies for COVID-19: a modelling study Mirjam E Kretzschmar, et al. Lancet Public Health 2020 Published Online July 16, 2020 https://doi.org/10.1016/