Guest Opinion: We need contact tracing now and for the future
Anyone who has been through medical school or doctoral training in the health professions can identify with the decision point that must be made as part of this training: selecting a specialization. Twenty-five years ago I was greatly inspired by the book “The Coming Plague,” written by Laurie Garret. Thus, I choose to specialize in the prevention of infectious disease (and have spent my career since then working to prevent sexually transmitted diseases). As part of my assigned duties while working at CDC I became intimately familiar with the “backbone” practice of controlling the spread of STDs — contact tracing. This “old” method of disease control requires a modest degree of training, and it relies on the capacity to hire people who are innately adept at having sensitive conversations with community members who may be reluctant to disclose information about their sex partners.
In the age of COVID-19, we are now having national discussions about re-tooling contact tracing in service of locating people who carry and thus can transmit the virus. Because asking about sexual relationships is not part of this new method, it will be much easier to train a workforce to take on the door-to-door footwork often needed to locate and test the contacts of index cases (index cases are people confirmed to have the virus). Fortunately, CDC has already posted a set of teaching modules on its website thereby enabling anyone willing to take the online class to gain CDC-sponsored training in contact tracing for COVID-19.
Before I state the punch line of this column, it is vital to note that emerging infectious diseases are now common (as predicted in “The Coming Plague”), and they are exacerbated by climate change. To be proactive about the future then, we need contact tracing to be an established and ongoing part of the public health infrastructure. COVID-19 will not be eradicated anytime soon, and other highly infectious diseases will certainly follow.
I was reading in the Aspen Times that the Pitco board voted not to invest in contact tracing (they want an affordable alternative to hiring 14 to 18 people). I hope that Garfield County (my new home) will have the foresight to understand that the investment is well worth making, especially given a point not considered in Pitkin County: Colorado has three universities that train graduate students in public health. Working with the accredited schools of public health in our state, Garfield County may be able to establish and maintain an effective contact tracing program by hiring only two or three full-time employees, who would then serve as managers and supervisors for a cadre of public health masters students (many of whom will also have medical training). In turn, these masters students will gain credit for a one-year field practicum, thus fulfilling one of their key requirements for graduation. Having trained hundreds of students seeking the masters in public health degree, I want to be very clear that these soon-to-be professionals are fully capable and willing to take on this crucial role in an era when protecting the health of the public has never been so visibly important to us all. Consequently, annexing a full-fledged contact tracing program to the current public health infrastructure in Garfield County is feasible, and — more importantly — it is a wise investment in our future as we enter a world where pandemics can easily change our lives and threaten our existence.
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Dr. Richard Crosby is a professor of public health and holds a PhD in health behavior from Indiana University. He is the author of numerous textbooks on the topic of health behavior and has published well over 100 peer-reviewed journal articles addressing theories of health behavior change. He has recently moved to Glenwood Springs.
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