According to the Centers for Disease Control and Prevention (CDC), contact tracing is part of the process of supporting patients with suspected or confirmed infection. Public health staff work with a patient to help them recall everyone they have had close contact with in a short time period (a week or two). Staff or hired workers contact the exposed individuals that they may have been exposed. The identity of the patient is kept confidential. Contacts are provided with information to monitor themselves for illness and to let them know that they could possibly infect others. Contacts are asked to stay home and maintain social distance from anyone for 14 days. The CDC recommended checking your temperature twice a day, and watch for coughing and shortness of breath. If so, they should be evaluated by medical staff and possibly tested.

Massachusetts Contact Tracing

Massachusetts has launched a contact tracing effort to contain the coronavirus. As of today, Massachusetts is one of only a few states in the country conducting widespread contact tracing, according to Massachusetts Gov. Charlie Baker. According to chief strategist and co-founder of Partners in Health, Dr. Paul Farmer, the goal of contact tracing is to stop, not just slow, the spread of the virus in Massachusetts. Chief medical officer, Dr. Joia Mukherjee, helped organize similar projects to fight Ebola in West Africa and cholera in Haiti. She argues that we must go on the offensive against the virus, otherwise, “we’re going to get creamed. Instead, “lets use tools that can reach into that silent epidemic and start to cut that off.”

Andrew Cuomo announced that a tri-state (NY, NJ, CT) contact tracing will begin shortly with funding from Michael Bloomberg through a grant to the Johns Hopkins University.

Is there is a need for contact tracing where you and I live? I live in Georgia, and the governor has decided to open the state for certain businesses by next week. In my opinion, we aren’t ready for this, and the state should initiate a contact tracing program like other states. Unfortunately, I don’t think that will happen.

In the meantime, here is a case study of the country, bigger than most U.S. states, that carried out a contact tracing program that “flattened the curve” in its country. We can learn a lot here.

This article is republished from The Conversation under a Creative Commons license.

South Korea’s Contact Tracing

Michael Ahn, University of Massachusetts Boston

As countries around the world consider how best to reopen their countries, it’s worth considering how South Korea has been able to “flatten the curve” and even hold parliamentary elections without resorting to lockdowns.

After seeing an initial spike in COVID-19 infections in February, South Korea implemented several measures to bring the disease’s spread under control, a progression I’ve followed as a researcher on public policy. South Korea was able to lower the number of new infections from 851 on March 3 to 22 infections as of April 17 and the mortality rate from COVID-19 hovers around 2%.

Several measures contribute to Korea’s success, but two measures were critical in the country’s ability to flatten the curve: extensive testing for the disease and a national system for promptly and effectively tracking people infected with COVID-19.

Testing and triage

From the 2015 MERS outbreak, Korea learned that infection to medical staff sapped the ability to control the virus as infected citizens in hospitals turned them into hotspots for infection. As a result, at the onset of COVID-19 infection, the Korean government ensured that proper personal protective equipment was provided to avoid infection to the medical staff. It also created physically separated testing and treatment sites for health care workers.

Once safe testing and treatment facilities were secured, the government began testing for COVID-19 at massive scale – over 440,000 people – which essentially covered all those with symptoms. People who test positive are quarantined in COVID-19 special units and treated.

South Korea focuses attention on treating people with severe symptoms and therefore less likelihood of recovery, rather than focusing on people with mild symptoms. This helped lower the mortality rate of COVID-19, as some of the most vulnerable populations with severe symptoms recovered. Countries focusing their effort on treating patients with a greater likelihood of survival may lead to a higher mortality rate as more vulnerable patients perish.

Extensive testing is a crucial step in identifying the state of the infection in the country – where the outbreaks are taking place, who is infected and who is not. This data then becomes a stepping stone for identifying any hotspots of infection in the country and to trace and identify the population that came in contact with those infected.

COVID-19 contact tracing system with roots in MERS

What distinguishes the Korean model in controlling COVID-19 is its ability to trace individuals diagnosed with the disease who may have come into contact with the infected individuals. It’s known as the COVID-19 Smart Management System (SMS).

South Korea’s Centers for Disease Control and Prevention (KCDC) runs the contact tracing system that uses data from 28 organizations such as National Police Agency, The Credit Finance Association, three smartphone companies, and 22 credit card companies to trace the movement of individuals with COVID-19. This system takes 10 minutes to analyze the movement of the infected individuals. For people who come in contact with an infected person, the KCDC informs the local public health center near the infected citizen’s residence and the health center sends the notification to them. If they test positive, they are hospitalized at the COVID-19 special facilities. Those without symptoms are asked to remain self-quarantined for 14 days.

The legal basis for accessing such personal information was prepared after the 2015 MERS outbreak when the government learned that tracing the movement of infected individuals and people who came in contact with them is crucial. As a safety measure, only epidemic investigators at KCDC can access the location information and once the COVID-19 outbreak is over, the personal information used for the contact tracing will be purged.

Could the US emulate South Korea?

South Korea’s model – relying on rapid testing availability, safe COVID-19 medical facilities and a government-run contact tracing system – helps avoid an authoritarian approach of shutting down an entire city as we have seen in China. A forced lockdown has democratic and human consequences of restricting individual freedom and stockpiling. It may have lasting consequences in the post-COVID-19 world such as the abuse of political power and the threat to freedom through intrusive surveillance.

Currently, the U.S. is considering re-opening the country or states out of concern over the economy. But without effective measures in place to contain the virus, it may lead to exponential growth in infection again.

Epidemiologists have said the key in defeating COVID-19 pandemic is in identifying hotspots of infection and severing the vicious cycle of infection. An effective contact tracing system is a crucial component in this approach and this can be potentially emulated in the U.S.

The U.S. has the necessary technology and data and the government could form a partnership with the relevant entities, such as credit card and telecommunications companies, law enforcement, health care, and other related public and private organizations to create a COVID-19 contact tracing system. With the help of such system, the government could identify the infected population and hotspots, trace and quarantine them for treatment in medical facilities that are, with government’s continued effort, supplied with the necessary PPE.

At the citizen level, the practice of wearing masks and social distancing should be strongly encouraged to prevent infection while the government tries to flatten the curve.

Currently, there is a sense of normalcy returning to South Korea. No cities are under lockdown, the restaurants, churches, bars, gyms and learning institutes are allowed to open if they observe the government quarantine guidelines, trains and buses run on schedule, grocery stores are fully stocked, and the country just successfully held parliamentary elections in mid-April. Citizens wear masks and exercise social distancing at all times which helps preventing further infection. South Korea’s approach to COVID-19 with its focus on technology suggests a possible path for the U.S. in reopening the country without having to subject citizens to the coercive authority of the state and compromise our democratic ideal.

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Michael Ahn, Associate Professor and MPA Graduate Program Director, University of Massachusetts Boston

This article is republished from The Conversation under a Creative Commons license. Read the original article.