Local health departments that can't keep up with the rapid spread of the coronavirus are having to adapt. Some Michigan counties are asking people who test positive to do their own contact tracing.
ARI SHAPIRO, HOST:
Several local health departments in Michigan are so overrun with COVID-19 cases that they're asking people to do their own contact tracing. Brett Dahlberg reports there are similar do-it-yourself public health efforts taking place across the country.
BRETT DAHLBERG, BYLINE: Contact tracers in Washtenaw County are more slammed than they've ever been.
MADELINE BACOLOR: There's just so many more people that are gathering and then are exposed.
DAHLBERG: Madeline Bacolor is a contact tracer for the county, which includes Ann Arbor.
BACOLOR: So it used to be, you know, we'd have a case and maybe that person had seen two people. And now, it's a whole classroom full of daycare students, or it's a whole workplace.
DAHLBERG: Contact tracers get in touch with anyone who's been exposed to a person who tested positive for the novel coronavirus. Tracers tell those people about their exposure and walk them through how to quarantine.
BACOLOR: I call people who have been exposed but who don't have symptoms yet and try to keep them away from healthy people who have not been exposed.
DAHLBERG: But the number of exposures is piling up faster than contact tracers can make those calls. And recently, the federal government shortened the recommended quarantine period from 14 days to 10 days. But in Michigan, that only applies to some people in some counties. And now, they have to explain that, too.
BACOLOR: Yeah, it makes things more confusing (laughter).
DAHLBERG: Not only that, but they're making twice as many calls as they did earlier this year. So the health department has tried to shorten the time that they spend talking with COVID-19 patients by getting rid of some interview questions. They're sacrificing information for speed, but they're still not able to keep up. And that's true in hard-hit places across the country, from Virginia to Oregon.
On the brink of being overwhelmed, local public health departments have been forced to try something new. They're asking people to basically do their own contact tracing. Susan Ringler-Cerniglia is the spokesperson for the Washtenaw County Health Department in Michigan. She says people who test positive for the virus should start telling their contacts right away.
SUSAN RINGLER-CERNIGLIA: Basically, you know what to do. Don't wait for us to call you.
DAHLBERG: Because the department can't call everyone, Ringler-Cerniglia says they're prioritizing calls to people like the county's oldest residents, those living in nursing homes, and people who live in zip codes with the highest infection rates. But that means some people outside of those groups won't get calls at all. Public health professor Angela Beck says that kind of prioritization is a good response to a bad situation.
ANGELA BECK: It is a last-resort tool. It's not the ideal scenario. Is it better than nothing? Yes, I think it is.
DAHLBERG: Beck is an expert on public health workforces at the University of Michigan. She says cutting back on contact-tracing calls means health officials will miss information on where outbreaks are happening and who's at risk. They'll lose chances to break transmission chains and slow the virus's spread. Beck says, without enough contact tracers to track the virus at an individual level, the only option left to contain it is a generalized approach.
That's part of what's pushing governments toward really broad restrictions, like shutting down indoor dining and requiring schools to go online. She says this failure was predictable, the result of years of poor funding of health departments.
BECK: The chronic underinvestment in the public health infrastructure in our country has really cost us during COVID-19. We can see the consequences very clearly.
DAHLBERG: Beck and public health officials still want people to focus on the basics like masks and physical distance. And they still want you to answer contact-tracing calls. Just don't be surprised if the person who calls to say you've been exposed is a friend or relative. For NPR News, I'm Brett Dahlberg in Michigan.
SHAPIRO: And this story comes from NPR's partnership with Kaiser Health News.
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