What Is Contact Tracing and How Does It Work?

Contact tracing has been around for decades and could prove to be a lifesaver in the time of COVID-19. Learn the details of contact tracing.
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For Dan Bailey, there was no learning curve when he came face-to-face with a contract tracing experience stemming from COVID-19.

Bailey, president of WikiLawn Care, an online resource for lawn care professionals, was contacted in early May by local public health officials and told he’d been in contact with someone who had tested positive for the coronavirus.

He says the experience was a strange one, to say the least.

“When I got my call, I wasn't told the name of the infected patient,” he said. “I was just told that I'd come into contact with someone who was verified as testing positive for the coronavirus.”

Once contacted, Bailey said he was given knowledge and resources and told what to do for the next 14 days to limit his contact with other individuals. “I was told I didn't have to get a test unless I started showing symptoms, but since they were allowing testing for asymptomatic people at that point anyway, I went ahead and got tested.”

For Bailey, the entire contact tracing process was new and somewhat startling. Past that, though, he says he understands the need for it during a time of the pandemic.

“The whole process of contact tracing was painless and not at all as invasive as I think people make it out to be,” he said. “When I first heard the phrase, it seemed a little alarming to me, and I wondered how much information would be kept private in the face of a public health crisis. But from what I saw, I'm pleased to see contact tracing is keeping the public safe while still maintaining patient privacy."

What Is Contact Tracing?

Contact tracing was around long before there were apps or smartphones, and was used for decades to help eradicate smallpox and to help control the spread of HIV. It's never been a very high-tech process, only a manual one that involves tenacity and dedication on the part of public health staff.

How Contact Tracing Works

“Contact tracing is the organized recorded tracing of human movement and the spread of the disease over specific geographical regions,” said Brad Ducorsky, chief executive officer at a UBsafe, a contact tracing app that’s set for a late May rollout. “Contact tracing allows for the government and health institutions to see the spread and direction of the disease in near real-time while alerting individuals of high-risk areas."

“When done right and in a scientifically relevant manner, we will be able to stave off the spread of the virus by isolating areas of infection and encouraging focused testing,” Ducorsky said.

According to the CDC, once a patient is tested and confirmed infected, the contact tracing process for coronavirus involves:

  • Public health staff interview a patient to help them recall everyone with whom they have had close contact during a recent timeframe.
  • Public health staff then warn the exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible, usually by phone.
  • To protect the original patient’s privacy, contacts are only informed that they may have been exposed, but not the identity of the patient who may have exposed them.
  • Contacts are then provided with education, information, and support to understand their risk, what they should do to separate themselves from others who are not exposed, monitor themselves for illness, and the possibility that they could spread the infection to others even if they do not feel ill.
  • Contacts are encouraged to stay home and maintain social distance from others (at least 6 feet) until 14 days after their last exposure, in case they also become ill.

“By and large, the goal is to map an individuals' physical contact with other people over a predetermined amount of time,” said Kristian Romero, a senior marketing manager at VirtualHealth, a health care management firm based in New York, N.Y. “The person's risk of having the disease in question (likely COVID-19, in this case) is assessed based on variables like symptoms, length of time from contact with a known carrier, and/or a positive test,” Romero said.

Once contacted, an individual is asked many questions about where they have gone and with whom they have interacted to determine where (and to whom) the infection may have spread.

The type of information gathered can include public and private locations where the person went; where they may have interacted with businesses or their respective staff; and names and phone numbers of known people the individual came into contact with (like family, friends, co-workers, and acquaintances, Romero said.

“Contract tracing also targets levels of potential exposure, like prolonged face-to-face meetings versus briefly speaking with a bartender across a bar,” Romero said.

Once that data is established, the contact tracing firm and/or a public health office will contact these businesses and individuals that the person at-risk visited. “At that point, people who came in contact with an infected individual can self-quarantine and get their COVID-19 evaluations,” Romero added. "That process aims to check individuals who may be at risk based on symptoms and who are monitored to see if any symptoms arise in a few days or a few weeks.”

The entire contact tracing procedure is highly labor-intensive, Romero noted. "It usually requires a dedicated effort of specialists to call and document a potentially large group of people," she said. "It also requires a sophisticated enough platform for data entry and storage to make sure that anyone who needs monitoring or treatment."

Cooperation and trust from Americans is a critical component of contact-tracing success.

How Are Apps and Smart Phones Used?

The use of contact tracing apps is an emerging public health tool in the fight against COVID-19. 

The apps are intended to support the contact tracing process, not replace it, by helping speed up the public health workers' painstaking process of finding everyone a patient has been in close contact with, according to CNET.

The state of Texas recently signed a $295 million contract with a contact tracing firm, which will help the state monitor residents as to who they’ve been with, when they’ve been with them, and where they were together. The goal is to track and isolate Americans who’ve either tested positive for coronavirus or been in contact with someone who has been exposed to the virus.

“Technology and smartphones are making contact tracing accessible for most Americans, and it will take most Americans to make this technology as accurate and impactful as possible,” Ducorsky said. “Through the use of GPS-based geolocation, real-time data analytics, and self-reporting, it is very possible for Covid-19 tracking in the U.S. in a very short time.”

“Once enough Americans adopt a contact-tracing application, we can make data-based intelligent decisions to help slow down the COVID-19 spread as we all wait for a vaccine,” he said.

The actual contact tracing process using an app isn’t all that complicated or invasive as it sounds. One app allows a person who has tested positive to voluntarily upload information to a server that then lets others find out they've been near someone infected, according to CNET. It can also let you find out if you've been near others who have the disease. It doesn't share your identity, phone number or location with anyone, including the government.

Visualizing the Contract Tracing Process

The contact tracing process.

The contact tracing process.

Privacy Issues Are Still a Big Concern for Many

Even as the pandemic rolls on, Americans aren’t exactly sold on contact tracing, mostly due to privacy issues. Many U.S. adults don’t believe that tracing is effective, anyway.

According to a recent study by the Pew Research Center, six in 10 Americans say that if the government tracked people’s locations through their cellphone it would not make much of a difference in limiting the spread of the virus.

In April, Google  (GOOGL) - Get Report and Apple  (AAPL) - Get Report announced a plan to boost contact tracing effectiveness across the U.S. leveraging Bluetooth communications technology. That news raised eyebrows, as well.

"No contact tracing app can be fully effective until there is widespread, free, and quick testing and equitable access to health care,” said Jennifer Granick, surveillance and cybersecurity counsel at the American Civil Liberties Union. “These systems also can’t be effective if people don’t trust them. People will only trust these systems if they protect privacy, remain voluntary, and store data on an individual's device, not a centralized repository.”

“At the same time, we must be realistic that such contact tracing methods are likely to exclude many vulnerable members of society who lack access to technology and are already being disproportionately impacted by the pandemic,” Granick said. “We will remain vigilant moving forward to make sure any contact tracing app remains voluntary and decentralized, and used only for public health purposes and only for the duration of this pandemic."