The directive has prompted sighs of relief from some weary local health directors, but also concerns about how to impress upon their residents that COVID spreads rapidly with the Omicron variant and should always be taken seriously.
“It’s a difficult needle to thread,” said Timothy McDonald, Needham’s chief health officer. McDonald’s has opted to continue contacting all residents who test positive and tracking their contacts until January, when it drafts a message to residents that explains the changes but still captures the urgency to take precautions.
“We think right now it would be very difficult to get that message across because people’s attention, just on the holidays, is hard to capture,” he said. “And with a new variant. . . is this the right time to do it?
In April 2020, the state launched its Contact Tracing Collaborative, recruiting Boston-based Partners in Health to lead an initiative that state data shows has helped more than 1.2 million people and connected thousands of people to food and other essentials so they can stay home and prevent more infections. The collaboration was made up of workers recruited and trained by partners and local health service personnel. But after a bumpy start, with Partners computers not connecting to health services and cases falling through the cracks, some communities chose not to use the service, while others relied heavily on the help from Partners workers.
Contact tracing is a laborious but essential part of controlling some highly contagious diseases. Tracers are methodically tracking down anyone who has recently been in close contact with someone who tested positive and, if the contact is vaccinated, advising them to monitor their symptoms. If they show signs of COVID infection, they are advised to stay home and get tested. More aggressive advice is given to those who are not vaccinated.
In the early months of the pandemic, with thousands of cases reported daily in Massachusetts, the task overwhelmed health departments, prompting the state to call on Partners in Health.
“At this point, most people in Massachusetts know what to do if they become infected,” said Phoebe Walker, director of the Franklin County Cooperative Public Health Service, which includes 16 communities. “We’re thinking about how best to use our time to stop the spread of the disease, and that shifts our resources from contact tracing to greater vaccination awareness.”
But during testimony Thursday before the Legislative Joint Committee on COVID-19 and Emergency Preparedness, Walker acknowledged that she and many of her colleagues were still trying to figure out how to effect this change in completely safe.
“The public did not hear [about the shift] from the governor, which makes them really confused and angry when a public health nurse doesn’t contact them,” Walker said. “So we need leadership to explain this change to the Massachusetts public.”
Partners in Health workers took their last cases Nov. 30 and all of their work will be completed by Friday, according to a statement from the Baker administration.
“To prepare for this transition, the administration has provided more than $15 million in federal and state resources to local health boards to build local case investigation and contact tracing capacity, and the Department of Health public is preparing to award an additional $4 million to health boards for these efforts,” the statement read.
The Partners-led program has made more than 2.7 million calls to residents since April 2020, and the projected final bill for that work is $157.9 million, the state said.
Other states have also scaled back or scaled back their contact tracing, once a mainstay of the pandemic response, said Crystal Watson, an assistant professor specializing in public health preparedness at the Johns Hopkins Center for Health Security.
“Contact tracing is always valuable because it helps people take the actions we want them to take and creates some accountability,” Watson said.
“Without it, it’s much easier to ignore public health messages about what to do in terms of isolation and quarantine,” she said.
Watson said there are concerns that the fast-spreading Omicron could overwhelm many contact tracing efforts and reduce their usefulness because its incubation period, the time between when someone is exposed and shows symptoms, seems to be half of what it is for previous variants – two to three days, on average, rather than four to five.
“It makes contact tracing a lot more difficult because other people may be infected by then,” she said.
As the pandemic drags on, it’s increasingly difficult to get honest answers from people when contact tracers call, said Sigalle Reiss, president of the Massachusetts Health Officers Association and Norwood’s chief health officer.
“People are clearly lying to you and not telling you their close contacts, and it wasn’t as effective in the field,” she said.
Reiss agrees with the state’s decision to step aside and focus remaining efforts on vulnerable people in group settings.
“With cases climbing so high, even if you just focus on high-risk and institutional settings, it’s still overwhelming work,” she said.
The state has set few parameters on how cities and towns should restructure their tracing efforts, a flexibility that Reiss says is helpful but also problematic because it can confuse the public when many of the 350 State communities take different approaches.
To help fill in some of the gaps, the Baker administration is counting on MassNotify, a service that allows users who test positive to anonymously alert others via software on their cellphones that they may have been exposed to the virus. COVID-19. A person’s cell phone shares anonymous codes – but no identifying information – with other MassNotify users via the phone’s Bluetooth.
Since its launch in June, MassNotify has been activated by 1.74 million users, or 25.2% of the state’s population, the administration said.
But some local health department directors say they will stick to contact tracing in most cases, until it becomes overwhelming.
“We still think it’s important to get in touch, let them know how to take care of themselves and take care of the high-risk people around them,” said Maura Valley, a health worker from Tisbury and public health coordinator for the six communities on Martha’s Vineyard.
Cases are rapidly climbing the vineyard, and Valley said they are “sorting” now, prioritizing contact tracing for those most vulnerable to serious complications from the infection.
“We still see a lot of people neglecting [public health information]”Vallée said. “So it doesn’t hurt for us to reinforce it, as long as we can.
Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar.
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