There’s not much “tracing” in Florida’s COVID-19 contact tracing program

Contact tracing can break the chain of disease transmission, according to the Centers for Disease Control and Prevention.

The White House calls contact tracing “one of the state’s primary preparedness responsibilities” in the fight against the COVID-19 pandemic.

Australia’s prime minister credits diligent contact tracing with keeping his country’s coronavirus death toll at just under 1,400.

But while Florida is spending tens of millions of dollars on contact tracing, it can’t say whether the program is helping slow the coronavirus.

The state Department of Health does not know how many calls have come through its contact tracers because it does not keep track of them, a department spokesperson told the Tampa Bay Weather in spring. Since then, the state has not responded to more recent requests for information.

Additionally, Florida is only doing some of the contact tracing work as outlined in CDC guidelines.

Armed with a list of people who have tested positive, contact tracers should call them, inform them of the test results, obtain a list of people they have come into contact with, and then contact to notify those people, says the CDC.

In Florida, callers tell many infected people to contact their contacts themselves.

This practice raises two questions: Will patients be reluctant to tell others they have COVID-19 and make calls on their own? And does that conflict with the advice of federal civil rights attorneys that callers should refrain from identifying the patient — nearly impossible if it’s the patient calling?

It’s unclear if contact tracers in Florida are calling anyone other than the patient. Ministry of Health job postings for vacancies make no reference to contacting a patient’s contacts, only interviewing patients, compiling a list of their contacts and providing information and recommendations to patients.

Contact tracers in Florida tell patients to ‘tell people you had close contact with while you were sick that you tested positive’ and ‘tell them to self-isolate for 14 days’ . The state defines a “close contact” as anyone who has been within 6 feet of an infected person for more than 15 minutes.

Governor Ron DeSantis made his views on contact tracing clear in March, speaking to reporters during an appearance in Palm Harbor.

“I think we have to admit that contact tracing just didn’t work, okay?” said DeSantis.

But contact tracing can work, said Thomas Hladish, a researcher at the University of Florida’s Emerging Pathogens Institute, who previously worked as a software developer and epidemiologist with the state Department of Health.

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It’s not working in Florida because the state has failed to create a comprehensive contact tracing strategy — a task he described as herculean.

“It’s like walking up to a burning house with a water gun and saying water doesn’t put out fires,” Hladish said. “You didn’t do it right in the first place.”

Trinity’s Judie and Matt Faivre waited for a contact tracer to call them after contracting the coronavirus in September and quarantining for two weeks at home.

The 70-year-old couple had been careful to limit their exposure to the virus as Matt had underlying health conditions. They still wear masks, even today, and got vaccinated in January. They believe they contracted the virus when Matt played with his band for the first time in a year one day and attended a wake the next day.

No contract tracer ever called.

“I was surprised,” said Judy Faivre. “My friend in New York, her sister got COVID and was on the phone for two hours giving them all kinds of information.”

Even if they’re just calling the patient, contact tracers are overwhelmed with workloads of 100 to 150 a day, said Dr. Douglas Holt, director of the Hillsborough County State Health Office.

“Bottom line, contact tracing is not effective or designed (for) the level or number of cases we’re seeing,” Holt said. “But that doesn’t stop us from trying to reach everyone as quickly as possible.”

Another challenge is trust. Caller ID will often tag contact tracers as “Florida Department of Health” but sometimes as “potential spam” since many of them work remotely, Holt said. Real scammers have also made people suspicious, so they either hang up or hesitate to answer questions.

At the start of the year, 4,400 people statewide were involved in contact tracing, said Alberto Moscoso, a former spokesman for the Department of Health. The breakdown was 2,600 state employees and 1,800 contract workers, including 412 public health students and 645 workers provided by private health and social services contractor Maximus.

“The need for contact tracers is continually being assessed and adjusted as needed based on caseloads,” Moscoso said.

Moscoso spoke to the Time in the spring and the numbers quoted earlier this year. He has since left the agency. The state and its county branches did not respond to multiple requests for more recent numbers, or interview requests to further explain their efforts.

To stop the spread of the disease, communities would need 30 contact tracers per 100,000 people, according to the National Association of County and City Health Officials. That means Florida, with a population of 21.5 million, would need about 6,443 contact tracers, or 2,000 more than it has.

It’s unclear how many contact tracers are currently working for the state. Liz Halloran, a spokeswoman for Maximus, confirmed in an email that the company’s contract with the Florida Department of Health ended more than six months ago on March 31.

A measure of calls made by contact tracers in Florida indicates that they dropped dramatically after the summer surge that followed the outbreak of the pandemic in March 2020.

In a report to the state, contractor Maximus said its contact tracers made 535,136 calls statewide in July 2020, but less than half that number the following month.

An earnings report that Maximus sent to its shareholders in February 2020 valued the value of its contract with the Florida Department of Health at $73 million over six months. That’s in addition to the $138 million DeSantis has earmarked to support “not just contact tracing, but other staff,” he said in a 2020 budget announcement.

Meanwhile, Florida – with a population of 21.5 million – recorded 1,719 coronavirus deaths last week. That’s more than Australia, with 26 million people, has recorded since the virus emerged 19 months ago.

CORRECTION: Thomas Hladish is a research scientist at the University of Florida. An earlier version of this story incorrectly described his employment.

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