Speaker 1: (00:00)
The San Diego County contact tracing program was envisioned as a mainstay in the fight to stop the spread of COVID-19. The idea was to identify people who had been exposed to COVID-19 and warn them. So They Can Quarantine KPBS Investigative Reporter Claire Traeger Sir Looks At How The County Program Really Worked.
Speaker 2: (00:22)
It was the early days of the pandemic and Jessica wanted to do something, anything to help. So she jumped at the chance to be a case investigator for the San Diego Counties Contact Tracing Program.
Speaker 3: (00:34)
It was a pretty steep learning curve that Weaver threw, uh, into the mix within just days of training. But, uh, after a few days of pretty rigorous training, uh, I’d say I got the hang of it pretty quickly.
Speaker 2: (00:54)
KPBS is not using Jessica’s real name and has distorted her voice to protect her livelihood. She is part of a contact tracing program which at one point employed nearly 1,000 people and has so far cost the county millions, despite this commitment it has become clear within months that it is not wasn’t enough to stop the spread during the summer surge of 2020, only 11% of people with COVID-19 were contacted by a case investigator that day, well below the county’s goal of 70%. Now, more than 18 months into the pandemic, experts are looking into the program to examine how it could have been modified, to be more effective. Rebecca Fielding Miller is an epidemiologist at UC San Diego
Speaker 4: (01:42)
Contact tracing is most useful when you think it’s about putting out flare-ups rather than dealing with a wildfire. Uh, so in the very beginning, uh, February, March, April, uh, yeah, it was really important to catch those breakouts so quickly
Speaker 2: (02:07)
Because we might county officials wouldn’t agree to be interviewed for this story, but county spokesman Michael Workman insisted in email responses to questions that the program is still worth it. He acknowledged that even now the county is only able to interview about 50% of those exposed. Jessica thinks her job has made a difference, but the job has had a significant impact on her mental health, especially since the COVID vaccine became available and the virus became even more politicized. People will yell at her and tell her she can’t control them. And that COVID is a myth.
Speaker 3: (02:48)
There are people who just don’t want this information or potentially go out into the community after maybe testing positive or being exposed, knowing that they are potentially exposing other people.
Speaker 2: (03:10)
Then another setback as vaccination rates rose and case numbers declined in the spring and early summer, the county nearly halved its contact tracing staff then, as the Delta variant increased , the county attempted to rehire contract tracers who had been laid unreported cases will likely rise again during the holiday season, but in 2022 and beyond, as COVID becomes rampant, no pandemic contact tracing will occur. will prove particularly useful. So says Fielding Miller, the epidemiologist,
Speaker 4: (03:45)
The analogy of forest fires. We’ll be more in a place where we keep an eye out for hotspots. The sooner you can stop a hotspot from spreading, the better off everyone will be.
Speaker 2: (03:57)
Meanwhile for Jessica, the grief continues
Speaker 3: (04:00)
The news. Someone called me yesterday asking if the county could help me in any way. Uh, because she was going to miss 10 days of work and her employer wasn’t paying her any sick pay,
Speaker 2: (04:16)
Right? The stress that she will continue to work as long as she needs to.
Speaker 1: (04:22)
I am accompanied by investigative journalists from KPBS, Claire Tresor and Claire. Welcome. Thanks. Now, last year’s COVID tests were harder to get and took longer to get results than today. So how has this affected the contact tracing program?
Speaker 2: (04:37)
Right. Well, first of all, you didn’t necessarily know, uh, whether you were positive or not. I mean, if we think about it, it’s hard to remember, but in March and April of 2020, and people were getting sick and they just weren’t able to get tested necessarily, uh, you had to have quite severe symptoms. Um, and so people weren’t testing positive and therefore weren’t getting calls from contact tracers and contact tracers. Did not contact people with whom they had close contact. And then the other thing is just that if you get a call from a contact tracer saying, you know, someone you’ve been in close contact with has tested positive, there weren’t necessarily any tests available for you then to go out and see, uh, if you had caught the virus from this person. And when
Speaker 1: (05:25)
I did not test positive for COVID at the height of the pandemic, were there any barriers to tracing these contacts,
Speaker 2: (05:33)
Right? Yes. So like we said at the beginning of the story when there weren’t so many people testing positive they were fine because the goal was always just for them to start investigating the case within 24 hours after a person tests positive. Uh, so that means, you know, having them on the phone and going through the list of people they had been in close contact with, but then they reopened, you know, lifting the stay-at-home orders. Restaurants were open, people were back and we had that first real push in the summer of 2020, case investigators and contact tracers were just overwhelmed. The number of new cases they were able to start within 24 hours dropped to 11%. So they just didn’t have enough people to call everyone who had tested positive and do this in-depth interview with them. Uh, Rebecca Fielding Miller, epidemiologist D mentioned that in Asian countries like China or Taiwan, where they really do serious contact tracing, they just have thousands and thousands of extra contact tracers that work, uh , than we had in the United States to be able to track everything.
Speaker 1: (06:43)
Can you remind us Claire, how contact tracing works? In other words, what does the tracer ask of the person whose test is positive?
Speaker 2: (06:51)
Right. So you get this call, uh, if you’ve tested positive and they, they go through, you know, everything you’ve done, basically in the last two weeks, what stores you’ve been to, you know , if you went out to eat, if you went to work, to the office, uh, and then, you know, who you live with, who else you might have been in close contact with? And I think the definition was always that you had spent 15 minutes or more with a person. So you’re really trying to remember everything you did, uh, so they could collect all these trade names, and then, uh, collect all the names and contact information. If you had it, people with whom you had been in close contact,
Speaker 1: (07:34)
And then what do they do with that information? What do they say to the people on the other side?
Speaker 2: (07:38)
Right. So it’s the role of the case investigator who goes through someone who is a case who is a positive case. And then they pass those contacts on to the contact tracers who then reach out and say, uh, you know, someone you’ve been in close contact with has tested positive for COVID. And so you’re now, uh, obligated, or we’re asking you to, uh, stay home for the next two weeks to self-quarantine and, you know, get tested, monitor your symptoms, uh, things like that. So the idea is to prevent those people from there, if they continue to test positive, from spreading the virus further. And is
Speaker 1: (08:16)
Is the contact tracing program still ongoing?
Speaker 2: (08:19)
Yes. Yes it is. Uh, they’re shrinking, they halved the number of contact tracers they had after, uh, vaccines became more widely, widely available. And we started seeing cases go down, but then, uh, the Delta variant came up and cases went up and they tried to rehire people. And so, yes, it continues. In fact, about a month ago I got a call from a contact tracer because, uh, someone in my son’s class had tested positive. Of course, I already knew that from school, but, uh, she called and told me that my son had to be quarantined for two weeks, which we already knew too. But that’s, that’s how the call goes, I guess.
Speaker 1: (09:03)
And that suppressed anger that Jessica in your story says she experiences, has it increased?
Speaker 2: (09:09)
Yes. She says, uh, it just became a whole different world. Um, in the beginning, people were really, you know, grateful and grateful for the information. They were scared, you know, they didn’t know what was going on. And she says now a lot of the calls she gets are from people who just refuse to cooperate with her. They will not give contact details of people they have been in close contact with. They say, I’m not staying home. You know, COVID is a myth. The government can’t control me, things like that. And, you know, yell at him. And so it’s just, it’s become a whole different ball game. She says,
Speaker 1: (09:47)
You know, it’s surprising that Dr. Fielding Miller would say that when COVID goes from a pandemic to an endemic virus, contact tracing will be most valuable. Can you explain why? Yeah,
Speaker 2: (09:59)
I think the idea is that contact tracing only really works when you can somehow keep control of the number of cases. So when there’s just, you know, rampant spread and people everywhere are testing positive, you know, it’s kind of pointless, I guess, in some ways trying to call everybody and trace the cases, but when it’s become less of a common thing that hopefully fewer people will have it, then it really makes sense to say, okay, you know, this isolated person tested positive. Let’s get in touch with all their close contacts and, you know, try to stop the spread that way. When it’s something more like a rare virus.
Speaker 1: (10:42)
And does the county think enough contact tracers are in place now in case there is an increase in COVID cases over the holidays?
Speaker 2: (10:50)
Well, you know, like I said in the story, uh, they wouldn’t make anyone available to do an interview with me. Um, I think they would say, you know, by hiring people after the summer, they were able to stay on top of the cases and, you know, hopefully they would have that capacity to further increase their numbers if they needed them. Uh, if cases increase overall,
Speaker 1: (11:16)
I spoke with KPBS, investigative reporter, Claire Tresor and Claire. Thanks a lot. Thanks.
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