Part 4 of The CIDRAP Viewpoint series, “based on our current reality and the best available data.” Contact tracing is most effective early in the course of an outbreak, or much later when other measures have reduced disease incidence to low levels, e.g. it was “key in the late stages of the smallpox eradication program.” It is most effective when cases and contacts can be quickly and easily identified; less effective when contacts are difficult to trace (e.g. situations with airborne pathogens), the incidence of infection is high, or many infections are asymptomatic.
Among the 11 recommendations:
- Efforts are urgently needed to rapidly assess the value, outcomes, and benefit of tracing programs. “Adapting a ‘one-size-fits-all’ approach is not optimal”;
- Data are needed to determine if there is sufficient benefit to justify the cost of widespread contact tracing, and determining the “end game” when the effort can be slowed or demobilized;
- Efforts are need to define benchmarks for success, e.g.: what percentage of contacts need to be identified in what timeframes, and what follow-up is needed;
- Ongoing assessment is needed to evaluate training methods for contact tracers and strategies for improvement, especially culturally appropriate ways;
- National guidance is needed on how to promote compliance with contact tracing efforts, e.g.: communication tools or incentive programs;
- An easy mechanism is needed to share and discuss best practices for COVID-19 contact tracing and related activities.