Health experts say contact tracing is the best tool we have to stop the spread of COVID-19 until there is a vaccine. While it’s easy to see how this method could positively impact the infection rate, a debate has emerged on the legality and complexity of nationwide tracing.

So, what, exactly, is contact tracing?

Contact tracing relies on public health workers to track down anyone who may have come into contact with someone with COVID-19, so they can self-quarantine to prevent further spread of the pandemic. The Centers for Disease Control and Prevention (CDC) says “Contacts are 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 they could spread the infection to others if they themselves feel it.”

The CDC suggests communities take action to scale up, and train the large workforce required to work collaboratively across public and private agencies to stop the spread of COVID-19. The federal agency also recommends following certain core principles during case investigation, including:

• Supporting patients suspected or confirmed with COVID-19
• Working with patients to help them recall everyone with whom they have had close contact during the time they may have been infectious
• Warning exposed individuals (contacts) of potential exposure as rapidly and sensitively as possible
• Protecting patients’ privacy by only sharing information with contacts that they may have been exposed to someone with the infection; they are not told the identity of the patient who may have exposed them
• Encouraging contacts to stay home and maintain social distance from others (at least six feet) until 14 days after their last exposure, in case they also become ill. Individuals are advised to monitor themselves by checking their temperature twice daily and watching for cough or shortness of breath – and they are encouraged to seek medical care if needed

Contact Tracing in California

California’s contact tracing program, California Connected, has already launched to help those exposed to COVID-19 get medical care and determine how they might have exposed others to the virus without knowing it. Kaiser Health News reported on June 17 that among those helping the state in its outreach are dozens of librarians trained through a new virtual academy led by the University of California – San Francisco. The state awarded a contract to the university in May to train 20,000 new California contact tracers by July, one of the country’s largest efforts so far. More information about the state’s contact tracing program is available on the state’s COVID-19 web page.

Gov. Gavin Newsom has said counties should have 15 contact tracers for every 100,000 residents to help the state contain the virus as stay-at-home orders end. Health officials have said, based on the analysis of early data, each new person testing positive for COVID-19 was in close contact with an average of four or five people while infectious – usually family members or neighbors.

Through mid-August (8/13), according to the Los Angeles Times, California reported 594,762 confirmed coronavirus cases and 10,813 deaths. While home to only one-fourth of the state’s residents, Los Angeles County has recorded 214,000+ confirmed cases and 5,112 deaths. Based on recent trends, California is doubling confirmed infections every 68.6 days.

New Contact Tracing Technology Comes to the Forefront

TraceTogether, a Bluetooth-based contact-tracing app developed in Singapore, launched in March. Google and Apple rolled out their technology in May. All three apps allow health authorities to access a person’s Bluetooth history on their smartphone and call the people on that list to notify them of the potential need to quarantine. Other countries with similar apps include the United Kingdom, Australia, and Malaysia.

Reuters reported several states and more than 20 countries are interested in the tracing technology; however, it is uncertain how many may actually use it. Critics note the iPhone app needs to be open at all times to work and some encounters between iPhone and Android users, or pairs of older devices, may not be recorded for interactions.

Legal Obstacles to Contact Tracing Tech

Bipartisan legislation was introduced by U.S. Sens. Cantwell (D-WA), Cassidy (R-LA), and Klobuchar (D-MN) in June to protect consumer privacy and promote public health in connection with contact tracing apps. The Exposure Notification Privacy Act regulates apps that track the spread of COVID-19, ensuring individuals’ rights, restricting usage, and empowering the Federal Trade Commission and states’ attorney generals to pursue violations of the act. The full text of the proposed legislation is here.

The FTC published a May notice regarding contact tracing fraud. Individuals posing as contact tracers are sending messages that include a link suggesting it will connect them to health authorities. Clicking on the link downloads software on users’ devices that give scammers access to personal and financial information. The FTC is advising smartphone users not to take the bait, and to consider using a filter to block messages from unknown senders.

Contact tracing has been around, in one form or another, for centuries. It has proven quite effective in helping citizens globally cope with the spread of numerous diseases. It could be very effective in extinguishing the spread of COVID-19.