Tennessee ends most COVID-19 contact tracing

FILE - In this Monday, May 11, 2020, photo, Salt Lake County Health Department public health nurse Lee Cherie Booth points to a board showing a hypothetical case that serves as a training tool to teach new contact tracers how to track all the people they need to reach out to after a person tests positive.

The Tennessee Department of Health will stop investigating the vast majority of COVID-19 cases and instead focus contact tracing efforts on high-risk settings only, according to a department spokesperson.

Spokesperson Bill Christian said in an email the state is in the process of reviewing recently released recommendations that support no longer trying to trace the chain of transmission for every positive case.

"At this point in the pandemic, the public knows the appropriate actions they should take if they are COVID positive or suspect they have been exposed," Christian said. "States have the opportunity to transition to more effective and strategic approaches. As such, our universal contact tracing efforts will decrease significantly over the coming weeks and months with our efforts remaining on case investigations in more high-risk settings."

The department's contract with Xtend Healthcare - a for-profit medical billing firm that took over COVID-19 contact tracing for the state in June 2020 - ended Jan. 31, he said.

Contact tracing was key to understanding and slowing the spread of coronavirus in the earlier days of the pandemic. When a COVID-19 case was confirmed, case investigators worked to determine the infected person's whereabouts and help notify their close contacts that they, too, could be infected and should be tested and quarantined.

But both the virus and other circumstances have changed in recent months, and many public health experts agree universal contact tracing is now much less useful.

Tracking from the National Academy for State Health Policy shows that over a dozen other states have announced they are scaling back their contact tracing efforts.

Christian referenced a joint statement from five national organizations, including the Association of Public Health Laboratories and Association of State and Territorial Health Officials, dated Jan. 24 that says universal case investigation is much less useful and feasible due to the highly-contagious omicron variant, widespread vaccination in the U.S. and the large number of asymptomatic and less severe cases.

Contact tracing for omicron is difficult in part because there are so many more cases and because its incubation period is much shorter, meaning people who are infected fall ill much faster and risk spreading disease sooner, according to the statement.

(READ MORE: Hamilton County's record COVID-19 case levels persist, 1,000 deaths surpassed)

Also, the rise in at-home tests means many infections are never reported to public health agencies.

"Consequently, only a very small portion of total cases and close contacts are being reached by public health contact tracers in time to prevent onward transmission," the statement reads. "Therefore, it is appropriate for our public health agencies to transition our resources into more effective strategies to lessen the impact of COVID-19 by focusing surveillance and prevention efforts on the most severe outcomes of COVID-19: hospitalizations and deaths."

The statement said contact tracing remains an important tool for preventing COVID-19 in the most vulnerable populations, especially in certain high-risk settings, such as correctional facilities and nursing homes. It also remains vital in controlling other infectious diseases, such as measles, tuberculosis, hepatitis A and sexually transmitted diseases.

Officials from the Hamilton County Health Department said they continue to contact trace when possible based on U.S. Centers for Disease Control and Prevention guidance.

"We still do reach out to these people when capacity allows it as much as we can," said Megan Sloan, an epidemiologist at the Hamilton County Health Department, who said most people have no idea where they contracted COVID-19 because community spread is so high at this time.

A data tracking page by Jesse Houser, a volunteer data analyst who worked with the local COVID-19 task force in the past, shows that the health department was able to trace to the source only 4.23% of new COVID-19 cases in the county in the past week.

Contact Elizabeth Fite at efite@timesfreepress.com or 423-757-6673. Follow her on Twitter @ecfite.