New York’s program to mitigate the spread of the coronavirus is showing signs of success and executives say it’s largely because New Yorkers from underserved areas are leading the effort.
The city launched its contact tracing program, called NYC Test & Trace Corps, on June 1, shortly after it experienced an onslaught of COVID-19 cases that overwhelmed hospitals. The program, which is overseen by the city’s public health system, NYC Health + Hospitals, relies on about 4,000 New Yorkers from a variety of neighborhoods contacting those who test positive for COVID-19, advising them to isolate, and then asking for the names and contact information of those they have recently interacted with so they can inform them to get tested and quarantined.
Employing New York residents as contact tracers, with half from communities hardest hit with COVID-19 cases, has helped establish the trust needed to convince people to give contact information of family and friends, as well as allowing the tracers to come to their homes for check-ins, said Dr. Ted Long, executive director of Test & Trace Corps and vice president of ambulatory care at NYC Health + Hospitals.
“We believe they are able to connect with the person on the other end of the phone who has also had this lived experience,” he said.
The most recent data from the health system shows that tracers reach 91% of all new COVID-19 cases and 76% of those complete the intake process. The city’s goal was that 90% of cases would be reached and 75% would complete the intake process. The intake process involves the tracer connecting with a person who agrees to isolate, be monitored over the next 14 days and provide contact information for others they’ve seen recently.
The city averages about 30,000 tests a day, which are free, and the positivity rate now hovers around 1%, down from the beginning of June when the positivity rate was 3%.
But New York’s tracing program had a rocky start, with tracers only completing the intake process for less than 70% of all cases during its first six weeks. The slow start fueled criticism, especially from outside public health officials who worried the health system didn’t have the same level of experience with tracing programs as the health department.
“COVID-19 demands an all-of-government response, and what we were able to bring to bear in New York over the last three months has been an all-of-government response to our testing, tracing and isolation program,” Jackie Bray, deputy executive director of Test & Trace Corps, said in defending NYC Health + Hospitals’ efforts.
Bray said the program didn’t hit its stride until mid-July when leadership realized changes were needed, such as more supervisors and more time dedicated to training tracers.
Onboarding for tracers lasts several days and involves training on the epidemiology of COVID-19 as well as cultural sensitivity, implicit bias and sexual and gender orientation. Training continues routinely on key topic areas. “Training is not something that starts and stops,” said Dr. Neil Vora, director of tracing for the Corps.
The city has also messaged to the medical community that they should inform patients who receive a COVID-19 test to expect a call from a contact tracer if they test positive, which has helped increase awareness of the program, Vora added.
In late June, the program launched its doors initiatives, which involves tracers meeting the person at their home at least once. Face-to-face interaction helps build additional trust, Bray said.
The tracers remain in contact with the individual every day for 14 days. In August, text messaging was enabled so tracers can connect with people via text.
The program also involves offering hotel rooms to those who test positive so they can safely quarantine, although it’s rarely used. “It’s not popular at all, but I think it’s important to offer,” Bray said.
NYC Health sends a package with a mask, sanitation wipes, hand sanitizer and thermometer to those asked to isolate or quarantine; those testing positive are sent a pulse oximeter.