Rapidly increasing the scale, speed, and effectiveness of contact tracing in the US

Problem

A fundamental tool in the fight against COVID-19 is contact tracing, the process of identifying people who have come into contact with someone who has an infection, so they can be quarantined, supported, and tested until the train of transmission stops. According to the Centers for Disease Control and Prevention (CDC), the plan to ease lockdown measures across the country relies on both ramped-up testing and very aggressive contact tracing. Right now, the U.S. health system lacks the critical prevention infrastructure to deploy this effectively. Public health departments are massively under-resourced, outmatched by the speed and scale of the virus’ spread. With mounting public pressure for Americans to return to work, school, and everyday life, the demand for contact tracing will only increase. The CDC also warns that a second wave of coronavirus could be even more devastating, as it is likely to coincide with the flu season. States must build the capacity for contact tracing, testing, and other control measures now to avoid dire consequences.

Big Idea

For 33 years, Partners In Health (PIH) has been a global leader in disease prevention, treatment, and care. They've been on the front lines with governments from Haiti to Rwanda during outbreaks of Ebola, HIV, and tuberculosis — building the capacity of public health systems to develop and implement solutions. With Audacious support over the next year, PIH will disseminate its contact tracing expertise across the U.S., supporting more than 19 public health departments to not only "flatten the curve," but bend it downward and help stop the spread of COVID-19. They plan to customize and scale their programs through a combination of direct technical assistance and open source sharing of best practices. This effort will reduce the spread of COVID-19 in cities and states home to an estimated 133 million people.

Plan

Drawing on their experiences designing and implementing contact tracing programs globally, PIH will support the quick, effective scale-up of contact tracing across the U.S. by providing three tiers of support to a variety of partners well-positioned to deploy contact tracing rapidly. (1) PIH will provide deep technical assistance, embedding small teams of experts for 2-4 months in departments of health to co-create contact tracing programs. (2) For departments of health that already have a command of the fundamentals, they will provide lighter touch technical assistance, advising on select aspects of their approach, as needed. (3) PIH will make their approach available through an open-source, online toolkit and launch a national contact tracing learning collaborative so that organizations can develop, rapidly share, and utilize best practices in contact tracing. Through the online toolkit and learning community, PIH will reach countless other COVID warriors across the globe.     

Why will this succeed?

PIH’s longstanding partnerships with Harvard Medical School and Brigham and Women’s Hospital in Boston have generated decades of evidence on the effectiveness of community-based approaches in reaching the most vulnerable and slowing the spread of infectious diseases. The Governor of Massachusetts recently engaged PIH to design and implement a statewide COVID-19 contact tracing program, and within weeks they received dozens more requests for support from other departments of public health, city governments, NGOs, and private sector partners. Furthermore, PIH has a strong track record of directly implementing epidemic controls (including contact tracing programs), providing technical assistance to governments and health departments, building the capacity of implementation partners, and fostering learning networks. PIH is also a clinical leader of learning collaboratives like the Community Health Impact Coalition and the NCDI Poverty Network.