We Need a Contact Tracing Army

And colleges should urge students to enlist, Howard Koh and Michael Fraser write.

October 22, 2020
 
 
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It’s no surprise that more than 88,000 new COVID cases have roiled college and university campuses since the fall semester began. Students, like the rest of America, are now confronting viral spread exacerbated by an unacceptably underresourced public health system.

But instead of simply blaming students for the problem, what about viewing them as part of the solution? For starters, colleges could encourage students to help amplify the work of health agency-based contact tracers in their communities. Using the microcosm of campuses as a testing ground could generate more modern-day contact tracing experiences, not just for colleges but also the country at large.

A number of colleges have already partnered with their local health departments to signal that the future of public health means harnessing the energy and commitment of young people. In recent years, public health budgets, usually less than 3 percent of any state or federal budget at baseline, have faced repeated cuts in staff and other resources that have made health promotion and disease prevention next to impossible. For example, federal public health emergency-preparedness funding per capita has been cut by nearly a third since 2002. Nearly 50,000 public health jobs have been lost in recent years and, astonishingly, workers have even been furloughed in the midst of the pandemic.

With health departments desperately looking to build contact tracing armies, students could enlist as part of their community volunteer programs. Many students have already begun training either online and/or by shadowing current health department tracers. To begin, all that is needed is a commitment to serve as empathetic local health promoters for their peers. And, with the United States considering introducing new technology and contact tracing apps regularly used abroad, college-aged youth are the ideal stewards to deploy such tech solutions at their alma maters.

Contact tracing efforts at the college level can then grow to support the health of surrounding communities. College experience could easily motivate tracers to pursue further on-the-job training or degrees to prepare them to be epidemiologists, case managers, disease intervention specialists or even managers for immunization campaigns for seasonal flu and eventually COVID-19. Their attention to COVID co-morbidities -- such as obesity and tobacco/e-cigarette use -- could generate broader health promotion benefits. Doing so would address both the rapid pandemic of COVID-19 and the slower pandemic of preventable chronic disease that has fueled it.

Contact tracing has already proven vital in interrupting viral spread in Native American communities, as well as countries in Europe and Asia. But in the United States, communities have often hired contract tracers who lack deep knowledge of the populations they are trying to reach as temporary workers or call-center staff. Students can help ground such efforts in dedicated communities. National efforts -- coordinated by the Association of State and Territorial Health Officials, the Centers for Disease Control and Prevention, and several other organizations -- have promoted rapid online training and collaboration with local and state public health departments, encouraged contact tracers to become permanent members of the public health workforce of the future, and brought jobs to those displaced from the hospitality, service and other industries.

Dedicated federal resources and the engagement of youth and local communities must make this all work. National leaders must show they are serious about rebuilding our nation’s public health infrastructure, especially in hard-hit communities of color with widely disparate access to health and services during COVID-19.

Two proposed Senate bills support rapid expansion of a cadre of public health practitioners. The CORPS Act -- which was co-sponsored by Senators Chris Coons, a Democrat from Delaware, and Roger Wicker, a Republican from Mississippi, and has received badly needed bipartisan backing -- would expand the AmeriCorps program over the next four years to place 750,000 unemployed youth in projects related to pandemic recovery. Separately, Massachusetts Democratic senator Elizabeth Warren’s Coronavirus Containment Corps Act calls for $10 billion in funding -- a drop in the bucket compared to the trillions already released -- to hire at least 100,000 workers unemployed during the pandemic as contact tracers, support specialists and case investigators. Such efforts are reminiscent of bold national programs such as the Works Progress Administration and Civil Conservation Corps that restored jobs and well-being for millions during the Great Depression.

Crises require committed and creative responses from everyone, not just the experts. Colleges can serve as laboratories of innovation for the next generation of public health professionals. And such students can revitalize their campuses, inspire communities and bring hope back to a country yearning for a better tomorrow.

Bio

Howard Koh is a physician, former assistant secretary for health in the Obama administration and professor of the practice of public health leadership at the Harvard T. H. Chan School of Public Health and the Harvard Kennedy School. Michael Fraser is chief executive officer of the Association of State and Territorial Health Officials and an affiliate faculty member at the George Mason University College of Health and Human Services.

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