Nations around the world are bracing for a second wave of Covid-19, and the countries that have embraced a program of test and trace appear to be keeping the spread under control. Important to understand is that testing must be accompanied by tracing, or there really isn’t much point in testing. If the United States were to adopt the same measures as Germany, for example, it is likely that Covid-19 infections would significantly slow.
Germany made a bold move by legislating mandatory testing for all travelers that have visited Covid-19 hotspots. That meant that every German that had returned from their summer vacation was subjected to a test as soon as they returned home. German authorities managed to do this by sending mobile testing units to border crossings, airports and railway stations.
When the test results come in, positive cases are then ‘traced’. Teams of contact tracers will consult with the Covid-19 patient to discover who they had recent contact with. All contacts are then telephoned to be informed that they may have caught Covid-19 and must self-isolate. If the contact tests positive for Covid-19 themselves, then all of their recent contacts are traced.
By tracing all potential Covid-19 infections, Germany was able to slow the spread and reopen their economy. To pull this off, Germany designated 1 tracer for every 4000 people. In total, Germany only required 21,000 tracers to monitor all 83 million Germans. That is pretty efficient.
“We’ve recruited staff from other district authorities, including social services, but we also have traffic wardens and librarians working for us,” says Dr. Uwe Peters, director of the Pankow district health authority. “We’ve even recruited gardeners from parks and recreation. They all help man the hotline. We also have students helping out and we’re about to be allocated five soldiers as well.”NPR
To date, Germany has had a total of 273,965 infections, and 9390 deaths. To put this in context, Los Angeles County alone has had 260,000 cases and 6,330 deaths. While Germany has 83 million people, Los Angeles County has a population of just under 10.1 million.
Many states have not participated in contact tracing, or have not yet funded a contact tracing strategy. Although federal money has been made available through the Cares Act, there is no national test and trace guideline for states to model their programs on.
Instead of increasing test and trace capacity, the United States had lost much of it’s testing infrastructure by the end of July . Many testing labs do not have the supplies they need, and it can take as long as 10 to 15 days for results to come back. This excessive time-delay in receiving results means that a tracing strategy becomes irrelevant as it is too late to prevent spread of infection.
The consequence of inadequate test infrastructure and long delays in obtaining results is that, according to the CDC, only 1 out of every 10 Covid-19 cases is being identified. That is a really big deal.