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States Nearly Doubled Plans For Contact Tracers Since NPR Surveyed Them 10 Days Ago


We are investigating the relentless math of containing the pandemic. The next phase of fighting the coronavirus leans heavily on contact tracing. And numbers will measure the result. How many people have tested positive? How many people have they recently contacted? And how quickly can those people be quarantined?

To establish those numbers, the United States needs a very large workforce of people to do contact tracing. Are we hiring enough people? NPR's Selena Simmons-Duffin has spent the last week putting that question to officials in every single state, along with Puerto Rico and the District of Columbia. And she's on the line. Selena, good morning.


INSKEEP: What'd you find?

SIMMONS-DUFFIN: So we were able to get data from 41 states. And the total they currently have added up to 7,300. Most states said they were planning a hiring surge. And after that, we will have 35,600. This is a snapshot from the past week. And a lot is in flux. But that's our best estimate for what's planned, more than 35,000 contact tracers nationally.

INSKEEP: Which sounds like a lot. But is that enough?

SIMMONS-DUFFIN: The short answer is not even close. Yesterday on the show, you had some influential former officials saying the country needs 180,000 total. Other estimates have put the number needed at 100,000. Here's what Tom Frieden, former CDC director, told me about the totals we found.

TOM FRIEDEN: It's a start. I think an increasing number of health departments around the country recognize the need to substantially scale up activities.

SIMMONS-DUFFIN: One guidepost some epidemiologists have been using is, during a pandemic, you want 30 contact tracers per 100,000 residents. Only one state has that now and it's North Dakota. After the planned surge, only three more places will - Michigan, Nebraska and the District of Columbia.

Of course, if you have a huge population, this is a bigger task. California wants 10,000 contact tracers. And even then, it won't meet the threshold. A few other states that are building up - Louisiana is hiring 700 contact tracers. Texas is working towards 4,000, which has not been previously reported. And we have a state look-up online so you can see how your state stacks up at

INSKEEP: OK. First, thanks for doing this work since this is being done state by state, which makes it hard to keep track of. Second, because it's not a federal effort, it is in the hands of every individual state. Does every state need to do more here?

SIMMONS-DUFFIN: So no one knows where this virus is headed or how severe a local outbreak could get. And as states ease social distancing, a situation that seems under control could change quickly. Still, a few states told us they were not planning to hire more. Minnesota was one.


SIMMONS-DUFFIN: Other states said, hey, we're playing this by ear. If we need more, we'll get more. I talked to Crystal Watson. She's a senior scholar at the Johns Hopkins Center for Health Security. And she warned against this approach. Here's what she said.

CRYSTAL WATSON: It really is not a wait and see if we need it. It's we need it in order to open up and manage epidemics in different locations as they arise.

SIMMONS-DUFFIN: She says contact tracing is fighting back against the epidemic at its source. And it's a smart investment even if you ultimately overshoot and have too many contact tracers.

INSKEEP: Could some of the tens of millions of people who've filed for unemployment in recent weeks get these jobs?

SIMMONS-DUFFIN: Well, certainly. You don't need to be an epidemiologist to do it. But it is a job that takes empathy. Here's how Tom Frieden explained it.

FRIEDEN: You have to be able to engage in conversation with the patient. Earn, maintain their trust. Respect their confidentiality and privacy. Then you have to reach the contact, develop that same human bond with them.

SIMMONS-DUFFIN: There are lots of ideas from states on where to find contact tracers - medical students, the National Guard. And then there's the CDC, which has dispatched about 500 workers and plans to more than double that.

INSKEEP: OK. Up to 1,000. But we're talking about 100,000 or more. Are states having trouble paying for more contact tracers given that they all now face fiscal issues?

SIMMONS-DUFFIN: Right. One estimate for 100,000 tracers is it could cost $4 billion. States said they could really use more money from the federal government and more guidance on how to do this, how to create a giant, public health workforce on a dime.

INSKEEP: Selena, thanks for your reporting.


INSKEEP: NPR's Selena Simmons-Duffin. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.