Lessons Learned Through the Implementation of a Large-Scale COVID-19 Contact Tracing Program

The integration of COVID-19 contact tracing (CT) with support services may have improved cases’ adherence with isolation guidelines and diminish pandemic-related hardships. Despite this, the timing of CT relative to infectiousness and difficulty eliciting non-household contacts may have attenuated the intervention’s effect.

Case investigation and contact tracing (CI/CT) programs were widely implemented during the first years of the COVID-19 epidemic but have since largely been de-emphasized in the United States COVID-19 control strategy. There is limited data available to inform decisions about how much to invest in CI/CT in the current stage of the COVID-19 pandemic or in future pandemics. In the Journal of Public Health Management and Practice, we describe the implementation of the Public Health-Seattle & King County (PHSKC) CI/CT program and evaluate its reach, timeliness, patient-reported impact on adherence to isolation guidelines, and provision of support services. We found that the integration of COVID-19 CI/CT with support services provided tens of thousands of households directly impacted by COVID-19 with prevention education and guidance, groceries, and referrals for financial assistance and other services, which may have improved cases’ adherence with isolation guidelines and diminished the effects of the pandemic on disproportionately impacted communities. Despite this, the epidemiologic impact of the intervention is uncertain, given cases’ reluctance to name non-household contacts and the fact that most infected persons likely received the intervention after their period of greatest infectiousness. The uncertainty of CI/CT’s impact on disease transmission needs to be weighed against CI/CT’s demonstrated potential in advancing health equity objectives, especially as public health agencies consider programmatic priorities for managing endemic COVID-19 on a longer time horizon.


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Author Profile

Julia Hood
Dr. Julia E. Hood is a Senior Epidemiologist at Public Health – Seattle & King County and holds affiliate/adjunct faculty positions with the University of Washington and Seattle University.  Over the past 15 years, Dr. Hood has led the development and implementation of surveillance projects, studies, program evaluations, and risk assessments in the context of COVID-19, substance use, and HIV/STD.