When someone tests positive for COVID-19, it’s critical to test everyone they’ve had contact with in the preceding 48 hours in order to reduce community spread. The sooner these tests are administrated, the greater the impact on reducing further transmission.1 Unfortunately, a number of challenges make it difficult to achieve this goal.
Challenge #1: Not enough tracers. Public health organizations are staggering under the sheer volume of positive cases. Nearly 301,000 new cases were reported in the first week of October alone.2 The U.S. had about 2,200 contact tracers prior to the pandemic.3 Federal, state and local governments have been working hard to staff and train additional workers, but they still fall far short of the 98,000 tracers that best practices dictate.4 Chronic underfunding and recent budget cuts make it even more difficult for government organizations to scale up staff to perform contact tracing duties.
Challenge #2: Poor response rates.According to a Reuters survey, more than a third of agencies said their contact tracing efforts had been impeded by individuals’ failure to answer the phone or name their contacts when they were approached about test results.5 A number of factors contribute to poor response rates, including concerns about robocalls, identity theft and answering calls from unknown numbers; fear of losing work, being deported or suffering other repercussions; and continued misinformation and distrust about the virus itself.
Challenge #3: No one-size-fits-all strategy. Different scenarios require different approaches to contact tracing and case management. An elderly, high-risk population or a particularly critical case may need more personal, human interaction throughout case management. Younger or healthier individuals, on the other hand, may be better served by automated follow-up calls or text messages once they have received initial notification and testing. Communities that are opening schools and businesses need a different approach than areas that are in the midst of rising infection rates.
To speed contact tracing and make it as effective as possible, forward-thinking state and local governments are using artificial intelligence (AI) and machine learning to automatically track, monitor and notify contacts across a variety of channels. This technology also enables agencies to automatically suggest next steps, identify infection hot spots and improve communications between call center agents and the people they contact.
In addition to boosting response rates, expediting processes, and improving accuracy, automated AI-driven solutions free up call center staff to focus on more complex cases and one-on-one interactions with individuals who need more attention. They also enable staff to reach thousands of constituents with minimal involvement. In Harris County, Texas, officials are using the technology not only to deliver COVID-19 test results and follow-up instructions but also to proactively engage with citizens about elections and voting, including their registration status, where to vote, how to register and more.
On the whole, AI and automation capabilities enhance the contact tracing process in a number of keyways:
- Automated communications for outbound voice calls, SMS, and email across any device
- Automated forms for completing intakes, surveys and other processes
- AI virtual agents that use natural language processing to make intuitive patient contact, helping to fill gaps in staffing and free call center staff from routine tasks related to exposure notification, testing referrals, symptom monitoring and other activities
- AI-driven voice analysis that intelligently prompts agents with suggested responses based on a contact’s words, phrases, accents and other language properties and thereby improves the call experience
- Cloud-based proactive notifications (with response tracking, text interaction and auto-forms features) for automatically reaching out to individuals or groups to collect critical information, make referrals for testing and clinical services, and better inform next steps
- Proximity tracing to quickly identify and notify individuals who may have been in close contact with an infected individual
- Journey mapping to identify traffic patterns and dwell times for individuals who have tested positive for COVID-19, assess risk and identify potential hot zones that require remediation or additional safety measures
- Branded toll-free numbers that identify calls as coming from a public health department or other trusted source
Public health organizations are increasing the efficacy of contact tracing by using AI, automation and other technologies to scale, accelerate, tailor and improve contact tracing processes. These technologies are also gaining traction in schools and universities, as educators face the prospect of minimizing virus transmission among students, faculty and their families.
As state and local government leaders become more experienced with using AI and automation to support contact tracing, new use cases will emerge. While technology adds tremendous value to the contact tracing process, to have the greatest impact, these capabilities must go hand in hand with careful assessment of overall processes, a clear understanding of the populations being served and improvements in testing availability and the wait time for test results.
1 M. Kretzschmar et al. Impact of Delays on Effectiveness of Contact Tracing Strategies for COVID-19: A Modelling Study. July 2020. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30157-2/fulltext
2 CDC. United States COVID-19 Cases and Deaths by State. Website accessed 10/4/2020. https://covid.cdc.gov/covid-data-tracker/#cases_casesinlast7days
3 T. Henry. Experts: Here’s How Many More Contact Tracers U.S. Needs. July 2020. https://www.ama-assn.org/delivering-care/public-health/experts-here-s-how-many-more-contact-tracers-us-needs
4 National Association of County & City Health Officials. NACCHO Position Statement: Building COVID-19 Contact Tracing Capacity in Health Departments to Support Reopening American Society Safely. April 2020. https://www.naccho.org/uploads/full-width-images/Contact-Tracing-Statement-4-16-2020.pdf
5 O. Khazan. The Atlantic. The Most American COVID-19 Failure Yet. August 2020. https://www.theatlantic.com/politics/archive/2020/08/contact-tracing-hr-6666-working-us/615637/