As COVID overwhelms health departments, some scale back on contact tracing

After Jamie White tested positive for COVID-19 on Dec. 28, she didn’t receive any information on what to do for a full week.

"When I tried to reach the health department, I was told they're no longer doing contact tracing and was given a phone number to call,” said White, who lives in southern Illinois’ Williamson County. “But that number never picks up."

It's a stark contrast to the experience of her husband and oldest son, who tested positive just two days earlier, on Dec. 26. They were quickly connected with a contact tracer, who confirmed the positive result and sent paperwork spelling out the length of isolation and their release date.

Communities across the U.S. are reporting record numbers of new coronavirus cases as the highly transmissible omicron variant continues to spread.

While the highly transmissible variant appears to be more mild than previous strains, it's still overwhelming hospitals — and local health departments tasked with contact tracing to prevent the spread of the virus.

"At the level of cases we're seeing right now, contact tracing does become very difficult, if not impossible to do," said Bart Hagston, administrator with Jackson County Health Department in southern Illinois.

Throughout the pandemic, efforts to identify and quarantine close contacts have varied from state to state. By the summer of 2021, many states had begun winding down contact tracing programs they scrambled to grow the prior year, according to a survey of health departments conducted by NPR and Johns Hopkins.

More recently, several states, including Michigan, New York and Vermont, announced reductions in contact tracing efforts due to lack of resources and an overwhelming number of new daily cases. In Illinois, where more than 200,000 cases are being reported each week, the state is taking over contact tracing efforts and will prioritize high-risk cases involving people 65 and older. The move aims to relieve the burden on local health departments.

While that transition takes place, some residents say they aren’t getting any guidance from anyone and that the work of contacting people that may have been exposed to COVID-19 is being left to those testing positive.

White said when she finally did get contacted by public health officials following her positive test, no one asked her who she'd been in contact with before she got sick. The link she was sent told her to notify close contacts herself.

"It was just, ‘please inform anyone you have had contact with.’ So, kind of the honor system, so to speak,” she said.

White said she reached out to her close contacts — and her family played it safe, staying home for the full isolation period. But she worries not everyone will do the same.

"The more frustrating part is knowing that no one is receiving any guidance right now,” White said. "It just seems like it isn't very helpful … like this is kind of a time when maybe it would be really good to have guidance because everyone is testing positive and nobody's really sure what to do."

Several factors are causing ‘a pretty big mess’

Jeremy Rosene's son also got COVID over the Christmas holiday. Like White, he said the experience was very different from when he tested positive for the coronavirus in 2020.

"I was bombarded,” Rosene said. “I remember getting multiple phone calls from the health department, different people contacting me, not realizing others had already done so … which is a stark contrast from what we've experienced recently, where I can't get a hold of anyone, even when I'm the one making the effort.”

The recent change in isolation and quarantine guidelines from the U.S. Centers for Disease Control and Prevention has also increased confusion.

Meagan Jarrett said when she and her kids tested positive in late December, all she got at first was an automated text message.

"We just had a link to the website and then the phone number, that's the generic phone number to the state that they give out the website that said if you needed further guidance to contact your physician," said Jarrett, who lives in southern Illinois’ Jackson County.

While the CDC has shortened isolation to five days, Jarrett said her children's school was still requiring a 10-day period of isolation. She said the Jackson County Health Department did contact her eventually — a week after her positive test.

Jarrett said she has also been unable to get documentation to prove that she was instructed by public health officials to isolate at home and miss work.

"I have to have documentation for work; the kids have to have documentation for school. You know, if I don't have documentation, I can lose a job," she said. "It's a terrifying, terrifying thought. I'm the sole breadwinner of the household."

The Jackson County Health Department announced on Facebook in December that it is no longer providing letters of documentation. And Jarrett and others said they have been unable to get that documentation they need from the state or their physicians.

“Some employers are not understanding, even when people are actually sick," she said. "What worries me is people could lose their livelihoods over this."

The Illinois Department of Public Health said in an email that the surge in cases has made it difficult to circle back and issue release papers. But the agency expects people to follow the CDC's latest isolation guidance.

Hagston, with the Jackson County Health Department, said right now, several recent developments are creating a perfect storm.

"The giant spike in cases of COVID, the state centralizing the contact tracing, the CDC changing the isolation and quarantine guidance, and testing, especially access to home tests, not being what it needs to be right now,” Hagston said. “So you've got all these factors converging right now and making a pretty big mess, quite frankly.”

The changing guidance and protocols are confusing, even for some who work in health care.

Hannah Howell said she struggled to make sense of the information posted on the Illinois Department of Public Health's website, despite being a registered nurse. Howell, who is studying for a master's degree in nursing, worries it will be a lot more difficult for people without medical training.

"I don't think that people are going to understand the instructions, but I also don't think a lot of people care,” Howell said. “There's so much pressure to get back to work. [And] we live in a society right now where opinions and beliefs are more valid than actual facts and scientific fact.”

This story comes from a reporting collaboration that includes WSIU and Side Effects Public Media — a public health news initiative based at WFYI. Follow Steph on Twitter: @stephgwhiteside.

Copyright 2022 Side Effects Public Media. To see more, visit Side Effects Public Media.